PT Hepatitis Flashcards
What are characteristics of hepatitis A infection?
self limiting illness, acute and rarely lead to chronic infection
3 stage of hepatitis A infection?
Incubation (14-50 days)
acute hepatitis
convalescence
How to dx hepatitis A infection?
1) IgM antibody HAV (anti-HAV) detectable in the serum 5–10 days before the onset
of symptoms
2) Once the infection clears, the IgM antibody is replaced by IgG antibodies during a 2 to 6month period (lifelong protective immunity against subsequent infection
3) Elevated aminotransferases
What are post-exposure prophylaxis for HAV?
- Immune globulin can be given at a dose of 0.1 mL/kg intramuscularly within 2 weeks of exposure.
- HAV vaccine is recommended in patients 12 months to 40 years
old who are otherwise healthy. - HAV vaccine with or without concurrent immune globulin in patients older than 40 years.
- Both the vaccine and immune globulin in patients 12 months and older who are immunocompromised or who have chronic
liver disease.
Which hepatitis virus affect most patient and commonly spread worldwide?
Hepatitis B Virus
Transmission routes of HBV?
- Parenteral: iv drug abuse, needlestick, ear or body piercing.
- Bodily fluids: saliva, semen, vaginal fluid.
- Sexual contact: heterosexual and homosexual.
- Perinatal: mother to child at birth.
What the most effective strategy in preventing complications of HBV infections?
Vaccination
What is initial therapy of chronic HBV?
Entecavir
Tenofovir
Monitoring for efficacy should be based on the following responses?
- Primary nonresponse: decrease in HBV DNA of less than 100 copies/mL after at least 24 weeks of therapy. alternative treatment.
- Response should be assessed by reductions in HBV DNA for HBeAg‐negative patients.
Dose for Peg‐α‐2a (Pegasys)?
180 mcg SC once weekly for 48 weeks
same duration for HBeAg‐negative and positive disease
Adverse effect of pegylated interferon?
Bone marrow suppression
CNS depression
Exacerbate underlying autoimmune disorder
Thyroid dysfunction
(Manufacturers give recommendations for dose reductions in patients who
develop bone marrow suppression and depression while on therapy.)
What is dose for entecavir in tx chronic HBV infection?
- 0.5 mg orally once daily for patients > 16 years and nucleoside naive;
- 1 mg orally once daily for patients > 16 years with HBV viremia while receiving lamivudine or in lamivudine resistant
HBV - Dose adjustments required for renal impairment
What is Doses of HBV immune globulin in postexposure prophylaxis for HBV
0.06 mL/kg intramuscularly and must be given within 7 days of exposure.
Patient populations requiring postexposure prophylaxis for HBV?
a) Perinatal transmission
(1) Children born to HBsAg‐positive mothers should receive the first dose of the three dose vaccine series plus
HBV immune globulin within 12 hours of birth.
(2) Children born to mothers with unknown HBsAg status (but suspected) should receive the first dose of the
three‐dose vaccine series within 12 hours of birth; testing should be performed on the child, and if positive,
HBV immune globulin should be administered within 1 week.
(3) Infants weighing less than 2 kg at birth whose mothers are documented as HBsAg negative should receive
the first dose of the vaccine series 1 month after birth or at hospital discharge, whichever comes first.
(b) Sexual contact or household contact with an infected person: Should receive HBV immune globulin plus
vaccine series if exposed person is previously unvaccinated
(c) Sexual contact or household contact with an HBV carrier: Should receive vaccine series if exposed person
was previously unvaccinated
What major cause of chronic liver disease infection (71 millions worldwide)?
HCV infection
