Viral Hepatitis Flashcards
How is hepatitis A spread
Faecal-oral spread
Shellfish
How is hepatitis B spread
Blood-borne
Sexually transmitted
Childbirth
What immunoglobulins are detectable in hepatitis A
IgG for life (including vaccines)
IgM is detectable immediately following infection
What are the clinical features of hepatitis A
Fever, malaise, anorexia, nausea, arthralgia
THEN:
- jaundice
- hepatosplenomegaly
- adenopathy
What antigens can you test for hepatitis B and what do they show
HBsAg = present 1-6 months after exposure
HBeAg = secreted by active cells. Present 1 - 3.5 months after acute illness. Indicates high infectivity.
HBsAg after 6 months means that the patient is a carrier
How is hepatitis C spread
Blood borne
sexual transmitted
How does hepatitis C present
After exposure to the hepatitis C virus only around 30% of patients will develop features such as:
- a transient rise in serum aminotransferases / jaundice
- fatigue
- arthralgia
What is the investigation of choice for hepatitis C
HCV RNA
Anti-HCV confirms exposure
How can you define chronic hepatitis C
HCV RNA in the blood for >6 months
What is the outcome for hepatitis C
Around 15-45% of patients will clear the virus after an acute infection and the majority will go on to develop chronic hep V
What is the current treatment for hepatitis C
a combination of protease inhibitors with or without ribavarin
What is the main side effect of ribavarin
haemolytic anaemia
Describe the complications of hepatitis A
complications are rare and there is no increased risk of hepatocellular cancer
What is the spread of hepatitis E
faecal oral route
Give some complications of hepatitis b
- chronic hepatitis (5 - 10%), ground glass hepatocytes may be seen on light microscopy
- HCC
- glomerulonephritis
- cyroglobinaemia
- fulminant liver failure
