Viral Hepatitis Flashcards
Of the hepatitis viruses, which ones are transmitted via faeco-oral transmission?
Which ones are transmitted via blood?
FAECO-ORAL:
Hepatitis A
Hepatitis E
BLOOD-BORNE:
Hepatitis B
Hepatitis C
Hepatitis D
Define acute hepatitis.
Inflammation in the liver
Define chronic hepatitis.
Inflammation in the liver persisting for more than 6 months
What is the incubation period of hepatitis A?
What are the symptoms of acute hepatitis A? (6)
30 days
SYMPTOMS: Fever Abdominal pain Diarrhoea Jaundice Itch Muscle pains
List 2 complications of hepatitis A infection.
Fulminant hepatitis
Relapsing hepatitis
How would you treat hepatitis A? (2)
Self-limiting
Supportive treatment, e.g. hydration
Which 3 serology tests would you do to detect hepatitis A infection?
What does each one indicate?
Hep A IgM
-New infection and acute hepatitis
Viral RNA in blood/stool
-New infection and acute hepatitis
Hep A IgG
- Previous infection or vaccination
- Immunity
How would you diagnose hepatitis A? (3)
Hep A IgM positive
Viral RNA positive
Abnormal LFTs
How is hepatitis A immunity acquired? (3)
Hepatitis A vaccine
Hepatitis A immunoglobulin
Previous infection
Is the hepatitis A vaccine live or inactivated?
Who is it used for? (2)
Inactivated vaccine
Used for:
- High risk groups (e.g. travelers)
- Outbreak control PEP
How long does immunity given by hep A immunoglobulin last?
Who is it used for? (2)
3-6 months
Used for:
- Patients allergic to vaccine
- Household contacts of infected patients
What type of virus is hepatitis B?
What is the most common route of transmission?
Hepadnavirus (DNA)
Vertical transmission (mother-child)
What are the 2 types of chronic carriers of hepatitis B?
What does each suggest about the viral load?
eAg positive (high viral load)
eAg negative (low viral load)
What is the incubation period for acute hepatitis B?
Describe the symptoms of acute hepatitis B. (5)
2-6 months
Fever Fatigue Jaundice (BUT only in 10%) Muscle pain Joint pain
List 4 complications of acute hepatitis B.
Weight loss/cachexia
Abdominal mass (e.g. hepatocellular carcinoma)
Bloody ascites
Chronic hepatitis B
List 5 complications of chronic hepatitis B.
Chronic liver disease Cirrhosis Decompensation Hepatocellular carcinoma Death
How would you treat acute hepatitis B? (1)
Usually self-limiting
How would you treat chronic hepatitis B? (2)
List the indications for treatment. (2)
TREATMENT:
First line: pegylated interferon alpha
Second line: antiviral drugs (e.g. tenofovir, entecavir)
INDICATIONS: Evidence of active infection -Viral load: 2000+ Evidence of inflammation -Fibrosis -Raised LFTs -Biopsy -Cirrhosis
What are the 6 different types of antigens/antibodies detected in hepatitis B serology?
HBV surface antigen (sAg) HBV surface antibody (sAb) HBV core antibody (cAb) e antigen (eAg) e antibody (eAb) HBV DNA
Which hepatitis B serology markers indicate new infection and acute hepatitis?
HBV surface antigen (sAg)
HBV DNA
In hepatitis B serology, what does HBV surface antibody (sAb) indicate?
What does HBV core antibody (cAb) indicate?
Surface antibody (sAb): immunity due to previous infection OR vaccination
Core antibody: (cAb): immunity due to previous infection ONLY
In hepatitis B serology, what does e antigen (eAg) indicate?
What does e antibody (eAb) indicate?
e antigen (eAg): high viral load in chronic carriers
e antibody (eAb): low viral load in chronic carriers
How to you acquire hepatitis B immunity?
Previous infection
Vaccination
HBV immunoglobulin
What type of vaccine is the hepatitis B vaccine?
What does it contain?
Recombinant vaccine
Contains HBV surface antigen (sAg)
