Hepatitis A

Question 1

State the clinical features of hepatitis A

Answer 1

Mild and often subclinical or anicteric in children under the age of 5

Question 2

State the incubation period of hepatitis A

Answer 2

28 days, range of 10-15 days

Question 3

State the common symptoms of hepatitis A in adults which occur after the mean incubation period

Answer 3

Fever, malaise, anorexia, nausea, vomiting and upper abdominal pain

Question 4

When does jaundice occur in patients with hepatitis A

Answer 4

Occurs 3-10 days after the onset of the first symptoms

Question 5

State the spread of hepatitis A infection

Answer 5

Faecal oral route

Question 6

When are patients with hep A most infectious

Answer 6

A week before the onset of jaundice and until a few days after

Question 7

List the risk factors for contracting hepatitis A

Answer 7

MSM, persons who inject drugs

Question 8

Describe the structure of hepatitis A

Answer 8

Small RNA virus from the family picornavirus from the genus hepatovirus

Question 9

Describe the presence of HAV IgM antibodies in patients serum with hepatitis A

Answer 9

Usually present in the serum at the onset of symptoms and usually decline to non-detectable levels over 3-6 months

Question 10

Which antibodies show immunity to hepatitis A

Answer 10

Anti-HAV IgG antibodies

Question 11

State the treatment of hepatitis A

Answer 11

No specific treatment, management is supportive

Question 12

Faecal shedding of the virus is highest during which point

Answer 12

Prior to the onset of symptoms so there is no need for isolation of cases

Question 13

When is human normal immunoglobulin given

Answer 13

Prophylaxis of close contacts of patients with hepatitis A

Question 14

How long does human normal immunoglobilin give protection for against hepatitis A

Answer 14

4 months

Question 15

How long does a dose of vaccine take to give protection

Answer 15

2 weeks

Question 16

State the regiment of hepatitis A vaccination

Answer 16

Primary vaccination, booster given at 6-12 months, second booster at 20 years

Question 17

When should immunisation be considered

Answer 17

Sewage workers, seronegative haemophiliacs, MSM with multiple sexual partners, travellers to endemic areas and IV drug users, chronic liver disease (patients with hepatitis C).

Question 18

If protection against hepatitis A is needed immediatley what can be done

Answer 18

Human normal immunoglobulin and hepatitis A vaccine can be given together

Question 19

What time of vaccine is hepatitis A vaccine

Answer 19

Killed

Question 20

Describe the prognosis of hepatitis A

Answer 20

Recovery may be slow and fatigue may be prolgonged, death is rare, there is no chronic infection and damage to the liver doesnt occur.

Question 21

State the possible complications of hepatitis A

Answer 21

Prolonged cholestatic jaundice, relapsing hepatitis, haematological problems including anaplastic anaemia