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GI > Viral hepatitis > Flashcards

Viral hepatitis Flashcards

1
Q

What are the 5 types of heatitis viruses?

A

A, B, C, D and E

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2
Q

How is hepatitis A spread?

A

Faecal-oral spread
Due to poor hygiene or overcrowding
Clusters in gay men and PWID

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3
Q

What is the clinical presentation of hepatitis A?

A

Acute hepatitis, no chronic infection

Peak incidence of symptomatic disease in older children/ young adults

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4
Q

How is hepatitis A diagnosed?

A

Lab confirmation of acute infection via the presence of hepatitis A IgM

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5
Q

How is hepatitis A controlled?

A

Good hygiene

Vaccine prophylaxis

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6
Q

Where is hepatitis E common?

A

In the tropics `

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7
Q

How is hepatitis E transmitted?

A

Faecal-oral transmission
Evidence of chronic infection in pigs
Cases in UK are though to be zoonosis

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8
Q

Who can get hepatitis D?

A

Only found with Hep B, it is a parasite of a parasite and exacerbated hep B infection. It is a co-infection or superinfection

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9
Q

How is Hep B transmitted?

A

Sex
Mother to child
Blood

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10
Q

When are chronic infections likely to occur in hep B?

A

If first exposure is in childhood

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11
Q

Who is at high risk in the UK for infection of Hep B virus?

A

People born in areas of high prevalance
Multiple sexual partners
PWID
Children of infected mothers

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12
Q

What does hepatitis B surface antigen (HBsAg) show?

A

Indicates a patient is infected and infectious. More than 6 months indicates a chronic infection

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13
Q

What does Hepatitis B e antigen (HBeAg) show?

A

Usually high in highly infectious individuals

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14
Q

What does Hep B virus DNA show?

A

Predicts prognosis and infectivity

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15
Q

What does hep B IgM show?

A

Recently infected - acute cases

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16
Q

What is present in people who are immune to hep b?

A

Anti-HBs

17
Q

How is hepatitis B controlled?

A

Minimise exposure: safe blood, safe sex, needle exchange, prevention of needlesticks, screening of pregnant women
2 pre-exposure vaccination strategies
Post-exposure prohpylaxis - vaccine plus hyperimmune Hep B immunoglobulin

18
Q

How is Hep C transmitted?

A

Similar to Hep B but no vaccine avaliable

19
Q

What defines a chronic infection?

A

6 months of infection

20
Q

How is hepatitis C diagnosed?

A

Test for antibody to hepatitic C virus, is it positive this indicates a pat or active infection and then need to test for Hep C viruse RNA via PCR

21
Q

What does it mean if the hep C RNA is found via PCR?

A

Active infection

22
Q

How is hepatitis C controlled?

A

No vaccine, minimise exposure

23
Q

How is acute viral hepatitis managed?

A

No antiviral, monitor for encephalopathy and monitor for resolution
Notify public health
Immunisation of contacts if poss
Test for other infections

24
Q

What are notifiable diseases?

A

Those that are vaccine preventable, and others that can cause outbreaks or public alarm or high mortality

25
Q

What are the common antivirals used in HBV therapy?

A

Adefovir

Entecavir

26
Q

How is chronic viral hepatitis managed?

A 
Antivirals
Vaccination 
Infection control
No alcohol
Hepatocellular carcinoma awareness
27
Q

Who should be treated for chronic infection?

A

HCV RNA present

HBsAG and Hep B DNA present

28
Q

When should hepatitis be treated?

A

Before complications

When evidence of inflammation

29
Q

What are the adverse effects of peginterferon?

A

Flu like symptoms
Thyroid disease
Autoimmune disease
Psychiatric disease

30
Q

What are the virological benefits of chronic hep B therapy?

A

Reduction in HBC DNA (suppression)
Loss of HBeAg
Loss of HBsAg (cure)

31
Q

What are the other benefits (not virological) of hep B treatment?

A 
Imrpoved liver biochemistry 
Improved histopathology 
Reduced infectivity 
Reduced progression to cirrhosis and primary HCC 
Reduced mortality
32
Q

What are the principles of HCV therapy?

A

Genotype of virus and viral load
Genotype of patients interferon response genes
Stage of disease
Past treatment experience

GI (42 decks)

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