Viral Hepatitis Flashcards
Besdies the hepatitis viruses, what other viruses can cause hepatitis?
CMV
EBB
HSV
Parvovirus B19
Describe the presentation of Hep A?
aself limited illness with jaundice, fatigue, fever, anorexia, diarrhea, dark urine, pale stools, abdominal pain
How is the spread of Hep A?
fecal-oral
How long is the incubation for Hep A?
15-50 days
2-6 wks
Why has Hep A incidence declined since the 1990s?
a vaccine became available
only 1200 cases in the US in 2014
What are the appropriate serologic tests for HAV?
Total Anti-HAV antibody (indicates acute, previous infections or immunization)
IgM Anti-HAV (indicates acute infection)
Who shoul dbe vaccinated for hep A?
all kids at 1 yo
kids 2-18 yo where routien vacc is implemented
travelers to high prevalence areas
Men who sleep with men
high risk: drug users, occupational exposures
chronic liver disease patients
patients receiving clotting factors
What percentage of the 3-4 million people in the US with hep C are diagnosis?
only 25-50%
What is the rate of chronic hep C infection?
75-85%
What is the rate of chronic liver DISEASE?
60-70%
What is the rate of cirrhosis in the next 20-30 yrs?
5-20%
When can you start to detect viral hep C RNA in the blood?
1-3 weeks post exposure
When can you start to detect hep C antibodies?
can take 20-150 days before you can see the antibodies
Who’s more likely to clear the hep C virus - people who get acutely sick or people who are asymptomatic?
symptomatic patients more likely to seroconvert
so you want to get sick
What are the HCV modes of transmission?
percutaneous exposure to infected blood
sexual transmission (less common)
mother to child (4% risk of trans in preg/labor)
What are the lab test options for HCV?
- screening with EIA/CIA
- Molecular assays (quantitative and genotyping)
- liver biopsy not usually needed
Positive antibody screens for HCV should be confirmed by what? Unless?
usually RNA detection
unless their titer is super high, then you can just go on th eone test
What are the ost common genotypes of HCV in the US?
1a and 1b
2 and 3 less common
What are some reasons for false negative results?
immunosuppression
low levels of anti-HCV Ab
Absence of antibodies against antigens in the test (if they’re directed at a different part of the virus than the test is looking for)
testing in the “window period” - before 11 wks
Is it possible using the antibody screening test for HCV to determine acute, chronic or resolved infection?
no
that’s why you look for the RNA confirmation - is there actually virus in the patient’s blood?
Who should be screened for He pC?
- people born between 1945-1965 (baby boomers)
- hx of IVDU
- Recipients of clotting factor concentrates made before 1987
- recipients of blood transfusions/solid organ transplants before 1992
- Patient who have ever received long-term hemodialysis treatment
- known exposure
- w/ HIV
- kids with HCV moms
What is the goal for treatment HCV?
sustained virologic response (indetectable viral RNA 24 wks after therapy completed) - basically cure now
Is hep B a DNA or RNA virus?
DNA
How does age of infection with HBV affect severity and chronicity?
younger, more likely to go on to chronic
older - more likely to be acutely sicker
