Hepatitis Flashcards
5 hepatitis viruses
A, B, C, D and E
which viruses are transferred through faecal oral route
A and E
which viruses only occur acutely with no chronic phase
A and E
which viruses can have chronic stages
B, C and D
why don’t A and E cause chronic disease
because they are self-limiting infections
death toll to viral hepatitis each year
1 million
in HAV and HEV what do the immunoglobulins indicate about the infection
IgM = active infection IgG = recovery or vaccination
symptoms of hepatitis
fever, malaise, nausea
hepatomegaly
pain
is there a vaccination against HEV
no
is there a vaccination against HAV
yes - given to chronic liver disease, lab workers and gay men
what type of people is HEV a particular concern in
pregnant women
ways of acquiring infection of HBV, HCV and HDV
sex, drug use
what condition is associated with HBV infection
hepatocellular carcinoma
4 antigens in HBV
surface, e, core and DNA
what state is the virus in if e and core and DNA antigens are detected
active replication
where is DNA in a HB virus
in the middle, inside the inner protein core
if someone has high levels of IgM anti-HBc what does this indicate
they are in acute infection
if someone has high levels of IgG anti-HBc what does this indicate
chronic infection or exposure
if someone has anti-HBsurface what does that tell you
they are protected
treatment guidelines for HBV
antiviral drugs (end with “vir”) or peginterferon
transplant may be considered if end stage
toxicity of tenofovir
renal toxicity
LFTs in hepatitis
ALT>AST
low albumin or high bilirubin from cirrhosis
treatment for HCV
antiviral drugs or peginterferon
transplant may be considered if end stage
what hepatitis commonly co infects with HBV
HDV
what is HBV superinfection
someone with HBV get HDV some time after the initial HBV infection
where is hep E common
sort of equator especially asia
what is the commonest cause of acute hepatitis in grampian
HEV (I know I’m surprised too)
treatment for HEV
none really - just supportive care
