Microbiology 5s - Viral hepatitis

Question 1

Incubation period of Hep A

Answer 1

2-6 weeks

Question 2

which hep virus is DNA?

Answer 2

Hep B

Question 3

is HAV a notifiable disease?

Answer 3

Yes

Question 4

diagnostic test for HAV

Answer 4

HAV IgM

Question 5

differentiating between vaccinated HAV and infected

Answer 5

Infected have HAV IgM and raised ALT

Vaccinated only HAV IgG raised

Question 6

What is the definition of chronic hep and what % with HBV go on to have chronic disease?

Answer 6

hepatitis (HbSin Ag) >6 months

10%

Question 7

HBV incubation period

Answer 7

2-6 months

Question 8

Transmission of HAV/HBV/HCV/HEV?

Answer 8

HAV = FO route
HBV = Blood products, sexually, vertically
HCV = BLOOD products (Rarely sexual)
HEV = FO

Question 9

what % of <5 year olds with HBV develop chronicity?

Answer 9

90%

Question 10

In HBV, What serological marker suggests active infection?

Answer 10

Anti-HbC IgM +VE

Question 11

which marker is a marker of immunity in HBV?

Answer 11

Anti-HbS IgG if vaccinated and NO core or envelope antibodies

Question 12

drugs used in treatment of HBV

Answer 12

Peginteferon alpha

NRTIs which inhibit viral replication e.g. tenofovir, lamivudine, emtricitabine

Question 13

Baby HbSAg +ve, eAg -ve at birth

Answer 13

Vaccine at birth

Question 14

baby HbsAg +Ve eAg +Ve at birth

Answer 14

Vaccine at birth + HBIG <48 HRS

Question 15

incubation period HCV

Answer 15

6-8 weeks

Question 16

what % of HCV infection –> chronic?

Answer 16

60%

Question 17

how do you screen for acute HCV infection

Answer 17

You cannot check the anti-HCV as they tend to develop after HCV infection so need to do HCV RNA/viral load

Question 18

new treatment for HCV

Answer 18

DAAs = direct acting antivirals, 12 week treatment course

Question 19

WHAT KIND of virus is hep D?

Answer 19

Delta virus - ssRNA, smallest virus known to infect man

Question 20

co-infections vs superinfection of Hep B + Hep D

Answer 20

Co-infectino can get quite a nasty acute hepatitis but low risk of chronicity
if you first get hep B and then superimposed hep D, get chronic infection and high risk of liver disease

Question 21

HEV - describe the diff genotypes?

Answer 21

1 + 2 = human

3 + 4 = swine

Question 22

HEV - high prevalence in which country?

Time course?

Answer 22

India + North Africa

acute i.e. 2-8 weeks

Question 23

To whom is HEV particularly dangerous

Answer 23

Pregnant women –> high mortality, especially genotype 1

Question 24

Mx of HEV?

Answer 24

sUPPORTIVE unless chronic in which case you give ribacvarin

Question 25

which hepatitis viruses have vaccines?

Answer 25

A, B and E (only approved in China)