Viral hepatitis Flashcards
What is hepatitis?
Hepatitis is inflammation of the liver, and there are five main types of viral hepatitis: A, B, C, D, and E.
Each type has its own characteristics regarding transmission, treatment, and vaccination.
Compare the transmission, vaccine, and treatment for the different types of viral hepatitis.
Hepatitis Type:
* Hepatitis A: RNA, Faecal-oral route, Yes, Supportive
* Hepatitis B: DNA, Blood/bodily fluids, Yes, Supportive/Antivirals
* Hepatitis C: RNA, Blood, No, Direct-acting antivirals
* Hepatitis D: RNA, Always with hepatitis B, No, Pegylated interferon alpha
* Hepatitis E: RNA, Faecal-oral route, No, Supportive
How is viral hepatitis reported in the UK?
All viral hepatitis infections are notifiable diseases. The UK Health Security Agency needs to be notified of all cases.
What are some non-viral causes of hepatitis?
Non-viral causes of hepatitis include:
* Alcoholic hepatitis
* Non-alcoholic steatohepatitis (NASH)
* Autoimmune hepatitis
* Drug-induced hepatitis (e.g., paracetamol overdose)
What are the common symptoms of viral hepatitis?
Common symptoms include:
* Abdominal pain
* Fatigue
* Flu-like illness
* Pruritus (itching)
* Muscle and joint aches
* Nausea and vomiting
* Jaundice
What is a ‘hepatitic picture’ in liver function tests?
A ‘hepatitic picture’ refers to high levels of transaminases (AST and ALT) with a proportionally smaller rise in alkaline phosphatase (ALP). High bilirubin levels may also be present, causing jaundice.
What is Hepatitis A, and how is it transmitted?
Hepatitis A is an RNA virus transmitted via the faecal-oral route, often through contaminated food or water. It resolves on its own, but in rare cases, it can lead to acute liver failure.
What are the key markers for Hepatitis B infection?
Key markers include:
* HBsAg (surface antigen): Active infection
* HBeAg (e antigen): Marker of viral replication and high infectivity
* HBcAb (core antibodies): Implies past or current infection
* HBsAb (surface antibody): Implies vaccination or past infection
* HBV DNA: Viral load
How is the Hepatitis B vaccine administered and tested?
The Hepatitis B vaccine involves 3 doses at different intervals. Testing for HBsAb confirms the immune response after vaccination.
What is involved in the management of Hepatitis B?
Management includes:
* Screening for hepatitis B in at-risk populations
* Referral to specialists (gastroenterology, hepatology, or infectious diseases)
* Avoid alcohol and educate about transmission reduction
* Contact tracing and testing for complications (e.g., FibroScan for cirrhosis)
* Antiviral medications and liver transplantation for severe cases
What is Hepatitis C, and how is it treated?
Hepatitis C is an RNA virus spread by blood and bodily fluids. It is curable with direct-acting antivirals (e.g., sofosbuvir, daclatasvir), which cure over 90% of cases in 8 to 12 weeks.
What tests are used for Hepatitis C, and what is its management?
Tests include:
* Screening with HCV antibody test
* Diagnosis confirmed with HCV RNA testing and viral load
Management involves direct-acting antivirals (DAAs) tailored to viral genotype, with a cure rate of over 90%.
What is Hepatitis D, and how is it transmitted?
Hepatitis D is an RNA virus that can only exist in patients already infected with Hepatitis B. Treatment is with pegylated interferon alpha.
What is Hepatitis E, and how is it transmitted?
Hepatitis E is an RNA virus transmitted via the faecal-oral route, typically in contaminated water. There is no vaccine available.
