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Lab Medicine > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

What is the hepatitis panel used for? What are the normal findings?

A

Used to diagnose and identify the type and current status of hepatitis.

Normal findings are negative

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2
Q

What is the incubation period for HAV and how is it transmitted?

A

Has a short incubation period of 2-6 weeks and is highly contagious

Excreted in the stool and transmitted via oral-fecal contamination of food and drink.

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3
Q

What is the severity of the symptoms of HAV and what % does it account for in the US

A

Accounts for 50% of hepatitis in US
Symptoms typically not severe

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4
Q

What is the treatment of HAV?

A

Immune globulin (IgG) and IgM antibodies to HAV are used for treatment

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5
Q

Describe the progression of antibodies in HAV.

A

First antibody to appear is IgM antibody (HAV-Ab/IgM) which appears 3-4 weeks after exposure or just before hepatic enzyme elevations occur. IgM levels usually return to normal in 8 weeks.

Second antibody to HAV is IgG (HAV-Ab/IgG), which appears 2 weeks after IgM begins to increase and slowly returns to normal.

The IgG antibody remains detectable for more than 10 years after the infection

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6
Q

What is the indication of acute hepatitis A?

A

IgM antibody is elevated in absence of IgG antibody

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7
Q

What is the indication for a convalescent or chronic stage of HAV infection

A

If IgG is elevated in the absence of IgM elevation

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8
Q

What can cause a delay in the investigation of infectious hepatitis outbreaks?

A

Antibodies may not be positive soon after infection occurs

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9
Q

What is another name for HAV?

A

infectious hepatitis

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10
Q

Hepatitis B (HBV) is commonly known as?

A

serum hepatitis

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11
Q

What is the incubation period for HBV and how is it transmitted?

A

Has a long incubation period of 5 weeks to 6 months
Can be transmitted by blood transfusion or via body fluids

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12
Q

Can HBV be severe?

A

May cause severe form of hepatitis resulting in liver failure and death

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13
Q

What are the causes of increased incidence of HBV?

A

Incidence increased in transfusion recipients, male homosexuals, dialysis patients, transplant patients, IV drug abusers, and patients with leukemia or lymphoma

Hospital personnel are also at risk due to needle stick contamination

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14
Q

What are the properties of the Dane particle (HBV)

A

Made of an inner core surrounded by an outer capsule.
The outer capsule contains the hepatitis B surface antigen (HBsAg), while the inner core contains the HBV core antigen (HBcAg)

The hepatitis B e-antigen (HBeAg) is also found in the core.

Antibodies to these antigens are called HBsAb, HBcAb, and HBeAb

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15
Q

What is the most frequently performed test for HBV?

A

Hepatitis B Surface antigen

HBsAg is most frequently performed test for HBV, and is the first test to become abnormal

Rises before onset of clinical symptoms, peaks during the first week of symptoms, and returns to normal by the time jaundice subsides

Indicates an active infection by HBV

If it persists, then the patient is considered a carrier

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16
Q

What is the Hepatitis B Surface Antibody test and what does it indicate?

A

HBsAb appears 4 weeks after the disappearance of the surface antigen.

Indicates the end of the acute infection phase as well as immunity to subsequent infection

17
Q

Concentrated forms of HBsAB are used to make?

A

Concentrated forms of this agent make the hyperimmunoglobulin given to patients who come in contact with HBV infected patients.

HBsAb demonstrates immunity after the administration of hepatitis B vaccine

18
Q

Is there a test for the HBV core antigen?

A

No

19
Q

What is the only detectable marker of recent Hepatitis infection during the core window?

A

HBV core antibody

20
Q

When does the HBcAb appear and when is it elevated?

A

HBcAb appears 1 month after infection with HBsAg and declines (but remains elevated) over several years.

Also present in patients with chronic hepatitis

HBcAb is elevated during the time lag between disappearance of HBsAg and appearance of HBsAb (core window)

21
Q

What is the HBV e-antigen used for?

A

HBeAg not used for diagnostics.

Used as an index of infectivity

22
Q

What does the HBeAg’s presence correlate with?

A

Its presence correlates with early and active disease as well as with high infectivity in acute HBV infection

Persistent presence in blood predicts development of chronic HBV infection

23
Q

What does HBeAb indicate?

A

HBeAb indicates that acute phase of HBV infection is over or almost over and the chance of infectivity is greatly reduced

24
Q

What is hepatitis B-DNA used for?

A

Hepatitis B-DNA can be used to detect viral load to assess the early detection of HBV infection, monitoring of disease, and in determining low levels of viremia in patients with chronic hepatitis

25
Q

How is HCV normally transmitted, what is the incubation period, and how does it progress?

A

Typically caused by a blood transfusion.
Incubation period is 2-12 weeks after exposure with similar clinical presentation as HBV.

Unlike HBV, HCV infection is chronic in more than 60% of cases and is slowly progressive

26
Q

20% of HCV patients develop?

A

cirrhosis and hepatocellular cancers with chronic infection

27
Q

How is the screening test done for HCV?

A

Screening test for detecting HCV infection is the detection of anti-HCV antibodies to several HCV antigens. These can be detected within 4 weeks of infection

28
Q

What is HCV-RNA testing used for?

A

viral load can be detected, which correlates with likelihood to respond to treatment

29
Q

What is another name for HDV?

A

delta hepatitis

30
Q

How is HDV transmitted and what does it need in order to gain acess to the liver?

A

In the US, this is most commonly transmitted through infected blood

HDV must enter the HBV to gain access to the liver and be infective

Patient must have HBV in the blood from a past or simultaneously occurring infection

31
Q

What is the length of time before HDV antigen can be detected

A

HDV antigen can be detected within a few days after infection.
IgM and total antibodies are also detected early in the disease
Persistent elevation of antibodies indicates a chronic or carrier state

32
Q

Describe HEV

A

Short incubation virus with no accurate tests available

Lab Medicine (17 decks)

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