Viral hepatitis Flashcards
clinical signs of hepatitis
Typically malaise, myalgias, arthralgias, fatigue, anorexia, N/V/D
this type of hep has no chronic form
hep A
jaundice is seen in this age group MC with hep A
> 14 70-80% have jaundice
how do you get hep A
fecal oral
how do most hep A outbreaks occur in the US?
community wide outbreaks
how to prevent hep A
- hand washing
- vaccine
- immune globulin if exposed
- IVF/supportive care
IgM vs
IgG
acute phase
past exposure
you are way more likely to get this disease than HIV from a needle stick
Hep B
Risk of Chronic Infection After Acute Exposure is highest in
newborns of HepBeAg+ mothers
Actively replicating virus in the body (HBeAg), if mother has this then newborns are very likely to get chronic hep B
this is used to monitor antiviral therapy for Hep B
HBV DNA
this is the main test for Hep B and earliest indicator of acute Hep B infection
HBsAg
Response to surface antigen, this means you cleared it or have immunity
HBsAb or anti-HBsAg
Hep B virus is replicating and very infectious
HBeAg
Hep D requires
Hep B, treat Hep B and D will go away
Negative RNA indicates recovery
progression to chronic hep B is shown when
HBsAg is present forever
extrahepatic manifestations of hep B
Polyarteritis Nodosa (bumps under skin) glomerulonephritis
how to tx Hep b
acute-no tx required
fulminant/chronic-antivirals
as the pts ALT levels increase in response to chronic Hep B if HbEAg is +
more monitoring is required
Lamivudine (Epivir) Adefovir dipivoxil (Hepsera)
Nucleoside analog
less mutation shown
interferon
bad side effects, pt feels crappy
Entecavir (Baraclude)
guanosine analogue
very low mutation rate
Tenofovir (Viread)
nucleotide analog approved for HIV and Hep B
how do we define efficacy of tx
- termination of Hep B virus replication
- cessation of chronic liver injury
- disease free state
Most common blood-borne infection in U.S.
Hep C
- Leading cause of cirrhosis/chronic hepatitis/Hepato- Cellular Carcinoma in U.S
- commonly asymptomatic
