Viral hepatitis Flashcards
What are the causes of hepatitis
Non-infectious:
- Alcoholism
- Autoimmune disease
- Drugs
- Toxins
Infectious causes
- Viruses
- ….
List the different types of hepatitis virusses and their transmission
Hep A - Feacal oral
Hep B - Parenteral
Hep C - Parenteral
Hep D - Parenteral
Hep E - Feacal oral
How is HAV diagnosed
Serology: Stool sample needed and intact immune system - Be careful in immunosuppressed patient
- IgM
- IgG
Reverse transcription polymerase chain reaction (RT-PCR)
What is the prevention and prophylaxis for HAV
No treatment
Adherence to sanitary practiises
Heating foods appropriately
Chlorination of water
Vaccines - Inactivated HAV vaccines
HAV immunoglobulins
How is HEV diagnosed
Serology:
- IgM/IgG anti-HEV in the serum by ELISA
HEV PCR
What is the prevention and prophylaxis for HEV
Improved public hygeine
Prevention of zoonotic spread
No vaccine or immunoglobulins
How is HBV transmitted
Parenteral
Horizontal transmission
Vertical
Sexual
How is HBV diagnosed
Direct markers:
- HBsAg: Surface antigen - Used for determining acute infection
- HBeAg - Soluble e Antigen
- HBV DNA
Indirectr markers
- Anti-HBs: Used for determining immunity
- Anti-HBe
- Total Anti-HBc
- Anti-HBc IgM
How is chronic HBV defined
Presence of HBsAg for longer than 6 months
What is the treatment for HBV
– interferon alpha and pegylated interferon alpha 2a
– lamivudine* / emtricitabine*
– tenofovir*
– adefovir
– entecavir
– telbivudine
Explain prevention of HBV
Pre-exposure prophylaxis:
* HBV vaccination – part of EPI
Post-exposure prophylaxis
* HBV vaccine plus HBV immunoglobulins
– Needle stick injury and other exposures – administer both within 72 hours
– Infants of HBsAg-positive mothers – administer vaccine at birth and HBV immunoglobulins within 12 hours after birth
What is the HDV impact on a HBV infection
Increases progression to liver cirrhosis
Increases chronicity rate and mortality rate
Complicated treatment plan of HBV as HDV only responds to interferon alpha
What are the transmission routes for HCV
Parenteral
Vertical
Sexual
How is testing done for HCV
Serological assays: Total antibodies
HCV RT-PCR: Confirmatory test
How is HCV treated
Pegylated interferon and ribavirin
Protease (NS3/4A) inhibitors – e.g. simeprevir
Polymerase (NS5B) inhibitors
✓ Nucleotide analogue – e.g. sofosbuvir
✓ Non-nucleotide analogue – e.g. dasabuvir
NS5A inhibitors – e.g. daclatasvir
