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Infection Erin > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

Transmission HAV

A

Faecal to oral

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2
Q

Transmission HBV

A

Parenteral
Sexual
Perinatal

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3
Q

Transmission HCV

A

Parenteral
Sexual
Perinatal

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4
Q

Transmission HDV

A

Parenteral

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5
Q

Transmission HEV

A

Faecal-oral

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6
Q

Main risk population for HAV

A

Travellers to endemic areas
Sewage workers
Contacts of cases

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7
Q

Main risk populations for HBV

A 
Immigrants from high prevalence areas
PWID 
Multiple sexual partners 
Infants of HBsAg +ve mothers 
Health care workers
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8
Q

Main risk population for HCV

A

PWID

Recipients of unscreened blood products

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9
Q

Main risk populate HDV

A

PWID

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10
Q

Main risk population for HEV

A

Travellers to endemic areas
Sporadic
exposure to undercooked pig products

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11
Q

Chronic infection rate in HAV

A

None

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12
Q

Chronic infection rate in HBV

A

5-10%

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13
Q

Chronic infection rate in HCV

A

60-80%

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14
Q

Chronic infection rate in HDV

A

People infected with HBV

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15
Q

Chronic sequelae in HAV

A

None

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16
Q

Chronic sequelae in HBV

A

Chronic hepatitis
Cirrhosis
Hepatoma

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17
Q

Chronic sequelae in HCV

A

Chronic hepatitis
Cirrhosis
Hepatoma

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18
Q

Chronic sequelae in DV

A

Chronic hepatitis

Cirrhoses

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19
Q

Who is HEV VERY dangerous for?

A

Pregnant women

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20
Q

What is the prevention of HAV

A

Inactivated vaccine

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21
Q

What is the prevention of HBV

A

Recombinant vaccine

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22
Q

For which of the hepatitis are there no vaccine

A

HCV
HDV (need to immunise against HBV to protect)
HEV

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23
Q

Where is there a HDV vaccine present?

A

China

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24
Q

For which is there a vaccine

25
Q

For which is there no vaccine?

26
Q

Rx for HBV

A 
Pegylated interferon 
Nucleoside analogues 
Liver Tx (for advanced cirrhosis)
27
Q

Nucleoside analogues used in HBV

A 
Lamivudine 
Adefovir 
Dipivoxil 
Telbivudine 
Entecavir
28
Q

What is the main prevention of HBV

A

Vaccination

29
Q

Who is recommended for HBV vaccination

A 
Health care workers 
Travelling to endemic areas 
Renal dialysis 
PWID 
Close contacts with those who have acute/chronic HBV
30
Q

Which hepatitis viruses can be transmitted from the faecal-oral route?

31
Q

How can HAV and HEV be prevented?

A 
Good hand hygiene 
Good sanitation 
Clean water
Human normal immunoglobulin (HAV)
Active immunisation (HAV)
32
Q

How is HAV Dx in the laboratory

A

Detection of hepatitis A lgM antibody

in a serum sample.

33
Q

Which hepatitis virus are spread by infected blood

34
Q

How can HBV, HCV and HDV be prevented

A

Infection control precautions
Screening blood products
Safe sex
Vaccination for HBV

35
Q

What is the purpose for testing serum for anti-abc IgM antibody?

A

Its presence indicates recent hepatitis
B infection. If a patient is tested late in the course of illness, HBsAg may have disappeared but the presence of IgM-anti HBc indicates recent infection.

36
Q

Define chronic HB infection

A

HBsAg is persent in serum for at least 6 months

37
Q

What percentage of adults will become chronically infected with HBV after acute infection

38
Q

What percentage of children with acute HBV will become chronically infected

39
Q

What percentage of infants with acute HBV infection will become chronically infected

40
Q

Who should be vaccinated against HBV?

A

Healthcare workers
Close contacts of those with acute or chronic HBV infection
Selected police and emergency services
PWID
Individuals who change sexual partners frequently
Inmates of custodial institutions
Some patients with chronic liver disease

41
Q

What is the clinical important of infection with HCV

A

60-80% will show evidence of chronic liver disease and are at risk of progression to cirrhosis

42
Q

What laboratory assessment would you make of someone with antibodies to HCV

A

Serum ALT

HCV RNA

43
Q

What factors is essential for the transmission of HDV

A

Presence of HBsAg

44
Q

What is the commonest mode of hepatitis D transmission

A

Injection drug use

45
Q

Interpret:
History of recent jaundice in a 26 year old homosexual.
Hepatitis B surface antigen negative. Hepatitis B core antibody negative. Hepatitis A IgM positive.

A

Evidence for recent hepatitis A infection

No evidence for hepatitis B infection

46
Q

Interpret:
Antenatal screen in a 30 year old woman.
Hepatitis B surface antigen positive. Hepatitis B e antigen positive.
Hepatitis B e antibody negative. Hepatitis B core IgM antibody negative. Hepatitis B core total antibody positive.

A

Results consistent with chronic hepatitis B infection. The presence of surface antigen indicates infectivity. The presence of e antigen indicates high infectivity.
The absence of IgM anti-core indicates the infection is not recent.

Arrangements should be made in advance so that the baby is protected against HBV

47
Q 
Interpret:
History of past injecting drug use.
Hepatitis A antibody negative
Hepatitis B surface antigen negative. Hepatitis B core total antibody positive. Hepatitis B surface antibody positive. Hepatitis C antibody positive.
Hepatitis C RNA positive.
A

No recent or past infection with HAV

Results consistent with past HBV with seroconversion to antibodies

Ongoing infection with HCV

48
Q

Interpret:
Recent onset jaundice in a 65 year old diabetic man who has not been abroad recently.
Hepatitis A IgM negative.
Hepatitis B surface antigen negative. Hepatitis B core total antibody negative. Hepatitis C antibody negative.
Hepatitis E IgG antibody positive. Hepatitis E IgM antibody positive. Hepatitis E RNA positive

A

Recent HEV
No evidence for recent HAV detected
No evidence for infection with HBV

49
Q

Interpret:
Going to live in Africa. Is immunisation needed?
Hepatitis A total antibody positive. Hepatitis B core total antibody negative.

A

Evidence for past infection with hepatitis A immunisation not indicated

No evidence for previous HBV infection
Immunisation is indicated

50
Q

Interpret:
HBsAg negative
Anti-HBc negative
Anti-hBs negative

A

No infection
But not immunised
Therefore susceptible

51
Q

Interpret:
HBsAg negative
anti-HBC positive
anti-HBs positive

A

Resolved past infection

52
Q

Interpret:
HBsAg negative
Anti-HBC negative
Anti-HBs positive

A

Immunity due to vaccination

53
Q

Interpret:
HBsAg positive
Anti-HBC positive
Anti-HBs negative

A

Active HBV infection

54
Q

What does the present of Anti-HBC IgM indicated

A

May represent acute infection

55
Q

What does the presence of Anti-HBC IgG indicate

A

May represent more chronic HBV infection

56
Q

Interpret Vaccination result >100 Anti-HBs

A

Good response

Booster in 5 yrs

57
Q

Interpret Vaccination result 10-100

A

Response but poor response

Booster now and in 5yrs

58
Q

Interpret Vaccination result <10

A

No response to vaccine
Repeat course of vaccine
Recheck antibody dose after

Infection Erin (10 decks)

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