Viral Hepatitis Flashcards
What is hepatitis
Inflammation of the liver
What types of viruses are Hep B and C and what are their incubation and ways transmission
Hep B - enveloped dsDNA, transmission by blood/sex/vertical, incubation is 6wks to 6mths
Hep C - enveloped ssRNA, transmission by blood/sex, incubation is 6-12 wekks
What are the types of jaundice and give an example of a cause for each
Prehepatic - haemolysis
Intraheptaic - viral hepatitis
Extrahepatic - common duct stones
Which LFTs are used to determine the liver function
Bilirubin count
Liver transaminases - ALT (alanine transaminase), AST (aspartate aminotransferase)
Alkaline phosphatase (ALP)
Albumin
Coagulation test
What are the symptoms of acute Hep B
Jaundice
Fatigue
Abdominal pain
Anorexia
Nausea
Vomiting
Arthralgia
Describe what can be seen in the serology of a patient with Hep B from infection to clearance
- HBsAg is seen first, showing the patient is infected
- HBeAg seen next, this is the point when the patient is highly infectious
- HBcAb IgM is seen next, being the first antibody to be seen, shows the infection is starting to be cleared
- HBeAb follows, this causes the disappearance of e-antigen and decreases infectivity
- HBsAb is final antibody to appear showing clearance of virus and recovery of the patient
- HBcAb IgG is persists once the infection is cleared, persisting for life
What is the definition of a chronic Hep B infection and what can it cause
It is the persistance of HBsAg after 6 months - where it should have been removed
Chronic infections can cause cirrhosis and hepatocellular carcinoma
What is the treatment for acute Hep B
There is not any treatment as infection clears within 6 months
Treat any symptoms
What is the treatment for chronic Hep B
There is no cure since the virus integrates into the host’s genome
Give life-long antivirals to suppress viral replication - reduce risk of further complications like cirrhosis
What is given in a Hep B vaccination
Genetically engineered surface antigen - patient only produces surface antibody from this
How do Hep C infections usually progress
Large proportion become chronically infected
May develop chronic liver disease, cirrhosis, hepatocellular carcinoma
What are the symptoms of Hep C
80% do not have any symptoms
Symptoms:
Fatigue
Anorexia
Nausea
Abdominal pain in RUQ
What antibody is found in Hep C patients and what is special about it
Anti-Hep C antibody
Remains positive throughout life but is not protective so the patient can be re-infected
What is the treatment and vaccine for Hep C
Use a directly acting antiviral drug combonation for 8-12 weeks
But there is no vaccine
