Primer 28 - Hepatitis Flashcards
What is the genetic structure of Hepatitis A virus?
Single Stranded RNA virus.
How is Hepatitis A transmitted?
Fecal-oral route.
How is Hepatitis E transmitted?
Fecal-oral route.
Is there a carrier state for Hepatitis A?
No.
What is the incubation period for Hepatitis A?
2 weeks.
What outstanding fact is associated with Hepatitis E?
Very complicated or deadly in pregnant women.
What is the genomic structure of Hepatitis D?
It is incomplete, or defective single stranded RNA. “Hep D for Defective”.
What is unusual about Hepatitis D?
Cannot infect unless the patient already has Hepatitis B.
What is the genomic structure of Hepatitis C?
Single stranded RNA.
What is the most common way to transmitt Hepatitis C?
Parentally.
How is Hepatitis C diagnosed?
Anti Hep C virus antibodies.
What is the percentage of Hepatitis C becoming a chronic disease?
It is 80-90 percent.
What risk is increased in carrier states of Hepatitis C?
Hepatocellular cancer.
What is the treatment for Hepatitis C?
Interferon and ribavirin.
What is the most common transfusion mediated hepatitis?
Hepatitis C.
What is the genomic structure of Hepatitis B?
Double stranded DNA virus.
What is the only hepatitis virus that has DNA?
Hepatitis B.
What is the percentage of patients having a chronic hepatitis from hepatitis B infection?
It is 10 percent.
What is the percentage of infants or immunocompromised patients developing chronic hepatitis for Hepatitis B?
It is 80-90%.
What are the 6 big drugs to give to patients with Hepatitis B infection?
- Interferon
- Lamivudine
- Adefovir
- Entecavir
- Telbivudine
- Tenofovir
What is a Dane particle?
An intact hepatitis B particle.
What is the incubation time for hepatitis B?
It is 60 to 90 days.
What do the following stand for? HBsAg HBsAb HBcAb HBeAg HBeAb
HBsAg: Hepatitis B surface Antigen. HBsAb: Hepatitis B surface Antibody. HBcAb: Hepatitis B core Antibody. HBeAg: Hepatitis B "E" antigen. HbeAb: Hepatitis B "E" antibody.
What does HBsAg being positive mean?
That there is active disease going on.
“Hepatitis B surface antigen are the bad guys.”
What does HBsAb being positive mean?
It means that you do not have active disease. It can mean two things: Either you have had the disease before (and recovered) or have been immunized by vaccination.
“Hepatitis B surface antibody are the Good Guys.”
What does HBcAb being positive mean?
It means two things: It will be +IgM for early acute infection and window period. It will be +IgG for Chronic infection or complete recovery.
What does HBeAg being positive mean?
That the virus is actively replicating, which indicates a high transmissibility.
What does HBeAb being positive mean?
That there is going to be a low transmisibility.
What is the first particle to be elevated in Hepatitis B infection?
HBsAg.
Hepatitis B surface Antigen.
What is the window period in Hepatitis B?
HBsAg rises about a month after exposure and then after 5 and a half months later, it goes down. Two weeks later the HBsAb finally begins to rise. The two week period when both HBsAg and HBsAb are low/absent is called the window period.
What does this indicate? HBsAg: + HBsAb: - HBcAb: +IgM HBeAg: + HBeAb: -
Early Acute Infection.
What does this indicate? HBsAg: - HBsAb: - HBcAb:+IgM HBeAg: +/- HBeAb: +/-
Window period.
What does this indicate? HBsAg: + HBsAb: - HBcAb: +IgG HBeAg: + HBeAb: -
Chronic Infection with HIGH transmitability.
What does this indicate? HBsAg: + HBsAb: - HBcAb: +IgG HBeAg: - HBeAb: +
Chronic Infection LOW transmisibility.
What does this indicate? HBsAg: - HBsAb: + HBcAb: +IgG HBeAg: - HBeAb: +
Past Infection and fully recovered.
What does this indicate? HBsAg: - HBsAb: + HBcAb: - HBeAg: - HBeAb: -
Vaccinated.
What is an accompanying feature of autoimmune hepatitis?
A lot of patients have other types of autoimmune disease such as type I Diabetes, hemolytic anemia, autoimmune thyroiditis, ulcerative colitis.
What medications are used in the treatment of chronic hepatitis B and C?
Interferon alpha: Chronic hepatitis B and C
Ribavirin: Chronic hepatitis C
Which antibodies can be used to help make the diagnosis of autoimmune hepatitis?
- ANA (+), Anti-smooth muscle Ab (+)
- Anti-liver-kidney microsomal Ab (+)
- Anti-mitochondrial Ab (-)
What antibodies indicate Type I autoimmune hepatitis?
ANA (+) and/or anti-smooth muscle antibody (+).
What antibodies indicate Type II autoimmune hepatitis?
Liver/Kidney microsomal antibody (+) and/or liver cytosol antigen (+).
What is good lab finding to tell the difference between alcohol induced hepatitis versus a viral induced hepatitis?
AST is higher than ALT in alcohol induced hepatitis.
“A Scotch and Tonic”.
ALT will be equal or higher than AST in viral induced hepatitis.
