HEPATITIS B Flashcards
What is the structure of Hep B virus?
Partially double stranded DNA virus
What are the common ways to contract Hep B?
Sex including gay men sex
Blood
Mother to child
Travelling to endemic areas
Is Hep B Acute or chronic?
Both
What do HbsAg and HBsAb mean?
HBsAg- hep B surface antigen which indicates current infection of hep B when detected
HBsAb- hep B surface antibody indicates the infection has been resolved and subsequent immunity OR vaccine has been received hence immunity
What do HBcAg and HBcAb mean?
HBcAg- hep B core antigen which cannot be measured because it does not circulate freely in blood
HBcAb- hep B core antibody
It’s IgM- indicates recent infection less than 6 months
IgG- indicates resolved or chronic infection
What does HBeAg mean?
Hep B envelope antigen- indicates high infectivity and hence can easily be transmitted to others when levels of it are high
What is the main investigation done for Hep B?
HBsAg - current infection whether acute or chronic
HBcAb IgM- Acute infection
HBeAg - measure infectivity
Other labs for Hep B?
Increased alanine and aspartate aminotransferase levels
AST/ALT ratio is less than 1
Increased bilirubin
Echoeic liver on USG
Liver biopsy to exclude other chronic causes of liver disease
Test for coin fractions of the other hepatitis especially c and d
What is ground glass appearance of hepatoctyes for?
Hep B only
What are the extrahepatic manifestations of hep B?
Polyarteritis nodosa
Membranous glomerulonephritis
Aplastic anemia - anemia due to bone marrow failure hence not enough blood cells are produced not just rbcs
How Is hep b treated?
Acute is supportive like hep A
chronic - tenofovir, entecavir, pegylated interferon alpha
Which hepatitis forms don’t have vaccines available?
Hep c and e
