Viral Hepatitis Flashcards
What are the acute forms of hepatitis?
A and E
What are the acute and chronic forms of hepatitis?
B, C, and D
What is the only way that Hep D can occur?
In patients that also have hep B
What are the s/sx of hepatitis?
Often asymptomatic N/V Splenomegaly Elevated liver enzymes Weight loss Fatigue Fever Jaundice RUQ pain
What is the route of transmission of Hep A?
Oral-Fecal
What are the RFs of Hep A
Area w/poor sanitation
Poor hygenic practices
IV drug use
Homosexual activity in men
Is there a chronic form of Hep A?
no
What is the prevention for Hep A in at risk children and adults?
Havrix
Vaqta
Twinrix
What is twinrix?
Combo HAV and HBV vaccine
Is there IgG available for pre- and post-exposure prophylaxis for Hep A?
Yes
What is the diagnostic criteria for Hep A?
HAV IgM
What is the outcome of Hep A?
Rarely fatal
What is the route of transmission for Hep B?
Blood
Bodily secretions
What are the RFs for Hep B?
IVDU
Sexual activity
Occupational exposure to infected blood or bodily secretions
Uterine exposure to infected female
Is there a chronic form of HBV?
Yes 10%
Who gets screened for HBV?
Patients w/RF
Pregnant females
Pts with HCV or HIV
What is the prevention for at risk children and adults for HBV?
Energix-B
Recombivax HB
Twinrix
Is IgG available for pre- and post-exposure prophylaxis of HBV?
Yes
What are the diagnostic criteria for HBV?
HBsAg
HBcAb
HBeAg
HBV DNA
What is the outcome of HBV?
Hepatocellular carcinoma or cirrhosis
What is the route of transmission for Hep C?
Blood
What are the RFs for Hep C?
IVDU
Blood transfusion prior to 1992
Intranasal drug users who share paraphernalia
Tattoos or body piercings if performed without proper infection control practices
Is there a chronic form of Hep C?
Yes (80%)
What is the screening for Hep C?
Illicit drug use Blood transfusion prior to 1992 Blood clotting factors prior to 1987 Unexplained elevated liver enzymes Organ transplant Children born into HCV infected mothers Occupational exposure to HCV infected blood or needle stick In 2012, CDC and USPSTF recommended a 1x screen for all baby boomers
Is there prevention for at risk children and adults with HepC?
no
Is IgG available for pre- and post-exposure prophylaxis?
No
What are the diagnostic criteria for HepC?
HCV RNA
Anti-HCV
What are the outcomes of HCV?
Cirrhosis
Cancer (less common)
What is HBsAg?
Hepatitis B surface antigen
Surface protein of the HBV that is used as a marker to detect infection. If this blood test is positive, then the HBV is present
What is HBsAb or anti-HBs?
Hepatitis B surface antibody
The antibody formed in response to the surface protein of the Hep B virus. It can be produced in response to vaccination or recovery from an actual hep B infection. If this test is positive, then the immune system has successfully developed a protective antibody against the HBV that provides long-ter immunity
What is HBcAb or anti-HBc?
Hepatitis B Antibody
The antibody only refers to a part of the virus itself; it does not provide any protection or immunity against HBV. This test is often used by blood banks to screen blood donations. A positive test indicated a person may have been exposed to the HBV, but the result can only be confirmed in relationship to the above two tests
What is HBeAg?
Hepatitis B e Antigen
A marker of a high degree of HBV infectivity, it correlates with a high level of HBV replication. It is primarily used to help determine the clinical management of patients with chronic HBV infection
What is HBV DNA?
A marker of viral replication. It correlates well with infectivity. It is used to assess and monitor the treatment of patients with chronic HBV infection
What are drugs for HBV?
Pegylated interferon
Nucleos(t)ide Reverse Transcriptase Inhibitors
First line agents
Other agents
What are the first line agents for HBV?
Entecavir
TNF/TNF-alafenamide
How are TNF and TNF-alafenamide related?
TNF-alafenamide is a pro-drug of TNF and has less SE related to the kidneys and bone
TNF-alafenamide is shown to be non-inferior