Hepatitis B Virus Flashcards
What nucleic acid is present in Hepatitis B?
DNA
How many genotypes of Hepatitis B exist? How many serotypes?
- There are 4 serotypes
What genotype is associated with Hepatocellular Carcinoma?
Genotype C
Who is at risk for getting Hep B?
MSM, IV drug users, those with HCV and HIV, immunocompromised,
What tests are used to screen for Hep B Status?
HBSAg, HBSAb, Anti HBcAb
What tests are the markers of replication?
HBEAg, HBEAb, HBV-DNA
What other tests should be ordered?
HCD, HDV and Liver Ultrasound
What advice should be given to those who are HBSAg positive?
Use condoms for sex No alcohol Do not share toothbrushes, razors, Do not give blood Kissing, hugging, cooking and hand shaking are okay
What drugs are used to treat those with Hep B?
Pregnant 3rd trimester: Tenofovir, Lamivudine and Entecavir
Sorafenib
What % of HCC are missed by an ultrasound exam?
For HCC >3cm, 5 to 15%
Who should be screened for HCC?
Asian males > 40 yrs
Asian females> 50 yrs
African Americans
Those with Family Hx of HCC
What % of those with HCC do not have cirrhosis?
30%
Where is the highest prevalence of Hepatitis B?
Greenland, Northern Canada, China, MIddle East, Subsaharan Africa
How is Hep b transmitted to infants?
At time of birth, not trans-placentally.
What are the extra hepatic manifestations of Hep B infection?
Polyarteritis Nodosa
Membranoproliferative Glomerulonephritis
How is this disease managed?
Immunize everyone
test all Pregnant women
Treta all infants of positive mothers with Heb Immune Globulin and vaccine
What are the three stages of Hep B infection?
Immunotolerant- infected at birth,+HBSAg, + HBV DNA
Immunoactive- drugs work the best
Inactive Carrier- low level HBV DNA and HBEAg
Who should not be treated?
The immunotolerant
Inactive Carriers
Latent HBV infection,
Who are usually watched?
Those under 40.
What body fluids have the highest concentration of HBV?
Blood, Serum and Wound Exudate
What body fluids have the lowest concentration of HBV?
Urine, feces, sweat, breast milk and tears
What % of patients develop Fulminant Hepatic Failure?
1 to 2 %.
What is the treatment of Hep B?
Interferon Lamuvidine TDF LDT Clevudine PEG Interferon 2 alpha
What finding increases the risk of transmission?
Positive E Antigen.
What are the risks of infection from a needle stick?
HBV- 30%
HCV 3%
HIV- .3%
What action is taken when a mother who is Hep B + gives birth?
The infant receives HBIG.
