Hepatitis Flashcards
What is hepatitis ?
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
Hepatitis A
- Fecal- Oral
- poor hygiene, sanitation, contaminated foods
- HAVRIX vaccine (Prevention)
- Vaqta (Prevention)
- Immunoglobulin (prophylaxis)
Hepatitis B
- 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)
Hepatitis C
- 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
Hepatitis D
- Blood-Borne pathogen
- requires Hep B to replicate
- RECOBBIVAX (Prevention)
- book* HBV vaccine reduces the risk of HDV
- HBIG (Hep B Immunoglobulin) (Prophylaxis)
Hepatitis E
- Fecal-Oral
- acquired by drinking contaminated water (developing countries)
- No Vaccine ( Prevention)
- Enteric Precautions (wear grown, gloves, good hand hygiene etc.)
- No Prophylactic measures
Diagnostic testing
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)
Pharmacological Management Hepatitis A
- No meds for acute HAV infection
- HAV vaccine (prevention)
- EXPOSURE: IG Immunoglobulin given !
Pharmacological management Hepatitis B
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
Pharmacological management Hepatitis C
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
Nutritional support
Adequate nutrient & rest assist the liver to regenerate ⬆️ Protein ⬆️ Carbs ⬇️ Fats - Fluid intake: 2500-3000 ml/day
Chronic hepatitis
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
Clinical manifestations
- anorexia - dark urine, light stool - low grade fever
- N/V - weight loss
- ⬇️sense of smell
- RUQ discomfort
- pruritus, jaundice
- Hepatomegaly, splenomegaly