Hepatitis A

Question 1

Hep A is caused by what virus

Answer 1

Picornavirus

which is stable in environment for months but humans are the only natural host

Question 2

Mode of action of Hep A virus

Answer 2

fecal-oral transmission
incubation 28 days (range 15 - 50)
viral shedding from 10 days following exposure to 3 wks after onset of symptoms

Question 3

Hep A symptoms

Answer 3

abrupt fever, anorexia, dark urine, jaundice

Question 4

Hep A symptoms last

Answer 4

up to 2 mos with relapse up to 6 mos

Question 5

Who should get routine Hep A vacc

Answer 5

all children 1 to 2 yrs
catchup by preschool if poss
catchup by 18 especially if risk factors

adults if risk factors present

Question 6

Hep A Vaccines

Answer 6

Havrix (GSK) and Vaqta (Merck)
brands interchangeable
give 2 dose 6 mos apart

Twinrix (GSK) 
Hep A (ped dose) + Hep B (adult dose) - 3 dose series

Question 7

Dosing of Hep A

Answer 7

0. 5 ml IM if 18 or younger

1. 0 ml IM if 19 and older

Question 8

Hep B

Answer 8

Hepadnaviridae

also stable in environment for 7 days but humans only known host

Question 9

Hep B mode of action

Answer 9

blood-borne pathogen

incubation is 45-160 days

Question 10

Preicteric

Answer 10

3-10 days - anorexia assoc symptoms

Question 11

Hep B signs and symptoms

Answer 11

more common in adults than children
Preicteric
Icteric
Convalescence

jaundice, yellow skin and eyes, dark urine

Question 12

target groups for Hep B Vacc

Answer 12

all infants
all adolescents who have not been prev vaccinated
all high-risk adults

Question 13

recommended Hep B vacc schedule

Answer 13

infants:
birth
1-2 mo
6 mo (no earlier than 24 weeks)

adolescents and adults
0, 1, 6 mos

Question 14

Hep B dosing

Answer 14

0.5 ml, 1 ml, and 2ml IM

Question 15

immune due to Hep B vacc when

Answer 15

anti-HBs pos with >10

Question 16

What if a health care provider’s Hep B titer is zero

Answer 16

give 1 dose
repeat titer 1 mo later
if high, no more doses needed
if low or none, complete series

Question 17

Hep A target groups / risk factors for vaccination

Answer 17

all infants at least 1 year old
CLD
men who have sex with men
illicit drug users etc

Question 18

Hep B risk factors

Answer 18

Heterosexual encounters
injection drug use
etc.

Question 19

Hep B complications

Answer 19

10% liver cancer, death