Hepatitis

Question 1

What is hepatitis ?

Answer 1

A systemic viral infection
Necrosis & inflammation of the liver cells
Can also be caused by ETOH, mediations, chemicals, autoimmune disease, and metabolic abnormalities
RARELY caused by bacteria

Question 2

Hepatitis A

Answer 2

• Fecal- Oral
• poor hygiene, sanitation, contaminated foods
• HAVRIX vaccine (Prevention)
• Vaqta (Prevention)
• Immunoglobulin (prophylaxis)

Question 3

Hepatitis B

Answer 3

• Blood-borne pathogen
• can cause acute or chronic hepatitis
• having Hep B can lead to having Hep D
• RECOMBBIVAX vaccines (Prevention)
• HBIG (Hep B Immunoglobulin) (Prophylaxis)

Question 4

Hepatitis C

Answer 4

• Blood-borne pathogen
• bookRNA virus transmitted percutaneously
• No vaccine (Prevention)
• No post exposure treatment (prophylaxis)
• book most common cause of chronic liver disease and liver failure

Question 5

Hepatitis D

Answer 5

• Blood-Borne pathogen
• requires Hep B to replicate
• RECOBBIVAX (Prevention)
• book* HBV vaccine reduces the risk of HDV
• HBIG (Hep B Immunoglobulin) (Prophylaxis)

Question 6

Hepatitis E

Answer 6

• Fecal-Oral
• acquired by drinking contaminated water (developing countries)
• No Vaccine ( Prevention)
• Enteric Precautions (wear grown, gloves, good hand hygiene etc.)
• No Prophylactic measures

Question 7

Diagnostic testing

Answer 7

Ag= Antigen (I have it) (Viral load)
IgM= Antigen  (I have it) (Viral load)
IgG= Antibody ( I had it) ( I made antibodies)
Ab= Antibody ( I had it) ( I made antibodies)
Anti= Antibody ( I had it) ( I made antibodies)

Question 8

Pharmacological Management Hepatitis A

Answer 8

• No meds for acute HAV infection
• HAV vaccine (prevention)
• EXPOSURE: IG Immunoglobulin given !

Question 9

Pharmacological management Hepatitis B

Answer 9

Goal: decrease viral load & AST ALT levels
#1. Interferon (SE bad) block virus from entering cell
- meant to be taken 1 yr but patient will d/c after few months due to SE
#2. Nucleoside Analogs (Antiviral) suppress HBV replication
- Tenorovir, Entecavir, Lamivudine

Question 10

Pharmacological management Hepatitis C

Answer 10

Goal: eradicating/ reducing viral load & slow progression of HCV

• Individualize Base on GENOTYPE
• Direct Acting Antivirals: Block protein needed for HCV replication
• Harvoni
• 12 week therapy

Question 11

Nutritional support

Answer 11

Adequate nutrient & rest assist the liver to regenerate 
⬆️ Protein
⬆️ Carbs
⬇️ Fats
- Fluid intake: 2500-3000 ml/day

Question 12

Chronic hepatitis

Answer 12

Chronic HBV identified by HBsAG ( Hep B Antigen:I have it) for longer than 6 months.

bookHCV infection is more likely than HBV to become chronic
This can develop in cirrhosis and hepatocellular carcinoma
Once you have HCV 20-30 yr increase incidence of Liver cancer

Question 13

Clinical manifestations

Answer 13

• anorexia - dark urine, light stool - low grade fever
• N/V - weight loss
• ⬇️sense of smell
• RUQ discomfort
• pruritus, jaundice
• Hepatomegaly, splenomegaly