Hepatitis B (and D) Flashcards
what is the definition of Hep B?
The most common liver infection globally, caused by the hepatitis B virus (HBV). HBV is a DNA virus transmitted by percutaneous and permucosal routes. HBV infection is also a sexually transmitted infection
what is the epidemiology of hepB?
Nearly half of all infections are in the highly endemic areas of Southeast Asia (excluding Japan), China, and Africa.
what is the aetiology of Hep B?
Hepatitis B virus (HBV) is an enveloped, non-cytopathic, hepatotrophic, and highly infectious DNA virus that belongs in the hepadnaviruses family
what are the risk factors for Hep B?
Prenatal exposure in an infant born to infected mother High risk sexul behavious Injection drug use Highly endemic area Family history Household contact Incarceration
what is the pathophysiology of Hep B?
The virus does not directly kill hepatocytes. The host’s immune response to viral antigens is thought to be the cause of the liver injury in HBV infection. The cellular immune response, rather than the humoral immune response, seems to be primarily involved in disease pathogenesis. Induction of antigen-specific T-lymphocyte response is thought to occur when host T lymphocytes are presented with viral epitopes by antigen-presenting cells in lymphoid organs.
what are the key presentations of Hep B?
Presence of risk factors
what are the signs of Hep B?
Jaundice
Hepatomegaly
Ascites
what are the symptoms of Hep B?
Asymptomatic
Fever
Malaise
Rash
what are the first line and gold standard investigations for Hep B?
Liver function tests - elevated ALT/AST, alkaline phosphatase and bilirubin, low albumin
FBC - microcytic anemia and thrombocytopenia
Urea and electrolytes - hyponatremia, high urea
Coagulation profile - normal or elevated
Serum hep B surface antigen and antibody
Serum HBV DNA
what are the differential diagnoses for Hep B?
Acute Hep A, acute Hep C, chronic Hep C
how is Hep B mananged?
Supportive care, antiviral therapy and asses for liver transplant
how is Hep B monitored?
In patients who don’t meet the local criteria for treatment with antiviral therapy, the aim of monitoring is to identify a change in clinical status that indicates progression to disease state that requires treatment
what are the complications of Hep B?
Fulminant hepatic failure, cirrhosis, hepatocellular carcinoma
what is the prognosis of Hep B?
More than 95% of immunocompetent individuals with acute infection will achieve seroconversion with the appearance of antibody to hepatitis B surface antigen (anti-HBs) in the absence of treatment.
what is Hep D?
Hepatitis D can occur if the person has Hep B. They may occur at the same time or in patients with chronic HBV.
