Hepatitis Flashcards
Acute hepatitis is usually symptomatic. T/F?
True
How is chronic hepatitis defined?
Hepatitis virus which is present for more than 6 months
Chronic hepatitis is usually symptomatic. T/F?
False - it is usually asymptomatic
What are the routes of transmission of hepatitis virus?
Facial oral route
Blood borne
What can cause hepatitis?
Hepatitis A,B,C,D,E EBV,CMV,t toxoplasmosis leptospirosis Q fever syphilis malaria VHF toxins drugs alcohol autoimmune wilson's disease haemochromatosis
Which strains of hepatitis are RNA viruses?
Hepatitis A,C,D,E
Which strain of hepatitis is a DNA viruses?
Hepatitis B
How is hepatitis A transmitted?
Faecal-oral route and has a human reservoir
There is chronic carriage of hepatitis A. T/F?
False
In what group of patients can there be chronic carriage of hepatitis E?
In immunosuppressed patients
How is chronic hepatitis E treated?
Ribavirin
What is the incubation period for hepatitis A?
30 days
There is good immunity after infection of hepatitis A. T/F?
True
How does age determine the severity of hepatitis A infection?
It is usually symptomatic in children <5 years and is symptomatic in adults
How is hepatitis A infection treated?
No specific treatment as it is self limiting
Maintain hydration and avoid alcohol
What tests will be positive in acute hepatitis A?
IgM positive
Hepatitis A in blood or stool
What test will be positive in previous HAV infection?
IgG
Who is the hepatitis A vaccine given to?
Homosexual men
IVDUs
Chronic liver disease
What type of vaccine is the hepatitis A vaccine?
Inactivated virus vaccine
What can be used as an alternative to vaccination for hepatitis A in those with <4 weeks to travel or those who are vaccine allergic?
Hepatitis immunoglobulin
How can hepatitis E be transmitted?
Faecal-oral toute, pork products, minimal person-to-person spread
In what group of patients is mortality from hepatitis E highest?
Pregnant women
What are the possible neurological complications of hepatitis E infection?
Guillain-barre syndrome
Encephalitis
Ataxia
Myopathy
What genotype of hepatitis E is particularly associated with neurological complications?
GT3
HBV vaccination is given routinely in most countries. T/F?
True
How can HBV be transmitted?
Transfusion Fluid Organ/tissue transplantation Child to child Contaminated needles/syringes Mother to baby
What is the incubation period of hepatitis B?
2-6 months
How does age determine the severity and chronicity of hepatitis A infection?
Infection at birth or childhood is usually asymptomatic but leads to chronic infection
Infection as an adult is usually symptomatic but is cleared
What are the signs and symptoms of hepatitis B?
Weight loss, abdominal pain, fever, cachexia, mass in abdomen and bloody ascites
What are the potential complications of HBV?
Cirrhosis
Decompensation
Hepatocellular carcinoma
Death
In HBV serology testing, what is a marker of current infection?
sAg
In HBV serology testing, what is a marker of immunity due to either previous infection or vaccination?
sAb
In HBV serology testing, what is only positive in patient swoon have have infection (previous or current) and not in vaccination?
cAb
In HBV serology testing, what indicates high infectivity?
eAg
In HBV serology testing, what indicates low infectivity?
eAb
How is acute HBV treated?
It is not treated as it usually resolves and clears
Which patients require treatment for chronic HBV?
Those with liver inflammation (seen on LFT or biopsy) or fibrosis (seen on fibroscan or biopsy)
What is the possible treatment for HBV?
Interferon (immunomodulatory)
Tenofevir/entecavir which suppress viral replication
How is HBV infection prevented?
Education (e.g. safe sex, injecting)
Immunisation with the HBV sAg vaccine
Prevention of mother to child transmission
How is mother to child transmission of HBV prevented?
HBV vaccination given to the newborn in 6 doses immediately after birthHBV immunoglobulin if eAg positive
Tenofeovir during last trimester if high viral load
Hepatitis D requires infection with what other virus in order to replicate?
Hepatitis B
Hepatitis D increases the risk of chronic liver disease. T/F?
True
How is hepatitis D infection managed?
Interferon only
How is hepatitis C transmitted?
Transfusion/transplant
vertical or sexual transmission is rare
There is a vaccine for hepatitis C. T/F?
False
What is the incubation period of hepatitis C?
6-7 weeks
HCV is usually symptomatic. T/F?
False - it is usually symptomatic
What does the presence of IgG for HCV indicate?
Chronic HCV infection or cleared infection
What tests are used to assess for current HCV infection?
PCR or antigen tests
How is HCV treated?
Direct acting antiviral which inhibit the replication cycle
For how long is DAA treatment used in HCV?
8-12 weeks
How are direct acting antivirals for HCV infection often dispensed?
From community pharmacies with daily methadone on an observed basis
