Viral Hepatitis Flashcards
How is `Hep A spread and what is its incubation period
Faecal oral
2-6 weeks
Diagnostic test of Hep A
anti-HAV IgM
Acute infection- IgM reactive, unlikely if bilirubin is below 30
Past infection- IgM non reactive, IgG reactive
Route of Transmission of HBV
o Sexually transmitted
o Blood products
o Mother-to-Baby (vertical)
Chances of HBV causing a chronic infection
o Adults have a 5-10% chance of developing chronic infection
o Babies have a 95% chance of developing chronic infection
o Incubation period: 2-6 months
Serology of HBV
Acute infection- HBsAg, antiHbc Igm
Chronic infection, HBsAg, antiHbc IgG
Vaccinated- AntiHbS
Past infection- AntiHbS, antiHbc IgG
Consequences of HBV infection
o Hepatic fibrosis cirrhosis HCC
o Most common cancer associated = Hepatocellular carcinoma (HCC)
o It tends to occur in diseased livers
Chronic HBV Treatment
o Interferon Alpha (used in a subset of patients who look like they are clearing the virus by themselves)
Do not use in patients who may require a liver transplant
o Lamivudine
o Tenofovir
o Entecavir
o Emtricitabine
Treatment to baby in a HBV positive mother
Hep Vaccine and HBIG
Test for hepatocellular carcinoma
AFP levels
HDV infection types
HBC/HDV co-infection- similar to acute HBV, self limitng
If HBV infected and inoculated by HDV- superinfection- more severe can develop cirrhosis in 2-3 weeks
Chances of chronic infection in HCV
60%
HCV serology
HCV RNA is the best way to check whether you have the virus in your blood
Anti-HCV develop after acute infection
Treatment of HCV
• Early treatment with interferon has a HIGH success rate
• NEW HCV drugs / Direct Acting Antivirals (DAAs) cures the majority (94%) of patients
o NS3/4 serine protease
o NS5a RNA
o NS5b RNA dependent RNA polymerase
How is HEV spread
o Faecal-oral route (remember, fAEcal-oral)
It is also a zoonosis – It can be transmitted from animals to humans (mainly pigs)
Shellfish consumption, blood transfusion, sausages, pig liver consumption
Complications of HEV
o CNS Disease (Bell’s palsy, Guillain-Barre)
o Chronic infection
o Very dangerous to pregnant women (esp. in the third trimester)