Viral Hepatitis Flashcards
RNA or DNA, spread
Hep A RNA - faecal oral spread
Hep B DNA - blood borne - blood products, IVDU, sexual, direct
Hep C RNA - blood - transfusion, IVDU, sexual
Hep D RNA - co-infection with HBV
Hep E RNA - faecal oral
Hep A PASIM
P - RNA, faecal oral
A - poor hygeine
S: Nausea, anorexia, vomiting, diarrhoea, weakness, fever, malaise
Then: Jaundice, heaptisplenomegaly, lymphadenopathy
Ix: LFT: raised ALT, AST and bilirubin HAV IgM from day 25
Mx: Supportive
Immunisation available - inactivated protein - booster at 6m
Hep B PASIxMx
P: DNA virus
A: parenteral, sexual, vertical, IVDU, health workers, MSM, haemodialysis, babies of
S: Nausea, vomtiting, diarrhoea, weakness,f ever, arthralgia, urticaria, jaundice, hepatosplenomegaly, lymphadenoapthy
Ix:
HBsAg - present 1-6m after exposure
HBsAb - detectable once HBsAg clears (if alone, vaccinated)
HBeAg - present for >6 months defines carrier status
HBcAb - detectable 1-2 weeks after HBsAg (IgM then IgG)
HBC PCR quantifies viral replication
Mx:
Vaccination - passive immunisation - anti-HBs given
Avoid alcohol
Immunise sexual contact tracing
Antivirals - pegylated interferon, tenofovir
Aim is to clear HBsAg and prevent cirrhosis/HCC
What Hepatitis B serology in incubation Acute Carrier Recovery Vaccinated
Incubation: HBsAg, HBeAg Acute: HBsAg, HBeAg, Anti HBc IgM Carrier: HBsAg, Anti-HBc IgG Recovery: Anti-HBs, Anti-HBc IgG Vaccinated: Anti-HBs
HCV PASIxMx
RNA Spread parenterally - blood transfusion, IVDY, sexual contact S: Jaundice, hepatomegaly Ix: HCV antibody HCV PCR Liver biopsy
Mx:
Alcohol cessation
Antiviral - pegylated interferon alpha
Cx:
Glomerulonephritis,
Chronic infection
HCC
HDV PASIxMx
RNA virus
Co-infection with HBV - HBC vaccination prevents HDV infection
S:
Nausea, vomiting, diarrhoea, jaundice, hepatosplenomegaly, lymphadenoapthy
Ix:
HDV PCR
Anti-HDV antibody
Mx:
Supportive
Antivirals
HEV
RNA virus Faecal oral Like hep A Indochina old men Supportive Improve sanitisation
