Viral Hepatitis Flashcards
List the viral causes of the viral hepatitis;
HAV- picorna
HBV -Hepdna
HCV- flaviviridae
HDV -Delta
HEV - Calici/herpe
HGV- flavi
List the other viral cause of hepatitis
Tips:4zoonotic virus: 2Neonates, 2 fevers, Nigeria had it in your jss3
Marburg,
Ebola
Lassa fever
CMV in neonates
Herpes simplex in neonates
Yellow fever.
Another name for HBV
Serum hepatitis B virus
When was HBV discoverd
1942, amongst soldiers
Who and when was Au antigen found in serum discovered
1965 by Blumberg
Who used electron microscopy to describe hepatitis B in serum
1970 by D.s Dane
Which is a small hepatotrophic DNA virus that infects only humans
Hepatitis B virus
What is the major cause of Chronic liver, hepatocellular carcinoma and polyarteritis nodosa.
Hepatitis B virus
Infection of HB can be Acute or chronic T/F
True
List the extraheptic manifestation of HBV
Polyarteritis Nodosa,
Arthritis
Pericarditis
Glomerulonephritis
Transient serum sickness
◀️◀️◀️◀️◀️INTRODUCTION
EPIDEMIOLOGY▶️▶️🔜
Tips:
List it’s position in the world’s death
Mention the number of people that have it per year.
Mention it’s Antigenic cause
Mention the metrics (million)in a chronic conditions.
List the percentage distribution in a locality
What’s the position of HBV in the world death
9th
How many people have HBV in a year
About a million
How many people present with HBV chronically globally
350million
What’s the causative antigen
Hepatitis B surface antigen (HBSag)
What’s the distribution in Sub- Saharan Africa and East Asia
More than10% of population has it.
CLASSIFICATION 🔜🔜
How many subgenotype does HBV have ?
8
Which geographic location has Subtype A
Tip cAbin
Cameroon
Burundi
India
Norway
Which geographic location has Subtype B
CV…..
China
Vietnam
East Asia - Korea
Societal island
Which geographic location has Subtype C
Top: BC
China and Bangladesh
Which geographic location has Subtype D
Tips: Dinats
Denmark
India
North Africa
Tunisia
Sweden
Which geographic location has Subtype E
Tips: SwedeN
Sweden,
Nigeria
Which geographic location has Subtype F.
Tip: I failed CVS painfully then I columbi it
C- columbia
V- Venezuela
S- spain
Which geographic location has Subtype G
United States
Addendum to EPIDEMIOLOGY
What percentage of acute HBV in adults grows into chronic conditions
5%
What percentage of acute HSV in children grow into Chronic condition
93%
What are the advantage of those previously infected with HBV and cleared it completely?
It confers some kind of immunity against reoccurrence
What is the reason why the carrier rate of HBsAg in this part of the world is in the increase?
This is because of it’s Perinatal transmission
RISK FACTORs🔜🔜
List the risk factors of HSV
Blood transfusion
Through needles/syringes
Tattooing
Perinatal
Multiple sexual partners
MODE OF TRANSMISSION
List the mode of transmission of HBV
▶️ Sexual transmission; having multiple sexual partners
Risk is 30%
◀️ Parenteral transmission; through IV; seen in patients having Hemophilia, renal dialysis,organ transplant.
Risk is 5%
▶️ unknown mode of transmission; 27%
Why does perinatal hepatitis happen
This is due to the absence of exposure prophylaxis to mother’s before delivery, so they transmit to child
Rate the percentage of infectiveness and chronicity ,when mother has positive HBsAg and HBeAg
70-90% are infected
90% becomes chronic carries…
This is because of the replicating and infective power of HBeAg
What is the percentage of infectiveness and chronicity when mother has positive HBsAg
<10% of infant is infected
But 90% of infected infants are chronic carriers
REPLICATION
CLINICAL FEATURES 🔜🔜
What is the incubation period of HBV
120days on an average
45-160days
Which age group in children are likely to have jaundice and in what percentage
> 5yrs
Percentage: 30-50%
Which age group in children are not likely to have jaundice and in what percentage
<5yrs
Percentage= <10%
At what percentage does acute phase lead to death
0.5-1%
Using the age 5 yrs as a middle man which age is likely to have chronic infection and their percentage?
<5yrs
25-90%
Using the age 5 yrs as a middle man which age is not likely to have chronic infection and their percentage?
> 5yrs
6-10%
What percentage of premature mortality can be gotten from chronic liver disease
15-25%
List the clinical presentation of HBV
Prodrome: fever, malaise, nausea, vomiting, diarrhea.
Jaundice may occur but Anicteric hepatitis is more common i.e hepatitis without jaundice.
Chronic infection complications; Liver cirrhosis, hepatocellular carcinoma
What are the features of Acute phase HBV
It is a new infection
Symptoms are more common in adults
Children are symptomatic
Infection resolves in someone in immunity
Infection can persist and continues into chronic phase
What are the features of Chronic HBV infection
Individual carry it for more than 6months
Virus doesn’t develop anti- HBsAg
It’s a silent infection
Affects children more commonly
What is the most common symptom of active carrier state in pts with HBV
Fatigue
In inactive carrier state what amount of DNA copies are seen per mililiter
0-30,000copies
GOALS OF ANTIVIRAL TREATMENT OF CHRONIC HBV
List the targets of sustained suppression of HBV replication
To reduce the HBV DNA serum level to.
<10^5
To clear HBeAg to Anti-HBE seroconversion
To clear HBSAg to Anti-HBs seroconversion
List the targets of Remission of liver disease
To reduce serum ALT levels
To reduce serum Alkaline phosphatase levels
To decrease necroinflammation of the liver
List the goals target to improve clinical outcomes
To reduce cirrhosis development
To reduce liver failure
To reduce hepatocellular carcinoma
To increase survival
TREATMENT
List the approved drugs for HBV treatment
Interferon alpha2b
Peginterforn alpha 2a
Telbivudine
Lamivudine
Entecavir
Adefovir
Tenofovir DF
Emtricitabine/ tenofovir combination.
