Hepatitis B Flashcards
What is the most common cause of transmission of HBV?
vertical/perinatal
Is there a protective effect of C-section for HBV?
no
What percentage of infants with acute hepatitis B develop chronic hepatitis B?
> 90%
What percentage of immunocompetent adults with acute hepatitis B develop chronic hepatitis B?
< 5%
What is the genetic material of hepatitis B virus?
DNA
What specific tests should be ordered instead of ‘hepatitis B serology’?
HBsAg
HBcAb
HBsAb
What does HBsAg + indicate?
presence of surface antigen, indicates current infection
What does HbcAb + IgM indicate?
acute hepatitis B
What does HbsAb + indicate?
immunity
What does HBeAg + indicate?
active viral replication in patients with chronic hepatitis B
What does HBsAg -, HBcAb +, HBsAb + indicate?
quiescent HBV infection
What does HBsAg +, HBcAb +, HBsAB - indicate?
chronic HBV infection
What does isolated HBcAb + indicate?
distant quiescent HBV infection
false positive
resolving acute HBV infection
occult HBV infection
What tests should be ordered once you have diagnosed chronic HBV?
HBeAg, HBeAb, viral load, test for Hep A, Hep B, Hep D and HIV, LFTs, INR, AFP, FBE, liver US, fibroscan
When should hepatitis B be treated?
If HBeAg + -> when HBV DNA > 20,000 and elevated ALT
If HBeAg - -> when HBV DNA > 2000 and elevated ALT
What is the treatment for hepatitis B?
first line oral antivirals -> entecavir or tenofovir
What should be done for liver cancer surveillance in chronic hepatitis B?
ultrasound +/- AFP every 6 months
When should pregnant women with hepatitis B be treated?
Test viral load in 3rd trimester, if > 10&5 treat with tenofovir
How should the babies of pregnant women with hepatitis B be treated?
Hep B immune globulin and vaccination within 12 hours of birth
Is breastfeeding contraindicated in hepatitis B?
no, even if on tenofovir
When should patients receiving immunosuppressive therapy be treated for hepatitis B?
Treat if HBsAg+ and moderate-high risk treatment
Also treat if HBsAg - but HBCAb + and high risk treatment
