Hepatobiliary - Hep B

Question 1

Hep B - what is it and how does it spread?

Answer 1

Hepatitis B is a DNA virus

Transmitted by:

• Direct contact with blood or bodily fluids - sexual intercourse or sharing needles
• Sharing contaminated products such as toothbrushes or contact between minor cuts or abrasions
• Passed from mother to child during pregnancy and delivery (known as “vertical transmission”).

Question 2

Hep B - incubation period

Answer 2

6-20 weeks

Question 3

Hep B - main clinical features?

Answer 3

Fever

Jaundice

Question 4

Hep B - prognosis?

Answer 4

Most people fully recover within 2 months

10% patients become chronic hepatitis carriers - virus DNA integrated with their DNA, therefore will continue to produce viral proteins

Question 5

Hep B - management?

Answer 5

1st line - Pegylated interferon-alpha

Other antiviral medications that aim to suppress viral replication:

Tenofovir

Entecavir

Telbivudine

Question 6

Hep B - viral markers

Answer 6

Surface antigen (HBsAg) – active infection

E antigen (HBeAg) – marker of viral replication and implies high infectivity

Core antibodies (HBcAb) – implies past or current infection

Surface antibody (HBsAb) – implies vaccination or past or current infection

Hepatitis B virus DNA (HBV DNA) – this is a direct count of the viral load

Question 7

Hep B - can hepatitis B be transmitted through breastfeeding?

Answer 7

No (in contrast to HIV)

Question 8

Hep B - complications of Hep B infection?

Answer 8

Chronic hepatitis

Fulminant liver failure

Hepatocellular carcinoma