Viral Hepatitis Flashcards
Acute Infection:
Causes - 3
Transmission
Hep A, B and E
Faecal-oral transmission - food, water and sexual
Chronic infection:
Causes - 2
Which virus can Hep D co-infect with?
Hep B and C
Hep B
Hep B can be both acute and chronic
Chronic infection:
A common route of transmission for Hep C?
Which virus has a vertical (mother-to-child) route of transmission?
Which virus can be contracted via contact of broken skin or mucosa?
Other routes of transmission?
IVDU
Hep B
Hep B
Sex
Needlestick injury for HIV, Hep B and C
Blood products
Unhygienic piercings and tattoos
HBV natural history:
What happens when contracted during childhood?
When does it reappear, why and how?
It is asymptomatic through childhood with normal LFT
20’s
Acute hepatitis
Immune system attempts to clear the infection
S+S - acute hepatitis (HAV, HAB and HEB):
Prodrome symptoms
Main symptoms are peak
How long does it take to resolve?
Fever
Malaise
Anorexia
Nausea
Jaundice Pale stool and dark urine Itch RUQ pain Hepato/splenomegaly Lymphadenopathy
2-6 wks
HBV natural history:
What happens when contracted during childhood?
When does it reappear, why and how?
It is asymptomatic through childhood with normal LFT
20’s
Acute hepatitis
Immune system attempts to clear the infection
HCV:
What is one key feature of this one?
Most patients become chronically infected
DDx - other viruses that could cause infection?
EBV
CMV
HSV
Yellow fever
Non-infectious hepatitis causes - list a few
Obesity and alcohol - NASH, alcoholic hepatitis Autoimmune hepatitis Drugs Ischaemic hepatitis Wilson's
Blood tests for:
HAV
HBV
HCV
HEV
HAV IgM - immunoglobulin
HAB Ag - antigen
HCV Ab - antibodies
HEV IgM - immunoglobulins
HBV:
Transmission - 3
At-risk groups
Blood
IVDU
Direct contact
IVDU Health workers Haemophilliacs Homosexuals Dialysis
HAV:
Transmission - 1
What type of fish can you also get it from?
Faecal-oral
Shellfish
HCV:
Transmission - 3
What does it increase the risk of as it is chronic?
Transfusion
IVDU
Sexual contact
HCC
HDV:
What is needed for it to infect?
How is it prevented?
HBV
HBV vaccine
HEV:
What person has a high mortality if they contract this virus?
Pregnant women
Management:
Who should be notified once infected?
What should happen to contacts?
Public Health England
Screen and vaccinate contacts (HAV and HBV)
Management - Acute infection:
What should be avoided?
What should be given if ALF happens in acute HBV?
Alcohol
Antiviral medication
Management - Chronic infection:
How can transmission be prevented? - 2
What lifestyle advice should be given to prevent HCV progression?
What can be done every 2 years to detect cirrhosis?
What should be screened every 6 months with USS?
What should be monitored every 3 yrs using endoscopy?
Avoiding unprotected sex
Toothbrush sharing
IVDU
Alcohol use
Obesity
HIV co-infection
FibreScan
HCC
Varices
Complications - acute:
What increases the risk of ALF?
What might happen to the kidneys with HBV?
Hep D co-infection
Glomerulonephritis
Vaccination:
Which 2 viruses have vaccines?
Hep A and B
Hep A vaccine:
How long before exposure should it be given?
When should it be repeated once exposed for 10 yr protection?
Indications - list
2-4 wks
6-12 months
Sexual and household contacts Foreign travellers Men who have sex with men Haemophiliacs IVDU
Hep B vaccine:
3 doses are given. When though?
How long does protection last?
Indications - list
How long can you get post-exposure prophylaxis for?
Today, 1 month and 6 months
Lifelong
Sexual and household contacts
Children of affected mothers
Men who have sex with men
HIV + individuals
48 hrs
