Simple Viral Hepatitis Flashcards
What is Hepatitis A virus
RNA picornavirus
HAV transmission
Faecal-oral trasmission
Associated with contaminated shellfish
Virus passes into BILE after replication within liver cells
Immune system is activated by this process and leads to necrosis predominantly in zone 3 of the hepatic lobule.
In what organ does HAV replicate and where does it then go?
Liver (inside liver cells)
Virus passes into bile
HAV incubation period
2-3 weeks
Investigations for HAV
Anti-HAV IgM in serum
Conservative treatment of HAV
Vaccine for travellers to endemic areas
Medical treatment of HAV
Supportive since HAV is often self-resolving
Complications of HAV
(rarely) acute liver failure
What is Hepatitis B virus
a partially stranded, enveloped DNA virus
It has an e-antigen that indicates increased infectivity
HBV transmission
Vertical transmission
Contaminated needles
Infected blood products
Sexual intercourse
HBV incubation period
1-5 months
Investigations of HBV
HBV DNA in serum, HBsAg, HBeAg, anti-HBc
HBsAg presents on histology with a ‘ground glass’ appearance
Conservative treatment of HBV
Education and prevention of disease
Vaccine for at risk groups e.g. health workers
Medical treatment of HBV
Antiviral medications e.g. pegylated alpha-2a interferon, adefovir, entecavir, lamivudine, tenofovir, telbivudine
Complications fo HBV
Hepatic cirrhosis
Hepatocellular carcinoma (HCC)
Fulminant hepatitis B
What is Hepatitis C virus
Single stranded, enveloped RNA virus and a member of the flavivirus family
Transmission of HCV
Vertical transmission (occassionally)
Contaminated needles
Infected blood products
Incubation period of HCV
Intermediate
6-9 weeks
Investigations of HCV
Antibody to HCV in the serum
Complications of HCV
Hepatic cirrhosis
Hepatocellular carcinoma
Liver failure
Conservative treatment of HCV
Education and prevention of the disease
**Medical treatment of HCV
Antiviral medications e.g. Pegylated alpha-2a interferon, Ribavirin
(taribavirin, telaprevir)
What is Hepatitis D virus
Single stranded defective RNA virus that co-infects with hepatitis B virus
Co-infectivity with HDV leads to an increased chance of liver failure
Transmission of HDV
Contaminated needles
Infected blood products
Sexual intercourse (rare)
Incubation period of HDV
1-5 months
Investigations of HDV
Serum IgM anti-D
Treatment of HDV
Medical - Pegylated alpha-2a interferon (antiviral medication)
Complications of HDV
Hepatic cirrhosis
Hepatocellular carcinoma
What is Hepatitis E virus
Single stranded RNA virus
Transmission of Hepatitis E virus
Faecal-oral transmission, associated with contaminated water
Incubation period of HEV
2-3 weeks
Investigations of HEV
IgG and IgM anti-HEV
Treatment of HEV
Usually self-limiting
Complications of HEV
High mortality of pregnant women (~20%)
Name 2 scenarios where a patient is infected by HCV but gives a false negative blood result for HCV antibody
Immunosuppressed patients
Patients in acute infection stage
Name a country that had a failed public health initiative which resulted in widespread hepatitis C
Egypt
Why can a vaccine for HCV not be developed
Rapid mutations that rapidly change envelope proteins
Prevention of HCV spread
Screen blood products
Protection and precaution with handling of bodily fluids
