Liver Symposium Flashcards
Hep A & E?
enteric viruses
Hep B, C & D?
parenteral viruses
Hep A & E?
self-limiting acute infections
Hep B, C and D?
chronic disease
Hep A?
Occurs sporadically or in epidemic form Transmission: faecal, sexual, blood 5-14yrs commonest group Asymptomatic disease cases very common Acute disease diagnosed by IgM antibodies Patients with chronic liver disease Haemophiliacs Occupation exposure: lab workers Men who have sex with men (MSM)
Hep B?
Hepatitis surface antigen (HBsAG) = presence of virus
Hepatitis e antigen (HBeAg) = active replication
Hepatitis core antigen (HBcAg) = active replication not detected in blood
HBV DNA = active replication
Drugs: Lamivudine, Adefovir
Hep C?
Rarely causes acute liver failure
Most asymptomatic until cirrhotic
May have normal LFTs
Drugs: Ledipasvir, ABT-333
Hep D?
Small RNA virus, does not code for its own protein coat, enveloped HBsAg
Co-infection or super-infection with HBV
Transmission as for HBV
Very resistant to treatment
Hep E?
Previously thought to be limited to tropical countries – increasing in UK
COMMONEST cause of acute hepatitis in Grampian
Self-limiting, no long term sequelae
No specific treatment and no effective vaccine currently
What can non-alcoholic fatty liver disease be?
simple steatosis
non-alcoholic steatohepatitis
fibrosis and cirrhosis
what is NAFLD associated with?
metabolic syndrome
DM, obesity, hypertension
Diagnosis of NAFLD?
biochemical AST/ALT ratio? enhanced liver fibrosis panel US fibroscan MR/CT Liver biopsy
Treatment of NAFLD?
diet and weight reduction excercise insulin sensitisers (metaformin) GLP-1 analogues vitamin E weight reduction surgeries
Autoimune hepatits?
Female predominant Elevated IgG Three antibody types: 1: ANA, SMA. 2: LKM1. 3: SLA Liver biopsy diagnostic Responds well to steroids Long term azathioprine
Primary biliary cholangitis?
Female predominant IgM elevated Anti-mitochondrial antibody positive Intrahepatic bile duct involved Pruritis and fatigue common UDCA treatment of choice