viral hepatitis Flashcards
how is HAV and HEV tested for
IgM antibody test
how is HCV tested for
have to IgG as no IgM test
how is HBV tested for
surface antigen
what type of virus is HAV
Acute Rna PICORNAVIRUS
how is hav transmitted
faecal oral transmission
which hepatitis have vaccines
hav
hbv
treatment for HAV
supportive treatment
is hav a chronic or acute infection
only acute as IgG produced gives lifelong immunity after
symptoms of hepatitis
- Loss of appetite
- Yellowing of skin and eyes jaundice
- N&v
- Abdo pain
- Weakness
- Fever
- Joint pain
- Dark urine
- Clay coloured stool
complications of HAV
- 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
incubation hav
30 days 15-50
course of HAV
- anti hav igm in blood
- hav rna in the blood present at onset of symptoms
- igg for life
how is hav excreted
-replicates in the liver, excreted in bile and shed in stools
when is hav peak infectivity
2 weeks period before the onset of jaundice or elevation of liver enzymes
-then declines after the jaundice appears
which hepatitis is dna
hepatitis b
what genotype of hep b is seen in europe
hep a
what is a chronic hepatitis b infection
hep b surface antigen positive for >6 months
how is hep b often transmitted
via vertical transmission
but also blood and sexual
treatment for hep b
interferon alpha and tenofovir
prevalence of chronic infection from acute
5-10% of adults and assoc. to hepatocellular carcinoma
what is HBeAg seroconversion
- 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
why is hep b hard to clear up
it replictaes into host dna
markers of hep b
hbsag hbeag hbv dna viral load hb surface antigen alt and ast hep b core antigen IgG/m
how does hbeag guide treatment 4 steps
- if hbeag positive but no immune active phase- only treat in pregnancy
- if hbeag positive and immune system activated so alt increased then treat
- hbeag negative will have low viral load so don’t treat unless cirrhotic
- hbeag negative but high viral load then treat with tenofovir
high viral load classification for hep b dna
> 20,000
what is given prophylactically for immunosuppressed individuals that are inactive carriers of hep b
lamivudine
prophylaxis after liver transplant with hep b
given immune globulin therapy for first 12 months and then tenofovir long term
most common way of transmitting hcv
parenteral transmission sexual and IVDU
what type of virus is hep c
flaviviridae family
complications of hep c
- chronic infection
- cirrhosis 5 year survival 50%
- hepatocellular cancer-survival 6monthly
treatment hcv
PEGylated interferon
ribavirin
direct acting antivirals
protease inhibitors
nucleoside inhibitors ns5a
non-nucleoside inhibitors ns5b
nucleoside inhibitors ns5b
what are the protease inhibitors
simeprevir previr
what are the ns5a inhbitiors
daclatasvir
svir
what are the ns5b non nucleoside inhibitors
sofosbuvir
buvir
ribavirin side effects
haemolytic anaemia
interferon side effects
-myalgia flu like dermatitis neurtopaenia thrombocytopaenia
efficacy ribavirin and interferon
99%
when are daa’s used then
if failure of above 2 or side effects
hepatitis e acute or chronic
chronic only in immunosuppressed
how is hep e transmitted
faecal oral and undercooked pork
mussels
treatment of hep e
ribavirin if immunocompetent
interferon
hepatitis d diagnosis
use hep b surface antigen as needs hep b to replicate
