S6 Hepatitis Flashcards
What is hepatitis?
Inflammation of the liver
What can hepatitis be caused by?
- systemic viruses e.g. EBV, CMV, VZV
* hepatitis viruses
What are the routes of transmission of Hepatitis B and C?
B - blood/sex/vertical
C - blood (sex)
What are the incubation times for hepatitis B and C?
B - 6 weeks to 6 months
C - 6 to 12 weeks
Can hepatitis B and C be chronic illnesses?
Yes
What is the viral structure of hepatitis C?
RNA, single-stranded, enveloped, icosahedral
What is the viral structure of hepatitis B?
DNA, double stranded, enveloped
What are the liver function tests you would carry out? Which of these do you test for viral hepatitis B?
- bilirubin
- liver transaminases (ALT and AST)
- alkaline phosphatase (ALP)
- albumin
- coagulation tests
The first 3
What type of jaundice suggests viral hepatitis?
Cholestatic - intrahepatic
What are the symptoms of acute hepatitis B?
- jaundice
- fatigue
- abdominal pain
- anorexia/nausea/vomiting
- arthralgia (joint pain)
In how many cases does acute hepatitis B become chronic?
In less than 10% of cases in those infected as adults, 90% if infected in infancy
What is the definition of chronic hepatitis B infection?
Persistence of HBsAg (hep B surface antigens) after 6 months
What liver conditions can chronic hepatitis B lead on to?
Cirrhosis
Hepatocellular carcinoma
What is the natural progression for clearing of hepatitis B?
- Surface antigen
- E-antigen
- Core antibody (IgM)
- E-antibody
- Surface antibody
- Core antibody (IgG)
What is the treatment for hepatitis B? Is it curable?
It isn’t curable
Use life-long antivirals to suppress the viral replication, however some don’t need these - some are inactive carriers who can keep the levels of virus low naturally (they just need to be monitored)
What is the hepatitis B vaccine like? How many doses do you need? What sort of response does it produce?
A genetically engineered surface antigen
3 doses + a booster
Produces a surface antibody response
Will a person test positive or negative for surface antigen, core antibody and surface antibody in acute hepatitis B infection?
Surface antigen - positive
Core antibody - positive (IgM)
Surface antibody - positive or negative
Will a person test positive or negative for surface antigen, core antibody and surface antibody in past/cleared hepatitis B infection?
Surface antigen - negative
Core antibody - positive (IgG)
Surface antibody - positive
Will a person test positive or negative for surface antigen, core antibody and surface antibody in chronic hepatitis B infection?
Surface antigen - positive
Core antibody - positive (IgG)
Surface antibody - negative
Will a person test positive or negative for surface antigen, core antibody and surface antibody in someone who is never infected, vaccinated?
Surface antigen - negative
Core antibody - negative
Surface antibody - positive
How many people become chronically infected from a hepatitis C infection?
80%
What are the symptoms of hepatitis C?
- most have no symptoms (chronic/acute)
* few have vague symptoms - fatigue, anorexia, nausea, abdominal pain
What do blood tests for hepatitis C show?
- serology - anti-hepatitis C antibody only
- person remains positive for life even after cure/clearance
- viral PCR - if positive confirms chronic infection
What is the treatment for hepatitis C? Can it be cured?
It can be cured
Use a directly acting antiviral drug combo for 8-12 weeks with over 90% chance of cure but can become reinfected and is very expensive
There’s no vaccine
Out of HIV, Hep C and Hep B, which ones have the highest and lowest risk for transmission from needle stick injury?
Highest - Hep B (1/3)
Lowest - HIV (1/300)
