hepatitis Flashcards by Jess Fazekas

hepatitis infects

liver
-liver enzymes elevated
causes mild jaundice to death

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how is hepatitis diagnosed

serologically

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how to treat hepatitis

can’t really but viral agents can reduce duration

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hepatitis A also known as

enterovirus
-infects enteric tract and liver

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what kind of virus is hep A

RNA
non enveloped

-short incubation up to 30 days

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how is hep A transmitted

fecal to oral

-contaminated hands of food handler

illegal drug use- not main
contaminated blood -RARE
(blood products in US not tested for hep A)

mother to baby

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when is hep A most infectious

right before the onset of symptoms

rarely causes life threatening illness

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when is fecal HAV found

2 - 7 weeks after exposure

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where can hep A be found

in stool

short life in blood stream so rarely look there

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IgM anti-HAV

acute infection

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IgG anti-HAV

second

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how to determine if acute infection with IgG

look for 4 fold titer

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when is vaccine for hep A recommended

when traveling to 3rd world countries

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how to prevent hep A

-wash hands
-vaccination if at risk (underlying liver disease, homeless)

no known carrier state

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what enzymes increased in acute viral hep A

AST 4+
ALT 4+
ALP 2+ (lower)

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hep b is what type of virus

DNA
circular
double and single stranded
envelope- bud out

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hep B route of transmission

-sexual
-mother to baby
-contaminated blood

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hep b virus is found in

every body fluid- transmissible

-blood
-sweat
-urine
-semen
-breast milk

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hep b incubation period

after transmission can have incubation period up to 90 days

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what percent of hep b people will get fulminating

1%
lead to liver cancer
high mortality rate

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what percent of people with hep b will recover within 6 months

90%

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what percent of people will develop chronic hep B

8-9%

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dane particle-envelope composed of

HBcAg: core capsule
-hep b core antigen

HbsAg: surface
-hep b surface antigen
-infectious particle

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what makes up subviral particle

-spherical and filamentous

both contain surface antigen, no nucleic acid (not infectious)

very immunogenic, we can produce antibodies against it

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first antigen to rise in hep B infection

HBsAg used to be known as australian antigen -earliest indicator of hep B -will not see if vaccinated/ people recovered -increases in ALP or AST

found in core of dane particle

hepatitis B core antigen -is NOT a marker of hep B infections -not seen in serum/plasma

if you have this you are in acute phase of hep B

HBeAg -indicated virus is reproducing in host -more E= higher infectivity -we want this to be undetectable in someone recovering -not in vaccinated people

if E antigen and surface antibody found at same time

chronic infection

Anti-Hbs

producing antibodies to surface antigen -indicate recovery -WILL HAVE when vaccinated -present for life

window period

both surface antigen and antibody are non detectable -look for core antibody

anti-Hbc

hepatitis b core antibody

HBsAg + HBcAb + HBcAb -

acute hep b

HBsAg - HBcAb IgM + HBsAb -

Window period; late acute phase

HBsAg - HBcAb - HBsAb +

vaccinated

anti-HBe

e antibody sign of recovery person is becoming noninfectious will not rise until E antigen has fallen

never get rid of surface antigen, no production of surface antibody, IgG positive for core antibody

chronic infection

hepatitis b carrier state

will not clear from system when recovering -underlying illness

2 ways you are carrier

- If you are hepatitis B surface antigen + on 2 tests 6 months apart - Surface antigen +, core IgM antigen -, core IgG antibody + on a single specimen if a carrier higher risk of liver cancer

when will you get full immunity from hep b vaccine

when you get all 3 shots 90% will be antibody + 6 months after last shot 10-20% people will need a 4th booster

If we have a mother who is hep b surface antigen + upon delivery, you have to give infant

antibody to hep B within 12 hours of birth

hep D known as

delta virus -mutant needs hep B in order to replicate

what kind of virus is hep D

RNA

hep D can either be

co infect or super infector

co infect

does not make hepatitis B infection anymore serious; might change the way we treat

super infector

hep D change hep B from mild case to full blown bad case (even death)

when should hep d be suspected

if patient isn't recovering from hep b or see biphasic ALT pattern -ALT will go up, come down and go back up

for blood donations what do u test for

hep b- deferred for life hep c -surface antigen, core antibody, surface antibody

if vaccinated do not donate blood for

21 days after vaccination

If you’ve had exposure to hep b and are given passive antibodies you are deferred for

1 year

what kind of virus is hep C

RNA virus no vaccine

what program was made by CDC for Hep C

look back program - look back file and anyone who received blood donation before 1992 and were sent a notion saying they needed to come in and get tested for Hep C because was not tested before this year

how is hep C transmitted

blood products, mother to baby, and sexually

incubation period of hep C

short incubation period to not being symptomatic for 20 years known as silent hep

which hepatitis can lead to chronic infection

B and C

some people can spontaneously heal with what hep

acute hep C 70% will have chronic

#1 cause of liver transplants

hep C -now on list for carcinogens

testing for hep C starts with

antibodies Antibody -= non reactive Antibody + = next is Hepatitis C RNA look for presence

RNA +

current hep C virus

RNA -

no current infection to Hep C; past infection or below detectable limits

If you take immunosuppressant drugs can cause

HEP B OR C flare up if below detectable limits

viral load testing

determine the number of RNA iu/mL of blood you have of the virus -always done when +RNA test baseline to determine treatment is working

treatment for hep C

Harvoni -can cause flare up -interferon base

Can see hep B and C in same people because

same transmission and same risk group

acute phase reactant that everyone makes and excreted by virally infected cells and surrounds non virally infected cells to prevent them from coming infected

interferon

what determines the type of treatment given for hep C

genotype -different ethnicities has different genotypes african american respond worst to treatment

what kind of virus is hep E

RNA

what population does hep E infect

pregnant women -cause acute liver failure think this if preg women goes into liver failure with nothing before

what transmission is thought for hep E

contaminated water