Hepatitis Flashcards
How is Hepatitis A spread?
Faecal-oral spread
How does Hep A harm the liver?
Directly cytopathic - kills hepatocytes by being in them
Is it possible to have a carrier state for Hep A?
No
What are the symptoms of Hep A?
jaundice
pale stools
dark urine
How is Hep A confirmed in the lab?
Clotted blood for serology
How is Hep A controlled?
Hygiene
Vaccine prophylaxis - travellers, MSM, IVDU
Pt presents with abnormal LFTs with high ALT/AST, should viral hep be considered a DD?
Yes
What are the general symptoms of viral hepatitis?
headache myalgia arthralgia nausea anorexia jaundice follows a few days to 2 weeks later with N&V and abdo discomfort
Where in the world is hep E most common?
Tropics
Is Hep A more common than Hep E in the UK?
No Hep E is more common
How is Hepatitis E spread?
Faecal-oral spread
Cases in the UK of Hep E are thought to be what?
Zoonoses
Is there a vaccine available for Hep E?
No
Hep D is only found with which other Hepatitis?
Hep B - parasitizes off this and exacerbates the Hep B infection
What are the modes of transmission of Hep B?
Sex - Intercourse
Mother to child - Infant
Blood to blood - Inoculation
What groups of people in the UK are at higher than average risk of Hep B infection?
Ethnic minorities
Multiple sexual partners
IVDU, tattoos, needle-stick injuries
Children of infected mothers
What blood tests are required for the diganosis of Hep B? At what time intervals are they required?
2 blood tests 6 months apart for HBsAg
Hep B IgM is most likely to be present in…
recently infected cases
HBsAg is present in…
blood of all infectious individuals
How is the spread of Hep B controlled?
Safe blood
safe sex
needle exchange programme
screening of pregnant women
How does Hepatitis B harm the liver?
antiviral immune response
After initial infection with Hep B, how do patients present?
asymptomatically
nausea for a period of days or weeks
may become very ill very quickly (fulminant hepatitis)
What is the mode(s) of transmission of Hep C?
sex
infant
blood- blood
Does Hep C result in chronic infection?
Yes, in about 75% of cases
What symptoms are caused by Hep C?
Most pts are asymptomatic - slip into the phase of chronic infection easily
How are Hep B and Hep C differentiated?
Serology
Is a spontaneous cure seen in Hep C?
No
Is a spontaneous cure seen in Hep B?
Not uncommon, even after many years of infection
How long does it take for chronic hepatitis to develop into cirrhosis?
typically >20 years
How long does it take for chronic hepatitis to develop into hepatocellular carcinoma?
typically >30 years
Histologically, how is Hep C described?
councilman bodies with small amounts of steatosis (fat infiltration of hepatocytes) present
Is autoimmune Hep more common in males or females?
Females
What autoantibodies are seen in autoimmune hepatitis?
autoantibodies to smooth muscle, nuclear or LKM
there is also raised IgG
Histologically, how is autoimmune hep described?
chronic hepatitis with marked piecemeal necrosis and lobular involvement. Numerous plasma cells.
What is the treatment for autoimmune hepatitis?
Prednisolone and azathioprine (long term)
What is the treatment for chronic hep B?
peginterferon alone
or
supressive antiviral drug (e.g. entecavir, tenofovir)
What is the pharmacological management for chronic hep C?
Peginterferon injections given in combination with ribavirin tablets (PR)
12-48 week course
