Viral hepatitis Flashcards
What are the hepatitis viruses?
Hep A, B, C , D, E
How is Hepatitis A spread?
Faecal-oral spread Poor hygiene/overcrowding Some cases imported Some clusters gay men and Injecting Drug Users
What are the clinical features of Hep A?
Acute hepatitis, no chronic infection
Peak incidence of symptomatic disease in older children / young adults
Relatively short incubation period
Mild illness, full recovery usual
How is acute infection of Hep A confirmed?
Lab confirmation.
Clotted blood for serology (gold top vacutainer)
same sample for all causes of viral hepatitis
Hepatitis A IgM (usually detectable by onset of illness)
How is Hep A controlled?
Hygiene
Vaccine prophylaxis
Where is Hep E found?
More common in tropics
Has become more common than Hep A in UK
What are the clinical features of Hep E?
Acute hepatitis, but immunocompromised humans can become chronically infected
How is Hep E transmitted?
Faecal-oral transmission
There is evidence of chronic Hep E infection in which animals?
Pigs
What are the Hep E cases in the UK thought to be?
Zoonoses
Is there a vaccine available for Hep E?
No
When is Hep D found?
Only found with Hep B
It exacerbates the Hep B infection
How is Hep B transmitted?
Sex
Mother to child (from blood during delivery)
Blood
When is chronic Hep B infection more likely to result?
Chronic infection more likely to result if first exposure is in childhood
What people in the UK are at higher than average risk of contracting Hep B?
Ethnic minorities
Multiple sexual partners
Injecting drug users
Children of infected mothers
How is Hep B confirmed in the lab?
Hepatitis B surface antigen (HBsAg) present in blood of all infectious individuals
the surface antigen is present for more than 6 months in chronic infection
Hepatitis B e antigen (HBeAg) usually also present in highly infectious individuals
Hep B virus DNA always also present in high titre (amount) in highly infectious individuals
Hep B DNA tests also used to predict risk of chronic liver disease and monitor therapy
Hep B IgM most likely to be present in recently infected cases
Anti-HBs present in immunity