Viral Hepatitis Flashcards
What is the underlying cellular pathology in viral hepatitis?
CD8+ T-cells kill the infected hepatocytes.
What is this a presentation of?
Fever, malaise, nausea, hepatomegaly, pain, rise in ALT and AST, jaundice, dark urine.
Viral hepatitis
At what point does viral hepatitis become chronic?
Persisting past six months
What is the route of transmission of hepatitis B and C?
Blood and bodily fluids
What is the route of transmission of Hepatitis A and E?
Faecal oral
What are the risk factors for hepatitis B?
IVDU, health worker, men having sex with men, sexually promiscuous, babies of HbsAg+ mothers.
What are the risk factors for the progression of hepatitis C?
Mail, older, alcohol, HIV, HBV, high viral load.
Which conditions are chronic HBV and HCV linked to?
Cirrhosis and hepatocellular carcinoma
What is the acute picture of hepatitis B infection in terms of immunology screen and LFTs?
- Markedly raised LFTs
2. HbsAg+, HBeAg+, Anti-HBc IgM+, Anti-HBc IgG+.
What is the chronic picture of hepatitis B infection in terms of immunology screen and LFTs?
- Raised LFTs
2. HBsAg+
How do you distinguish between an active infection and a recovered or vaccinated infection?
- IgM present in active infection.
2. IgG present in recovery for vaccination.
What is the recovery picture of hepatitis B infection in terms of immunology screen and LFTs?
- Normal LFTs
2. Anti-HBs+, anti-HBc IgG+
What is the vaccinated picture of hepatitis B infection in terms of immunology screen and LFTs?
- Normal LFTs
2. Anti-HBs+
In hepatitis C which test confirms exposure and which test confirms ongoing infection or chronicity?
- Exposure - Anti-HCV
2. Ongoing infection or chronicity - HCV-PCR (decreasing = recovering, static = chronic)
What is the management for hepatitis B?
- Avoid alcohol
- Immunise sexual contacts
- Antivirals for chronic liver inflammation
