Viral hepatitis Flashcards
What are the different types of viral hepatitis?
Hepatitis A, B, C, D, and E
Describe the illness course of hepatitis A
- Intubation
- Prodromal (3-10d)
- Icteric (1-3wks)
- Convalescent (up to 6/12)
How is hepatitis A transmitted?
Faecal-oral route
State two risk factors for hepatitis A
- Travellers to areas with high prevalence
- Clotting factor disorders
- Men who have sex with men; risky sexual behaviour
- IVDU
- Occupation eg. lab workers; residential institutions
State one complication of hepatitis A
85% make a complete recovery within 3/12
Hep A does not cause chronic liver disease; results in immunity
- Relapsing disease: persistent for several months
- Fulminant liver failure; death
Give four presenting features of hepatitis A
70-95% of adults are symptomatic vs only 5-20% of children <5
- Prodromal: 3-10 days
- Flu-like symptoms
- Anorexia; NaV; RUQ pain
- Headache; cough; sore throat; change in bowel habit
- Icteric: 1-3 weeks
- Jaundice; dark stools and pale urine if cholestasis
- Pruritus; Fatigue; anorexia; NaV
- Hepatomegaly; hepatic tendeness; splenomegaly
- Convalescent: up to 6 months
- Malaise; anorexia; weakness; hepatic tenderness
Outline the management of hepatitis A
Hepatitis A vaccination is available
- Admit if severely unwell
- Otherwise, supportive care
- Rest; stay hydrated
- Simple analgesia as needed
- Metoclopramide or cyclizine for nausea
- Chlorphenamine for pruritus
- Avoid alcohol during acute illness
- Avoid work/school till 7d after onset of symptoms/jaundice
How is hepatitis B transmitted?
- Vertical transmission
- Sexual transmission
- Infected blood or body fluids
- Sharing drug injecting equipment
- Occupational hazard eg. needlestick injuries
- Blood transfusions and blood products
- Tattoos; body piercings; acupuncture
List three risk factors for hepatitis B
- IVDU
- Men who have sex with men; multiple sexual partners
- Sex workers and clients
- Travellers to areas with a high prevalence
- Household contacs with infected individuals
- Clotting disorders; regular blood and product transfusion
- CKD; chronic liver disease
- Occupation eg. healthcare workers
- Prison inmates and staff
List three complications of hepatitis B
>90% of acute hep B resolves with immunity developing
- Fulminant hepatitis; death
- Chronic hepatitis: esp in young children
- Extrahepatic manifestations eg. glomerulonephritis; vasculitis
- Cirrhosis
- Increasing risk of HCC
List three presenting features of hepatitis B
- Prodromal fever; arthralgia; or rash
- Malaise; fatigue; fever; nausea; anorexia
- RUQ pain
- Jaundice; dark urine and pale stools if cholestasis
Acute hep B is asymptomatic in 99% children; 10-50% of adults
Chronic hep B is asymptomatic
Outline the management of hepatitis B
Hepatitis B vaccine available
- Refer to gastroenterology; hepatology; or infectious disease
- Notify the Health Protection Unit
- Supportive care whilst waiting referral
- Rest; stay hydrated
- Simple analgesia as needed
- Metoclopramide or cyclizine for nausea
- Chlorphenamine for pruritus
- Avoid alcohol
How is hepatitis E transmitted?
Faecal-oral route
Typically undercooked seafood or contaminated water
Differentiate between acute and chronic hepatitis C
- Acute:
- HCV up to 6/12
- >60% are asymptomatic
- Chronic
- Continued HCV for >6/12
- Follows 50-85% of acute hepatitis C
Name three complications of hepatitis C
- Acute fulminant hepatitis
- Chronic hepatitis
- Fatigue; anxiety; depression
- Cirrhosis; HCC
- Decompensated liver disease eg. varices; ascites
