hepatitis

Question 1

Pathophysiology of HAV

Answer 1

HAV (Hepatitis A Virus):
Type: Non-enveloped, single-stranded RNA virus.
Primary Host: Humans.
Replication Site: Hepatic (liver) cells.

Question 2

Pathophysiology of HEV

Answer 2

HEV (Hepatitis E Virus):
Type: Non-enveloped, single-stranded RNA virus.

Typically self-limiting.
Rarely results in hepatic complications unless the patient is immunocompromised.

Question 3

HBV (Hepatitis B Virus):

Answer 3

Type: Enveloped, double-stranded DNA virus.

Hepatocellular injury results from a cytotoxic immune reaction when HBcAg (hepatitis B core antigen) is expressed on the surface of hepatic cells.

Question 4

HDV (Hepatitis D Virus):

Answer 4

Type: Unusual, circular RNA, incomplete virus.
Replication: Unable to replicate on its own; requires co-infection with HBV.
Coated with the HBV surface antigen Genome: Resembles that of some plant viruses.

Question 5

Clinical Presentation

Answer 5

most: asymtomatic:
symtomatic: flu like symtoms: fever, malasia, fatigue, anoxeria, abdominal pain, dark urine, pale stools

jaundice: whites of eyes turns yellow
enlarge spleen, enlarge liver
fluminant: have asterixis and coma.

Question 6

HBVinfection:
Diagnosis

Answer 6

detection of HBsAg.
Chronic hepatitis B: presence of HBsAG for ˃ 6 months.
Chronicactive hepatitis B: detection of HBeAg and/or HBV DNA.

Question 7

HCV infection:
diagnosis

Answer 7

detection ofanti-HCV antibodiesand HCV RNA. Chronic hepatitis C: viraemiapersistsfor ˃ 6 months.

Question 8

General Approach to Treatment

Answer 8

prevention and treatment.
**Prevention **of hepatitis A and B (and indirectly for hepatitis D) with immune globulin or vaccines.

Acute viral hepatitis is primarily managed with supportive care.

Liver transplantation only option is crirrhosis

Treatment is available for chronic HBV, HCV, and HDV.

Question 9

Non-Pharmacological Treatment

Answer 9

Rest, hydration, but no special diet.

Do not administer certain drug therapy for symptomatic treatment (e.g. analgesics, antipyretics) during the acute phase as it may aggravate symptoms and the evolution of hepatitis.

Corticosteroids are not indicated.

Stop or reduce alcohol consumption.

Question 10

Hepatitis A Prevention & Treatment

Answer 10

Post-exposure prophylaxis (for those 12 months to 40 years of age if given within 14 days of exposure to HAV) can be accomplished with the vaccine and immunoglobulin.
Drug treatment does not significantly alter the course of disease.
Treatment is typically in the outpatient setting. IV fluid & electrolyte replacement, nutritional support, and antiemetic therapy may be needed in some patients.