Hepatitis

Question 1

Incubation HAV

Answer 1

average 30 days

Question 2

Incubation HBV

Answer 2

average 70-80 days (2-3months schutte)

Question 3

Incubation HCV

Answer 3

average 50 days (2month Schutte)

Question 4

Dx HAV

Answer 4

Anti-HAV IgM (acute infection) and Anti-HAV IgG (previous infection and life-long immunity)

Question 5

Dx HBV
HBV-DNA: 
Positive HBsAg  
HBsAg+ > 6 months
Anti-HBS+
Anti-HBc IgM+
Anti-HBc IgG+

Answer 5

HBV-DNA: Active, ongoing viral replication
Positive HBsAg (HBsAg+): current infection but not necessarily acute; is positive in carrier state
HBsAg+ > 6 months progress to chronic hepatitis or carrier state (HBsAg+ X 2 , 6 months apart)
Positive Hepatitis B surface ANTIBODY (Anti-HBS+): indicates convalescence & immunity; successful Hep B vaccination
Anti-HBc IgM+: Acute infection
Anti-HBc IgG+: Previous infection and long term immunity; does not appear in Hep B vaccination

Question 6

Dx HCV

Post Exposure Prophylaxis (PEP)

Answer 6

HCV RNA: Indicates active viral replication; genotyping required
HCV-Ab/IgG: Previous HCV infection
OraQuick HCV Rapid Antibody Test can be read in 20-40 minutes
Post Exposure Prophylaxis (PEP):
– Anti-HCV testing on person who is the source
– Baseline Anti-HCV testing and ALT level with follow up testing in 4-6 months. Testing at 4-6 weeks may be performed. Interferon monotherapy may be given in elevated levels.

Question 7

Manifestations in the Preicteric or prodromal phase

Answer 7

weight loss, anorexia, malaise, headache, arthralgia, hepatomegaly, etc

Question 8

Manifestations in the Icteric phase

Answer 8

jaundice, pruritus, dark urine, clay colored stools; fatique, hepatomegaly, etc

Question 9

Post icteric or convalescent phase

Answer 9

malaise, fatigue, hepatomegaly may continue; begins to feel better

Question 10

Treatment for HAV

Answer 10

Immunglobulin (IG) up to two weeks of exposure with temp. passive immunity for 6-8weeks

Question 11

Treatment for HBV

Answer 11

HBIG within 24hrs of exposure for temporary passive immunity (needle stick, splashes)
Pegylated alpha interferon
Antiviral/Nucleoside (NRTI) - If active replication

Question 12

Treatment for HCV
Genotype #1
Non-genotype

Answer 12

Genotype #1: sofosbuvir and simeprevir (very expensive)
Genotype #1: peginterferon alpha 2a and ribavirin
Non-Genotype: sofosbuvir with peginterferone alpha 2b and ribavirin

Question 13

Side effects of interferon alpha and ribavirin

Answer 13

flue like symptoms
bone marrow suppression: leukopenia, thrombocytopenia
Suicide ideation
Both men and women practice two forms of contraception during tx.

Question 14

Side effects of Sofosbuvir and Simeprevir

Answer 14

fatigue 
headache
nausea
insomnia 
anemia 
itching