Viral Hepatitis Flashcards
What non-hepatitis viruses can cause Hepatitis ?
CMV/ EBV
many others
What is the incubation period of Hepatitis A?
A: 2-6 Weeks
Usually 28-30 days
What test are done to diagnose acute Hep A infection
When do antibodies against hepatitis A generally increase?
When should it not be requestted in?
Might only increase in first week of symptoms
Only sent If ALT >500 sent (not under - unlikely to be positive.
Might be up to up to 14 Weeks
What is the general treatment approach for acute hepatitis A?
Largely supportive care
Vaccine for prevention
Live attenuated and inactivated preparations
How long a patients with acute hepatitis A infectious for?
2 weeks pre-symptom onset and
for 1 week after onset of
jaundice
* Advice for patient: stay off work for
7 days from onset symptoms
+ Notifiable disease
What is the incubation period of the hepatitis viruses?
A: 2-6 Weeks
B: 2-6 months
C: 2 Weeks - 6 m onthts
E: 2-8 week s
What is the likelihood of progression of acute hepatitis B to chronic hepatits?
If under 5 years: 90% (+acute infenction asymptomatic)
In adults 10% chronic hepatitis (and 20-40 sympaomtaitC)
Recall the differnt Hepatitis B serological markers that can be measured and explain what they mean
What is the surveillance of chronic Hep B infected people with cirrhosis to detect hepatocellular carcinoma?
AFP and liver USS every 6 months
What is the teratment for Hep B?
Generally reserved for chronic Hepatitis B with aim to reduce complications –> long-term oral therapy with antivirals unti HBsAg negative (can be indefinite)
- Peppyglafted INF alpha but low tolerability (injections for 48 weeks + loads of side-effects)
- Antivirals (similar to HIV)
* Lamivudine (nucleoside analogue)
* Entecavir (nucleoside analogue)
* Telbivudine (nucleoside analogue)
* Tenofovir (nucleoTide analogue)
How is vertical transmission Hepatitis B prevented ?
If Mother is
1. HBsAg positive, eAg-ve = low viral load accelerated couse of vaccine (Vaccine at birth + at normal intervals)
2. HBsAg positive, eAg positive , high viral load vaccine at birth and IvIg for Hep B
What is the main route of transmission of Hepatitis C?
Mainly via parenteral
* needle sharing
* blood products + needle stick
(rare transmission sexually)
What is the likelihood of progression of acute hepatitis C to chronic hepatits?
40-60% will progress to chronic
(many are asymptomatic)
What is the diagnostic test for suspected acute hepatitis C infection?
HCV RNA (as antibodies take 4 weeks to develop)
(If RNA negative –> no acute or chornic hepatitis C infection)
((anti-HCV Ab develops after acute infection))
What is the treatment for Hep C?
12 week course of antivirals
prevention of recurrent infeciton via risk behaviour
Usually a combination of 2 antivirals for 12 Weeks:
- NS3/4 protease inhibitors (-previrs,
block translation): telaprevir, boceprevir,
simeprevir, asunaprevir (learn one or two) - NS5A inhibitors (-asvirs, block release):
ledipasvir, daclatasvir - Direct polymerase inhibitors (-buvirs, block replication): Sofosbuvir, dasabuvir
What are some of the extra-hepatic manifestations of hepatitis E?
