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GUM, HIV and Infectious Diseases > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

What is the primary route of transmission of Hepatitis B in the UK?

A

Sexually

IVDU

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2
Q

What does a positive anti-HBc (IgG) indicate?

A

Current OR past infection with Hep B

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3
Q

What does a positive anti-HBc (IgM and IgG) indicate?

A

If both IgM and IgG are positive, this indicates acute infection with Hep B

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4
Q

What is the primary route of transmission of Hepatitis B worldwide?

A

Vertical transmission or transmission in early childhood

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5
Q

Which cells in the body does Hepatitis B infect?

A

Human hepatocytes

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6
Q

What are the main complications of Hep B infection?

A

Liver cirrhosis

Hepatocellular carcinoma

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7
Q

What is a tumour marker for hepatocellular carcinoma?

A

Alpha-fetal protein (AFP)

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8
Q

What does a positive HBsAg indicate?

A

Current infection with Hep B - either acute or chronic

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9
Q

How can you differentiate between acute and chronic infection with Hep B if a person has a positive HBsAg test?

A

Look at the types of anti-HBc antibody

In chronic infection IgG will be positive but IgM will be negative. In acute infection, both IgG and IgM will be positive.

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10
Q

What does Hep B serology show in an individual who has been vaccinated?

A

anti-HBs positive
HBsAg negative
anti-HBc negative

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11
Q

Which individuals are screened for Hep B?

A

Blood donors
Pregnant women
GUM clinics
Drug and alcohol services

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12
Q

What is the standard schedule for Hep B vaccination?

A

Vaccination at 0, 1, and 6 months

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13
Q

What are the complications of co-infection with HIV in patients with Hep B?

A

Reduced efficacy of Hep B vaccination

More likely to convert to chronic Hep B infection

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14
Q

What implication does a positive HBeAg have?

A

High risk of infectivity

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15
Q

What happens to the babies of pregnant women who are positive for Hep B?

A

Babies are given Hep B vaccination at birth

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16
Q

A pregnant women has a Hep B infection and is HBeAg positive - how would you manage her?

A

Give Hep B immunoglobulin to reduce risk of transmission to the baby (she is at high risk of transmission due to positive e-antigen)

17
Q

What serological markers are observed to check a person’s immune status against Hepatitis C?

A

Hep C antibody

Hep C RNA

18
Q

What does a positive Hep C RNA test indicate?

A

Acute or chronic Hep C infection

19
Q

How do you differentiate an acute Hep C infection from a chronic infection using Hep C serology?

A

Hep C RNA will be positive in both so look at Hep C antibodies to distinguish - in an acute infection, the antibodies will be negative as they have not developed yet (takes about 6/12), while in a chronic infection the Hep C antibodies will be positive

20
Q

What does a positive Hep C antibody test indicate?

A

Chronic infection or previously cleared infection

21
Q

How do you differentiate a chronic Hep C infection from a previous (now cleared) infection using Hep C serology?

A

Hep C antibodies will be positive in both so look at Hep C RNA to distinguish - In chronic Hep C infection these will be positive, while they will be negative if the infection has been cleared

22
Q

True / False: Patients with Hep B are at high risk of developing hepatocellular carcinoma even if they don’t have liver cirrhosis

A

True - A significant proportion of Hep B patients develop HCC despite never having cirrhosis

23
Q

True / False: Patients with Hep C are at high risk of developing hepatocellular carcinoma even if they don’t have liver cirrhosis

A

False - It is rare to develop liver cancer in Hep C if the patient doesn’t have liver cirrhosis

24
Q

Is there a vaccination for Hep C?

A

No

25
Q

How long after initial infection does it take for Hep C antibodies to develop?

A

About 6 months

26
Q

What serological markers are observed to check a person’s immune status against Hepatitis A?

A

Total anti-HAV

HAV IgM

27
Q

What does a positive ‘total’ anti-HAV indicate?

A

Either acute infection or previous infection (now immune)

28
Q

How do you distinguish between an acute Hep A infection and a previous infection (now immune)?

A

Total anti-HAV will be positive in both cases so do anti-HAV IgM antibodies to distinguish. IgM antibodies will be positive in acute infection and negative in previous (now immune) infection

29
Q

Is there a vaccination available for Hep A?

A

Yes - It is given to high risk (MSM) groups

30
Q

Of Hep A, B, C, E…which are DNA viruses and which are RNA viruses?

A 
DNA = Hep B
RNA = Hep A, C, E
31
Q

List some possible treatments for Hepatitis B

A

Conservative
Pegylated interferon-alpha
Other antivirals e.g. tenofevir, entecavir

GUM, HIV and Infectious Diseases (8 decks)

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