Hepatitis Flashcards
Hepatitis A
RNA - Picornavirus
Fecal oral transmission
Prevention for Hep A
Vaccine
Immunoglobulin pre- and post- exposure (within 14 days)
Hepatitis E
RNA - Hepevirus
Fecal oral transmission
IgM
Acute exposure <6 months
IgG
Previous exposure >6 months, now immune
Hepatitis B
DNA - Hepadnavirus
Parenteral, sexual, maternal-fetal
Hepatits C
RNA - Flavivirus
Primary blood
Hepatitis D
RNA - Delta virus
Parenteral, sexual, maternal-fetal
Anti-HAV (IgM)
IgM antibody to HAV; best test to detect active hep A
Anti-HAV (IgG)
IgG antibody indicates prior HAV infection and/or prior vaccination; protects from reinfection
HBsAg
Antigen found on surface of HBV; indicates hep B infection
Anti-HBs
Antibody to HBsAg; indications immunity to Hep B
HBcAg
Antigen associated with core of HBV
Anti-HBc
Antibody to HBcAg; IgM - acute/recent infection; IgG = prior exposure to chronic infection
Positive during window period
HBeAg
Indicates active viral replication and high transmissibility
Anti-HBe
Antibody to HBeAg; indicates low transmissibility
What is seroconversion?
Ability to clear Hep B – loss of HBeAg and development of HBeAb
How do newborns react differently than adults to Hep B?
Newborns develop the chronic disease
Adults have a developed immune system and are able to clear the disease
What is done in a case of Hep B exposure in an unvaccinated patient?
Give Hep B immune globulin within 24 hours (preferable) or within a week
Second dose of HBIG 1 month later
OR
Hep B vaccin (within 24 hours - or within 1 week)
Second dose 1 month after first
Third dose 6 months after first
What is done in the case of Hep B surface antigen positive mothers?
Give newborn both HBIG and vaccine
Can Hep B lead to HCC?
Yes! Even without going through cirrhosis
What are some treatments for Hep B?
Interferons - released by host cells when infected with viruses, activated immune system [Interferon alfa-2b, PEG-interferon alfa-2a]
Antivirals (nucleoside/nucleotide analogues) - block reverse transcriptase that is necessary for HBV replication [Entecavir, Tenofovir]
What is the success of HBV therapy?
Eliminate or suppress HBV replication = 30% after therapy discontinuation
ALT normalization = 30%
Loss of HBeAg, development of HBeAb (seroconversion) = 30%
Loss of HBsAg = 5-7%
What is the difference between an HBV-HDV confection and a superinfection?
Coinfection = get them at the same time; severe Superinfection = have Hep B first, then get Hep D; leads to chronicity
What are the nonstructural proteins of HCV for?
viral replication – these are the targets of therapeutics called Direct acting antivirals (DAA)
Who exhibits Hep C antibody?
All exposures make Hep C antibody and remains present in all patients including those who spontaneously clear the virus or undergo successful treatment
Hep C RNA is only present in those who are viremic
