Hepatitis Flashcards
What is the incubation periods for Hep A?
30 days
What is the biggest determining factor for the severity of Hep A?
Age
children most at risk
What is the vaccine for Hep A?
Inactivated virus
2nd dose of it gives immunity for life
What is the only DNA Hepatitis virus?
Hep B
What the incubation of Hep E?
40 days
List some complications of Hep E, and who is most at risk of these severe complications?
Neurological deficits.
- guillain barre syndrome
- encephalitis
**Associated with Genotype 3
High mortality in Pregnant women in 3rd trimester
**associated with Genotype 1
Whats the incubation of Hep B and what is the most common type of transmission?
2-6 months - due to lack of lytic activity
Vertical
If a child has Hep B from birth what is the likely outcome?
Asymptomatic with chronic disease
List some severe symptoms of Hep B:
Cachexia
Bloody Ascites
Weight loss
Severe abdominal pain
Those with chronic Hep B may develop what?
Cirrhosis
Hepatic cellular carcinoma
List the two treatments used for chronic Hep B:
Interferon alpha
- immune modulatory
- *remember it is the cytotoxic T cell activation that causes the most damage
Tenofovir
Entecavir
- reduce viral replication
What is it called when a person already has Hep B then develops Hep D on top of this?
Super infection
- severely ill usually
What drugs are used against Hep C? and what determines their regime?
Direct Acting Antivirals
Regime is decided on:
- serology of Hepatitis
- Severity of cirrhosis
Outline and contrast the difference in infection of Hep A and Hep B between children and adults
Both depend on the level of the immune response.
because the childs immune system is not as strong the immune response is less.
In Hep A - this leads to less severe disease with lasting immunity
In Hep B - there is a less severe symptoms but chronic state develops as child doesn’t clear the virus - unlike adults who would
Those with Chronic Hep B - what percentage will develop cirrhosis/ liver cancer
25%
Would a person who has been vaccinated against Hep but never actually been infected by Hep B, have cAb positive?
No they wouldn’t have a core antibody
the vaccine only has surface antigen
How do you manage Hep B?
Can only manage Chronic
- interferon
- Tenofovir
Vaccinate babies immediately after born to prevent spread
What is the only treatment for Hep D?
Interferon
Why can you get infected by Hep C over and over?
what percentage will go on to get chronic infection?
Don’t produce adequate antibodies
~70-75%
If a person has a Anti HCV IgG positive result, what does it mean? and what would the next test be?
means the person either has/ or has had Hep C
next test would be viral PCR to check for viraemia
Histologically what may Hep B appear like, and what is a specific marker for it?
May appear like acute inflammation
Ground glass appearance - accumulation of antibodies on it.
Outline the Life cycle of Hep B:
Stage 1:
Immune tolerance
Viral Replication
No liver damage
Stage 2:
Immune activation
Viral replication attacked
- liver damage
Stage 3.
Low replication of virus
Immune still active
limited liver damage
- *during this stage the HbsAg can’t be detected and neither can the surface antigen.
- only the core may be detected.
Stage 4:
Reactivation
Immune system reactivates in response
cirrhosis and damage to liver
