viral hepatitis Flashcards
what is the presentation of hepatitis?
Abdominal pain Fatigue Pruritis (itching) Muscle and joint aches Nausea and vomiting Jaundice Fever (viral hepatitis)
what happens to the liver function tests in a viral hepatitis?
transaminases (AST / ALT) with proportionally less of a rise in ALP. This is referred to as a “hepatitic picture”. Transaminases are liver enzymes that are released into the blood as a result of inflammation of the liver cells.
which hepatitis is the most common worldwide?
hep A
what is hepatitis A?
It is transmitted via the faecal-oral route usually by contaminated water or food. It presents with nausea, vomiting, anorexia and jaundice. It can cause cholestasis (slowing of bile flow through the biliary system) with dark urine and pale stools and moderate hepatomegaly. It resolves without treatment in around 1-3 months
what is the root os transmission for Hep B?
blood or bodily fluids, such as during sexual intercourse or sharing needles (i.e. IV drug users or tattoos). It can also be passed through sharing contaminated household products such as toothbrushes or contact between minor cuts or abrasions. It can also be passed from mother to child during pregnancy and delivery (known as “vertical transmission”).
what is the recovery process for Hep B?
Most people fully recover from the infection within 2 months, however 10% go on to become chronic hepatitis B carriers. In these patients the virus DNA has integrated into their own DNA and so they will continue to produce the viral proteins.
what does Core antibodies (HBcAb) suggest?
implies past or current infection
what does Surface antibody (HBsAb) suggest?
implies vaccination or past or current infection
what does Surface antigen (HBsAg) suggest?
active infection
what does E antigen (HBeAg) suggest?
marker of viral replication and implies high infectivity
how does hep C virus differ from hep B?
hep B= DNA virus
hep c= RNA virus
what investigations are done when suspecting hepatitis C?
Hepatitis C antibody is the screening test
Hepatitis C RNA testing is used to confirm the diagnosis of hepatitis C, calculate viral load and assess for the individual genotype
what is hepatitis D?
Hepatitis D is an RNA virus. It can only survive in patients who also have a hepatitis B infection.
It attaches itself to the HBsAg to survive and cannot survive without this protein. There are very low rates in the UK.
Hepatitis D increases the complications and disease severity of hepatitis B. There is no specific treatment for hepatitis D. It is a notifiable disease and Public Health need to be notified of all cases.
what is hepatitis E?
Hepatitis E is an RNA virus. It is transmitted by the faecal oral route. It is very rare in the UK. Normally it produces only a mild illness
the virus is cleared within a month and no treatment is required.
Rarely it can progress to chronic hepatitis and liver failure, more so in patients that are immunocompromised.
There is no vaccination. It is a notifiable disease and Public Health need to be notified of all cases.
