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infection > viral hepatitis > Flashcards

viral hepatitis Flashcards

1
Q

how is HAV and HEV tested for

A

IgM antibody test

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2
Q

how is HCV tested for

A

have to IgG as no IgM test

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3
Q

how is HBV tested for

A

surface antigen

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4
Q

what type of virus is HAV

A

Acute Rna PICORNAVIRUS

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5
Q

how is hav transmitted

A

faecal oral transmission

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6
Q

which hepatitis have vaccines

A

hav

hbv

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7
Q

treatment for HAV

A

supportive treatment

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8
Q

is hav a chronic or acute infection

A

only acute as IgG produced gives lifelong immunity after

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9
Q

symptoms of hepatitis

A
  • Loss of appetite
  • Yellowing of skin and eyes jaundice
  • N&v
  • Abdo pain
  • Weakness
  • Fever
  • Joint pain
  • Dark urine
  • Clay coloured stool
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10
Q

complications of HAV

A
  • 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
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11
Q

incubation hav

A

30 days 15-50

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12
Q

course of HAV

A
  • anti hav igm in blood
  • hav rna in the blood present at onset of symptoms
  • igg for life
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13
Q

how is hav excreted

A

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

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14
Q

when is hav peak infectivity

A

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

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15
Q

which hepatitis is dna

A

hepatitis b

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16
Q

what genotype of hep b is seen in europe

A

hep a

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17
Q

what is a chronic hepatitis b infection

A

hep b surface antigen positive for >6 months

18
Q

how is hep b often transmitted

A

via vertical transmission

but also blood and sexual

19
Q

treatment for hep b

A

interferon alpha and tenofovir

20
Q

prevalence of chronic infection from acute

A

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

21
Q

what is HBeAg seroconversion

A
  • 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
22
Q

why is hep b hard to clear up

A

it replictaes into host dna

23
Q

markers of hep b

A 
hbsag
hbeag 
hbv dna viral load
hb surface antigen
alt and ast
hep b core antigen IgG/m
24
Q

how does hbeag guide treatment 4 steps

A
  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
25
Q

high viral load classification for hep b dna

A

> 20,000

26
Q

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

A

lamivudine

27
Q

prophylaxis after liver transplant with hep b

A

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

28
Q

most common way of transmitting hcv

A

parenteral transmission sexual and IVDU

29
Q

what type of virus is hep c

A

flaviviridae family

30
Q

complications of hep c

A
  • chronic infection
  • cirrhosis 5 year survival 50%
  • hepatocellular cancer-survival 6monthly
31
Q

treatment hcv

A

PEGylated interferon
ribavirin
direct acting antivirals

protease inhibitors
nucleoside inhibitors ns5a
non-nucleoside inhibitors ns5b
nucleoside inhibitors ns5b

32
Q

what are the protease inhibitors

A

simeprevir previr

33
Q

what are the ns5a inhbitiors

A

daclatasvir

svir

34
Q

what are the ns5b non nucleoside inhibitors

A

sofosbuvir

buvir

35
Q

ribavirin side effects

A

haemolytic anaemia

36
Q

interferon side effects

A 
-myalgia
flu like
dermatitis
neurtopaenia
thrombocytopaenia
37
Q

efficacy ribavirin and interferon

A

99%

38
Q

when are daa’s used then

A

if failure of above 2 or side effects

39
Q

hepatitis e acute or chronic

A

chronic only in immunosuppressed

40
Q

how is hep e transmitted

A

faecal oral and undercooked pork

mussels

41
Q

treatment of hep e

A

ribavirin if immunocompetent

interferon

42
Q

hepatitis d diagnosis

A

use hep b surface antigen as needs hep b to replicate

infection (15 decks)

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