May10 M2-Hepatitis Flashcards
(IMPORTANT) can you cure hepB
no
(IMPORTANT) can you cure hepC
yes, with 8-12 weeks of treatment
most feared complication of hepatitis
cirrhosis
(IMPORTANT) how hepA is transmitted
- fecal-oral
- (sexual rarely)
- consumption of contaminated water, shellfish or other food
(IMPORTANT) how hepB is transmitted
- sexual
- vertical
- parenteral (IV iatrogenic, needles, etc.)
(IMPORTANT) how hepC is transmitted
- vertical
- parenteral (IVDU, needles, contam blood products, etc.)
- (sexual rarely, MSM)
- (health related work rarely)
(IMPORTANT) how hepD is transmitted
- sexual
- vertical
- parenteral (IV iatrogenic, needles, etc.)
- ALWAYS OCCURS WITH HEPB COINFECTION*
(IMPORTANT) how hepE is transmitted
- fecal-oral
- (sexual rarely)
- pigs and porks (swine fecal material)
- occurs with hepA, same mode of transmission*
(IMPORTANT) how hepB is transmitted in low prevalence regions like Canada (with low prevalence of hepB)
first time infections through IV
- drug use (IVDU)
- sharing contaminated needles
- occupationally
- sexually
- *get acute hepatitis BUT <5% get chronic hepatitis**
(IMPORTANT) how hepB is transmitted in high prevalence regons (like Africa)
- perinatal transmission (passed from mom to child during pregnancy and at child birth)
- 90% will dev chronic hepatitis
(IMPORTANT) how hepB is transmitted in intermediate prevalence regions (like Asia)
during childhood/horizontally (during childhood years)
(IMPORTANT) ‘‘vector’’ of transmission of hepB (how is it transmitted, through what substance)
- blood (the most)
- semen
- saliva
- cervical secretions
- (lives long tie on surfaces)
(IMPORTANT) 3 tests for hepB
- surface Ags
- surface Abs (Abs to the surface Ag)
- core Abs (Abs to the core Ag)
(IMPORTANT) how the 3 tests for hepB + total core Abs (includes IgG cAb) evolve with time when you get acute hepatitis B (infection in adult life, unprotected sex for example)
- sAg up then back down
- cAb IgM up a bit later then back down too
- Total cAb (IgM + IgG) goes up with cAb IgM and present for life (bc IgG stays)
- sAb goes up and stays for life (after cAb IgM down) IS PRESENT ONLY AFTER INFECTION
(IMPORTANT) how the 3 tests for hepB + total core Abs (includes IgG cAb) evolve with time when you get chronic hepatitis B (infection perinatally)
- sAg up and there for life
- then cAb IgM up and then down
- Total cAb (IgM + IgG) goes up with cAb IgM and present for life (bc IgG stays)
(IMPORTANT) how the 3 tests for hepB differ for chronic hepB vs acute hepB
- acute = sAg will go up then back down
chronic = sAg stays up for life - acute = sAb will go up late and stay for life. chronic = sAb never appears bc immune system can’t clear the sAg
*but both have cAb go up and stay for life (and IgM back down long term)
(IMPORTANT) what tests do you order to know if a patient is currently infected with hepB (acute or chronic, doesn’t matter)
sAg
(IMPORTANT) what tests do you order to know if a patient has ever been exposed to hepatitis B
total cAb
(IMPORTANT) what test do you order to know if a patient is immune to hepB (means acute and healed it. you’re not immune if chronically infected)
sAb
(IMPORTANT) what test do you order to know if a patient has ACUTE HEP B INFECTION SPECIFICALLY (want to discriminate acute vs chronic)
cAb IgM*
-NOT sAg bc is always there with chronic
(IMPORTANT) what is the Ab to hepB that gives you immunity to hepB
sAb
(IMPORTANT) meaning of sAg-, sAb- and cAb-
no prior exposure
(IMPORTANT) meaning of sAg-, sAb+, cAb-
vaccination (vaccine only has sAg in it bc anws it is the sAb that gives you immunity)
(IMPORTANT) meaning of sAg-, sAb+, cAb+
resolved acute infection
(IMPORTANT) meaning of sAg+, sAb-, cAb+
acute or chronic infection (sAb- bc only have sAb AFTER acute infection and not during acute)
(IMPORTANT) if you got a sAg+, sAb-, cAb+, how will you differentiate the acute infection from the chronic infection
by knowing if cAb IgM is + (acute) or - (chronic)
