Lecture 15- Hepatitis Flashcards
What is hepatitis?
Inflammation of the liver
Hep B?
6weeks to 6 months incubation and can be a chronic illness
Hep C- 6 to 12 weeks incubation can also be a chronic illness
Both transmitted through blood and sex
Hep B also transmitted vertically
Jaundice types?
Pre-hepatic- caused by increased haemolysis rate
Hepatic- caused by Hepatitis, cirrhosis, alcohol and drugs
Extra hepatic- caused by blockage of bile duct…. duct stones etc
How to determine jaundice type from blood test results?
Hepatic results from increased bilirubin and high alanine transaminase (ALT)
Extra hepatic results from high bilirubin and high ALP alkaline phosphatase
What liver function tests are ther?
Liver transaminases like ALT, AST
Alkaline phosphatase
Albumin
Coagulation tests like prothrombin time and INR
How is HEP B spread?
75% vertical transmission Sexual contact Drug injectors Needlestick Blood exposure
Symptoms of acute Hep B?
Jaundice, nausea, fatigue , abdominal pain
Acute HEP B?
6 weeks to 6 months incubation
AST/alt in thousands
Up to half have vague or no symptoms
Up to 80% clear infection within 6 months
Chronic in 10% of adults
Hep B serology?
HBsAg surface antigen with rise in ALT/AST indicates infection
Then HBeAg which means very infectious
Core antibody IgM
E-antibody which means e antigen and infectivity disappears
HBsAb surface antibody indicates clearance of infection
Core antibody HBcAb IgG persists for life and gives immunity
How is chronic Hep B infection defined?
HBsAg after 6 months
What happens if you end up with chronic Hep B?
No cure so go on life long anti retro virals
Hep B vaccine?
Genetically engineered surface antigen produces surface antibody response
What’s the status of Hep B infection given certain results?
See table in lecture
Hep C transmission?
Vast majority IV drug users
Also sexual and needlestick but far less common
How does Hep C progress?
80% will get chronic infection
Hep C blood test?
Test for surface antibody and if present will tell you that patient either has Hep C chronically or has had it acutely before
Must do PCR is positive to confirm if currently infected or not
Hep B and Hep C immunity?
Hep B surface antibody gives immunity Hep C one doesn’t. Must stop injecting drugs etc to prevent infection
Hep C treatment?
Can be cured with expensive anti retroviral drug combo but no vaccine and can get re infected
What to do with needlestick injury?
Wash wound Take blood sample from worker and patient Report to occupational health Check worker vaccination records Assess risk and need for HIV pep
If for example Hep c antibody or HIV detected to follow up Hep C PCR and give HIV pep and repeat tests at 12 weeks
