viral hepatitis

Question 1

how is HAV and HEV tested for

Answer 1

IgM antibody test

Question 2

how is HCV tested for

Answer 2

have to IgG as no IgM test

Question 3

how is HBV tested for

Answer 3

surface antigen

Question 4

what type of virus is HAV

Answer 4

Acute Rna PICORNAVIRUS

Question 5

how is hav transmitted

Answer 5

faecal oral transmission

Question 6

which hepatitis have vaccines

Answer 6

hav

hbv

Question 7

treatment for HAV

Answer 7

supportive treatment

Question 8

is hav a chronic or acute infection

Answer 8

only acute as IgG produced gives lifelong immunity after

Question 9

symptoms of hepatitis

Answer 9

• Loss of appetite
• Yellowing of skin and eyes jaundice
• N&v
• Abdo pain
• Weakness
• Fever
• Joint pain
• Dark urine
• Clay coloured stool

Question 10

complications of HAV

Answer 10

• fulminant hepatitis 50% fatality when the liver failure acutely- encephalopathy, necrosis, coagulopathy, coma and renal failure
• cholestatic hepatitis obstruction of bile secretion: high bilirubin levels persist for months cause relapsing hepatitis so exacerbations after recovery

Question 11

incubation hav

Answer 11

30 days 15-50

Question 12

course of HAV

Answer 12

• anti hav igm in blood
• hav rna in the blood present at onset of symptoms
• igg for life

Question 13

how is hav excreted

Answer 13

-replicates in the liver, excreted in bile and shed in stools

Question 14

when is hav peak infectivity

Answer 14

2 weeks period before the onset of jaundice or elevation of liver enzymes
-then declines after the jaundice appears

Question 15

which hepatitis is dna

Answer 15

hepatitis b

Question 16

what genotype of hep b is seen in europe

Answer 16

hep a

Question 17

what is a chronic hepatitis b infection

Answer 17

hep b surface antigen positive for >6 months

Question 18

how is hep b often transmitted

Answer 18

via vertical transmission

but also blood and sexual

Question 19

treatment for hep b

Answer 19

interferon alpha and tenofovir

Question 20

prevalence of chronic infection from acute

Answer 20

5-10% of adults and assoc. to hepatocellular carcinoma

Question 21

what is HBeAg seroconversion

Answer 21

• HBeAg negative means the body has produced antibodies so removed envelope
• HBeAg positive means body hasn’t produced antibodies so greater risk of flare up

Question 22

why is hep b hard to clear up

Answer 22

it replictaes into host dna

Question 23

markers of hep b

Answer 23

hbsag
hbeag 
hbv dna viral load
hb surface antigen
alt and ast
hep b core antigen IgG/m

Question 24

how does hbeag guide treatment 4 steps

Answer 24

1. if hbeag positive but no immune active phase- only treat in pregnancy
2. if hbeag positive and immune system activated so alt increased then treat
3. hbeag negative will have low viral load so don’t treat unless cirrhotic
4. hbeag negative but high viral load then treat with tenofovir

Question 25

high viral load classification for hep b dna

Answer 25

>20,000

Question 26

what is given prophylactically for immunosuppressed individuals that are inactive carriers of hep b

Answer 26

lamivudine

Question 27

prophylaxis after liver transplant with hep b

Answer 27

given immune globulin therapy for first 12 months and then tenofovir long term

Question 28

most common way of transmitting hcv

Answer 28

parenteral transmission sexual and IVDU

Question 29

what type of virus is hep c

Answer 29

flaviviridae family

Question 30

complications of hep c

Answer 30

- chronic infection - cirrhosis 5 year survival 50% - hepatocellular cancer-survival 6monthly

Question 31

treatment hcv

Answer 31

PEGylated interferon ribavirin direct acting antivirals protease inhibitors nucleoside inhibitors ns5a non-nucleoside inhibitors ns5b nucleoside inhibitors ns5b

Question 32

what are the protease inhibitors

Answer 32

simeprevir previr

Question 33

what are the ns5a inhbitiors

Answer 33

daclatasvir | svir

Question 34

what are the ns5b non nucleoside inhibitors

Answer 34

sofosbuvir | buvir

Question 35

ribavirin side effects

Answer 35

haemolytic anaemia

Question 36

interferon side effects

Answer 36

``` -myalgia flu like dermatitis neurtopaenia thrombocytopaenia ```

Question 37

efficacy ribavirin and interferon

Answer 37

99%

Question 38

when are daa's used then

Answer 38

if failure of above 2 or side effects

Question 39

hepatitis e acute or chronic

Answer 39

chronic only in immunosuppressed

Question 40

how is hep e transmitted

Answer 40

faecal oral and undercooked pork | mussels

Question 41

treatment of hep e

Answer 41

ribavirin if immunocompetent | interferon

Question 42

hepatitis d diagnosis

Answer 42

use hep b surface antigen as needs hep b to replicate