Hepatitis Flashcards
How are hepatitis viruses transmitted?
A - faecal-oral B - Perenteral, Sexual, Perinatal C - Parenteral (Sexual, Perinatal) D - Parenteral E - Faecal-oral
What are the average (and range) incubation periods of hepatitis viruses?
A: 28 days (10 - 50 days) B: 90 days (40 - 160 days) C: 60 days (15 - 160 days) D: (20-50 days) E: 40 days (20 - 60 days)
Which hepatitis viruses can cause chronic infection?
B, C, D (with HBV), E (if immunocompromised)
How are viral hepatitis infections diagnosed?
IgM (except hep C)
IgG
What immunisations are available for hepatitis A?
Active immunisation: inactivated vaccine
Passive immunisation: HNIG
What immunisations are available for hepatitis B?
Active immunisation: recombinant vaccine
Passive immunisation: HBIG
What immunisations are available for hepatitis C?
None
What immunisations are available for hepatitis D?
Hepatitis B immunisation
What immunisations are available for hepatitis E?
Vaccine only available in China
There is no passive immunisation available
What other viral infections are associated with hepatits?
Rubella CMV Herpes simplex Enterovirus EBV VZV
What bacterial and parasite infections can also be associated with hepatitis?
Leptospirosis
Q fever (Coxiella burnetii)
Psittacosis (Chlamydophila psittaci)
Malaria (p. falciparum)
Describe four presentations of acute viral hepatitis infection
- Subclinical illness = no symptoms
- Anicteric illness = symptoms but no jaundice
- Icteric illness = symptoms with jaundice
- Fulminant hepatitis = severe jaundice with hepatic failure (has high mortality)
List the clinical features of hepatitis A
- Usually mild, often subclinical or anicteric in children under five; severity increases with age
- Fever, malaise, anorexia
- Nausea, vomiting
- Upper abdominal pain
- Jaundice (develops later)
- Dark urine (due to presence of conjugated bilirubin)
List the clinical features of hepatitis B
- Fever, malaise, anorexia, lethargy
- Nausea
- Abdominal discomfort
- Arthralgia
- Urticarial skin lesions
- Jaundice (develops later)
- Dark urine (due to the presence of conjugated bilirubin)
List the clinical features of hepatitis C
- Usually subclinical or mild
- Malaise, anorexia, fatigue
- Can cause jaundice in severe cases
- Fulminant illness is rare
- Chronic infection is very common and often leads to cirrhosis
Describe how hepatitis D infection occurs
• Only occurs in conjunction with HBV, either;
o Co-infection – patient contracts HBV and HDV simultaneously
o Superinfection – patient with chronic HBV becomes infected with HDV
• Illness is more severe than HBV alone.
List the clinical features of hepatitis E
- Mean incubation of 40 days
- Clinically is very similar to HAV
- Usually subclinical or mild
- More likely to cause severe illness in elderly men
- Extra-hepatic features – anaemia, arthritis, neurological manefestations
