Infection 4 Hepatitis Flashcards
what is hepatitis?
inflammation of the liver due to cell injury or viruses
can cause collateral liver damage
describe hepatitis ABCDE
A - acute
B - bit of both
C - chronic
D - double trouble (only happens with B)
E - like A
transmission of hepatitis ABCDE
A - faeco-oral
B - blood, sex, vertical
C - blood, sex
D - blood, sex , vertical
E - faeco-oral
which hepatitis is chronic?
B and C (+D)
outline the viral structure of hepatitis A
ssRNA
positive
nonenveloped
icosahedral
same as E
outline the viral structure of hepatitis B
dsDNA
enveloped
outline the viral structure of hepatitis C
ssRNA
positive
enveloped
icosahedral
outline the viral structure of hepatitis E
ssRNA
positive strand
nonenveloped
icosahedral
same as A
blood test results of hepatitis patient
high bilirubin, ALT + ALP
damage to liver
what are the different types of jaundice and their causes?
Prehepatic - haemolysis
Intrahepatic - hepatitis, drugs, alcohol, cirrhosis
Extraheptic - gall stones, carcinoma
list some liver function tests
bilirubin
albumin
alanine transaminase ALT
aspartate aminotransferase AST
alkaline phophatase ALP
coagulation tests INR + PT
three causes of increased ALT >1000
viral hepatitis
drugs
blood clots
symptoms of acute hep B
jaundice
fatigue
abdominal pain
anorexia
vomiting
arthralgia
ALT/AST >1000
outline hep B serology
- HBsAg surface antigen within 6 weeks
- HBeAg highly infectious e-antigen appears
- IgM - core antibody appears
- HBeAb e-antibody appears > less infectious
- HBsAb surface antibody last to appear > clears virus
- HBcAg / IgG - persists for life
what is chronic hep B infection?
persistence of HBsAg after 6 months
treatment of chronic hep B
- no cure - integrates into host genome
- lifelong antivirals - suppresses viral replication
describe the hep B vaccination
consists of genetically engineered surface antigens
3 doses needed
produces a surface antibody response
outline whether or not there are HBsAg, HBsAb, HBcAb in acute hep b infection
HBsAg +
HBcAb + IgM
HBsAb +/-
outline whether or not there are HBsAg, HBsAb, HBcAb in cleared hep b infection
HBsAg -
HBcAb + IgG
HBsAb +
outline whether or not there are HBsAg, HBsAb, HBcAb in chronic hep b infection
HBsAg +
HBcAb + IgG
HBsAb -
outline whether or not there are HBsAg, HBsAb, HBcAb in patient who has been vaccinated for Hep B
HBsAg -
HBcAb -
HBsAb +
who is at risk of hep C transmission
IV drug users
sexual contact
infants born to hep C positive mothers
needlestick injury
complications of chronic liver disease due to chronic Hep C infection
decompensated liver disease
liver cancer
transplant
death
symptoms of hep C
80% asymptomatic
- fatigue
- anorexia
- nausea
- abdominal pain
describe serology test for Hep C
anti Hep-C antibody
remains even after clearance
what does a positive viral PCR for Hep C confirm?
chronic infection
treatment for Hep C
no vaccine but there is a cure > can get reinfected
antiviral drug combo
Who are at risk of hep B transmission/modes of tranmssion?
- vertical
- sexual transmission
- IV drug users
- close household contacts - blood exposure
- healthcare working via needle stick injuries
Patients who had a blood transfusion before what year are at risk of hepatitis C?
1991
What are the risks of transmission from needle stick injury in:
- HIV
- Hep C
- Hep B
- HIV: 1/300
- Hep C: 1/30
- Hep B: 1/3
