Hepatitis Flashcards
Viral hepatitis classification?
- enteric pathogens
2. parenteral pathogens
Parenteral route?
systemic action, but delivered by routes
enteric hepatitis pathogens
- eg HEP A/E
- self-limiting acute infection
parenteral hepatitis pathogens?
- eg hep B, C, D
- could be self limiting or progress to chronic liver failure
4 phases of natural history for hep B?
I. immune tolerance,
II. an immune active phase
III. Inactive HBV phase
IV. quiescent (cleared disease), or reactivation
Immune tolerance phase of Hep B Ix?
- normal alanine aminotransferase (ALT) levels,
- very high HBV DNA titres.
- This phase may last for up to 30 years.
Immune active phase of Hep B Ix?
- hepatocyte damage
* HBV DNA level remains elevated
Inactive HBV phase of Hep B Ix?
- antibodies against the HBeAg (anti-HBe) are present,
- ALT is normal,
- little detectable HBV DNA .
Age and chronicity of hep B?
the younger the exposure, the more likely to be chronic
Which hepatitis more likely to go chronic
B and C
Which hepatitis respond better to interferons
A and B
Which hepatitis have a higher rate of HCC
C
Which is the most common hepatitis?
A
Hep B mx?
I. interferons
- peginterferon α 2a (1 yr course)
II. nucleotide analogue
- eg: lamivudine, telbivudine, adefovir, entecavir, and tenofovir
Nucleotide analogue problem?
- lifelong treatment
- risk of resistance
Hep D infection method?
co-infection with hepB as requires hep b surface protein for lifecycle)
Hep D effect on the progression of HBV
increased rate of progression, fulminant hepatitis and HCC
Hep C transmission
Body fluids
Hep C chronicity?
common in adults (85%)
Mx of Hep C?
combination of DAAS (direct acting antivirals)
- highly effective
Hep A transmission?
faeco-oral
Hep A chronicity?
no chronocity
Hep A sx
mild to diarrhoea, vomiting, jaundice
Hep A mx?
no Tx, just supporative care
