Hepatitis

Question 1

What’s the contagious period for hepatitis A?

Answer 1

2 weeks before and 7 days after onset of jaundice.

Question 2

<3month old child going to Hep A endemic area. What should you give?

Answer 2

IM immunoglobulin 0.02mL/kg

Question 3

<1year old child going to Hep A endemic area for 3-5 months. What do you give?

Answer 3

IM immunoglobulin 0.06mL/kg

Question 4

<1year old going to Hep A endemic area indefinitely. What do you give?

Answer 4

IM 0.06ml/kg at departure and every 5 months therafter

Question 5

> 1 year old child going to Hep A endemic area, what do you give.

Answer 5

HAV vaccine.

- Give IgG if immunocompromised, chronic liver disease or chronic health problem.

Question 6

A child just came back from hep A endemic area <2 weeks ago. What do you give?

Answer 6

<1year, give IG 0.02mL/kg. Immunocompromised, CLD, give IG 0.02mL/kg and HAV vaccine.

Question 7

Child just came back from Hep A endemic area >2 weeks ago. What do you give?

Answer 7

Nothing.

Question 8

What’s the schedule for Hep A vaccine? How many doses do you give and how long does immunity last for?

Answer 8

2 doses (2nd dose 6-12 mn after 1st dose). Seroconversion 100% after 2nd dose and lasts for 10 years.

Question 9

What’s the greatest risk factor for children to acquire Hepatitis B?

Answer 9

Vertical.

Question 10

What’s the risk of transmission if mother HBeAg positive?

Answer 10

90%

Question 11

What’s the risk of developing chronic HBV infection?

Answer 11

90% <1year, 30% 1-5 year, 2% for adults.

Question 12

What are some extrahepatic HBV manifestations?

Answer 12

Papular acrodermatitis.
Polyarteritis
GN
Aplastic anemia.

Question 13

What are the phases of chronic HBV infection?

Answer 13

Immune tolerant immune active, inactive.

Question 14

What are some treatment strategies for HBV?

Answer 14

Interferon alpha 2b
Lamivudine
Adefovir
Pegylated interferon

Prevention

Question 15

When do you use HBIG?

Answer 15

Perinatal - within 12 hours.

Postexposure circmstances

Question 16

What’s the most prevalent mode of transmission of HCV in children?

Answer 16

Vertical

Question 17

What’s the vertical transmission rate of Hep C viraemic mothers?

Answer 17

5%

Question 18

What increases the risk of HCV transmission? By how much?

Answer 18

HIV. Transmission rate 20%.

Question 19

What’s the incubation rate of HCV?

Answer 19

7-9 weeks.

Question 20

Treatment for hCV?

Answer 20

Peginterfon, IFN alpha 2b and ribavirin can be used >3years of age.
Higher likelihood of response - age <2million, viral response at week 4 and 12 of treatment. Side effect (anemia, neutropenia, influenza like symptoms.3

Question 21

What is the incubation period of Hep A?

Answer 21

15-50 days.

Question 22

How does HAV present in children

Answer 22

Either asymptomatic or very mild illness without jaundice.

Those symptomatic usually have prodromal period (fever, malaise, n+v)