Viral hepatitis

Question 1

who is more likely tot get HAV and what is its transmission

Answer 1

MSM and PWID - older children and young adults

faecal oral

Question 2

how is HAV confirmed in lab

Answer 2

bloods

HAV IgM serology

Question 3

HEV is more/less common than HAV and has/doesnt have a vaccine

Answer 3

more common

no vaccine

Question 4

whos at risk of HDV and transmission

Answer 4

multiple sexual partners, children of infected mums, PWID, african, asian
sex, blood, mother to child

Question 5

how common is HDV

Answer 5

rare

Question 6

what figures may indicate a patient with HBV is more likely to need antivirals

Answer 6

raised alanine aminotransferase

raised HBV DNA

Question 7

what antigen is present in all HBV cases

Answer 7

HBsAg

Question 8

what antigen is present in highly infectious patients with HBV

Answer 8

HBeAg

HBV DNA

Question 9

what is present in those with recent HBV

Answer 9

HBV IgM

Question 10

true/false - chronic HBV may see spontaneous cure

Answer 10

true

Question 11

how do you manage acute viral hepatitis

Answer 11

supportive care
notify PH
Monitor for resolution/encephalopathy

Question 12

who do you treat with antivirals?

Answer 12

chronic infection - HCV RNA/HBsAg/HBV DNA
those at risk of inflammation/fibrosis
cirrhosis priority 
HIV priority 
Cancer contraindication

Question 13

how is increased liver inflammation seen in viral hep

Answer 13

increased ALT

Question 14

treatment options for HBV

Answer 14

suppressive antiviral

OR peginterferon alpha for cure attempt

Question 15

HCV therapy?

Answer 15

antivirals until SVR

2/3 antivirals for 12 weeks, oral, inferferon free

Question 16

how do you choose an antiviral for HCV

Answer 16

viral load/genotype 
stage disease
past treatment experience 
side effect/interaction
cost

Question 17

what % cases HCV should reach SVR

Answer 17

90%