Hepatitis Testing

Question 1

HAV

Answer 1

Anti HAV ab IgM - current
Anti HAV ab IgG - past

Question 2

HBV

Answer 2

HBSag - current infection
Anti HBS ab - past infection or immunity
Anti HBC ab - past or chronic infection
Anti HBe Ag - highly infective (viral replication)
Anti HBe ab - recovered from acute infection

Question 3

Isolated anti HBc an positive

Answer 3

False positive
Window phase (resolving acute infection, anti HBS to appear after)
Remote resolved infection
Occult HBV

Question 4

HCV

Answer 4

IgM - current
IgG - past

Question 5

HBV in pregnancy

Answer 5

Mom should get HBV viral load test and if high give antiviral therapy

Follow up infants with HBV vaccine and HBIG 12h after birth, repeat vaccine at 1 and 6 months

Question 6

HAV PEP

Answer 6

only close contacts, food handler, child care

HAV vaccine

HA IG if immune compromised

Question 7

HBV PEP

Answer 7

not needed if known to be immune with anti HBS>10IU/L or recovered from infection in past

HB vaccine (1, 2, 6 months) with in 24 hours full series if not immunized

HBIG if source HBS ag positive or high risk

Reassess labs at 6 months

Question 8

HCV PEP

Answer 8

none recommended

Question 9

If HBS ag positive and positive again at 6 months (chronic carrier)

Answer 9

Test HIV/HCV/HBeAg
Q6 month ALT, Q1yr viral load
Q6-12 month US for HCC
Refer

Question 10

If HCV Ab positive

Answer 10

HCV RNA and genotype
Refer to hepatology for treatment or transplant
EGD q1-2 yr for varices
Liver US q6-12 month for HCC

Question 11

HBV treatment

Answer 11

Interferon injection
Oral nucleoside analogue

Question 12

HCV treatment

Answer 12

Harvoni x12 weeks
Transplant