Schoenwald: Infections of GI tract-Hepatitis: slide 30 on Flashcards
Hepatitis B Vaccine: is a ___ dose series
3 dose series
Hepatitis B vaccine: 3 dose series schedule?
-typical schedule 0, 1-2, 4-6 months - no maximum time between doses (no need to repeat missed doses or restart) -FDA approved in **newborns and above -Engerix and Recombivax
Hepatitis B vaccine protection: -which demographic is the vaccine less protective for?
~30-50% dose 1; 75% - 2; 96% - 3; lower in older, immunosuppressive illnesses (e.g., HIV, chronic liver diseases, diabetes), obese, smokers
Hepatitis B vaccine: adults?
-2 dose series (adult dose) –licensed by FDA for 18 years and older –Heplisav-2 doses given Day 0 and at 1 month -TwinRix- see Hep A vaccine slides
Hepatitis B Vaccination ACIP Recommendations: which groups should be vaccinated?
-Routine infant -Ages 11-15 “catch up”, and through age 18(VFC eligible) -**Over 18 – high risk: –Occupational risk (HCWs) –Hemodyalisis patients –All STD clinic clients –Multiple sex partners or prior STD –Inmates in Correctional settings –MSM (males sex w males) -IDU -Institution for developmental disability -Pre-vaccination testing – if cost effective -Post-vaccination testing: 1-2 months after last shot, if establishing response critical (HCW)
Hepatitis C: infection is ___x as widespread when compared to HIV
5x
Hepatitis C: is the leading cause of ____ cancer and liver transplantation in the US
liver cancer
Hepatitis C: Vaccine?
no vaccine available (but it can be cured wihth newer meds)
Hepatitis C: risk for infection after a needle stick exposure is ___%
2%
Hep C virus infection: incubation period?
6-7 weeks (range of 2-26 weeks) -usually pts are asymptomatic
Hep C virus infection: acute illness (jaundice) (what % of Pts have jaundice)?
mild (<20%)
Hep C virus infection: case fatality rate?
low
Hep C virus infection: chronic infection?
60-80%
Hep C virus infection: Chronic hepatitis?
10-70% (most asymptomatic)
Hepatitis C virus infection: Cirrhosis ___%?
<5-20%
Hep C virus infection: mortality from CLD (chronic liver dz?
1-5%
Chronic Hepatitis C: list factors that promote progression or severity
-increased alcohol intake -Age >40 yo at time of infection -HIV co-infection -Other (male gender or chronic HBV co-infection)
Exposures known to be assoc. with HCV infection in the US
-injecting drug users -Transfusion, transplant from infected donor -Occupational exposure to blood (needle sticks) -Iatrogenic (unsafe injections) -Birth to HCV-infected mother -sex with infected partner -Multiple sex partners
Exposures known to be assoc. with HCV infection in the US
-injecting drug users (60%) -Transfusion, transplant from infected donor -Occupational exposure to blood (needle sticks) -Iatrogenic (unsafe injections) -Birth to HCV-infected mother -sex with infected partner -Multiple sex partners
Hepatitis C 2016 all age groups US: highest % in which age groups?
-25-34 yo -35-44 yo -15-24 yo
alcohol and hepatitis C are exponential risk factors for ______
cirrhosis
Hepatitis C Labs:
-Hepatitis C Antibody (if +, they may have hep C, but you will want to confirm with PCR test) -HCV (Hepatitis C Virus) PCR= **Confirmatory test -Genotype –1-6 –Genotype 1 is MC in US(80%) followed by type 2 and 3. 4-6 more common in Asian countries.
HCV testing is routinely recommended based on (2 things)?
-Based on increased risk for infection -Based on need for exposure management
HCV testing: describe the need for testing based on increased risk for infection
-ever injected illegal drugs -Pt received clotting factors made before 1987 - Received vlood/organs before 1992 -Ever on chronic hemodialysis - Evidence of liver dz
