Viral Hepatitis Flashcards
How many different types of Viral Hepatitis exist?
- 5
- Hep A, B, C, D, E
How is Hepatitis A spread?
- Faecal-oral spread
- More common if Poor hygiene/overcrowding
- Some clusters of cases in MSM and PWIDs
People can be Hep A carriers. TRUE/FALSE?
FALSE
- Hep A is always acute
- no chronic infection
At what age are patients with Hep A more likely to present symptomatically?
- older children / young adults
- Infants often ASYMPTOMATIC
How is Hep A infection confirmed in the lab?
- Clotted blood for serology (gold top vacutainer)
(same for all viral hepatitis) - Hepatitis A IgM
How is Hep A prevented?
- Hygiene Control
- Vaccine prophylaxis (esp. before going to high risk country)
How long does it take for the Hep A vaccine to take effect?
10 days
What other subtype of Hepatitis presents in a clinically similar way to Hepatitis A?
Hepatitis E
- More common in tropics
- also faecal-oral transmission
Hep E is more common than Hep A in the UK. TRUE/FALSE?
TRUE
Hep E can become chronic in certain patients. Which group is most affected by this?
- immunocompromised
Hepatitis D only co-exists with which other subtype of Hepatitis?
Hep B
Hep D exacerbates Hep B infection. TRUE/FALSE?
TRUE
- becomes like a super infection
How can Hep B be transmitted?
- Sex
- Mother to child
- Blood to blood
Who is at higher risk of developing Hep B?
- if born in countries of high prevalence (e.g. Africa etc)
- Multiple sexual partners
- People who inject drugs
- Children of infected mother
What makes a patient more likely to experience chronic Hep B infection?
- more likely to get chronic infection if first exposure is in childhood
How is Hep B infection confirmed in the lab?
- Surface antigen (HBsAg) present if pt is infectious
- HBeAg present in highly infectious individuals
- Hep B virus DNA high titre in highly infectious individuals
- Hep B IgM present in recently infected cases
- Anti-HBs present in immunity
HOw is Hep B controlled/ prevented?
- Minimise exposure => safe blood => safe sex => needle exchange => screening of pregnant women
- Post-exposure prophylaxis if exposed
=> vaccine + HepB Ig
The transmission routes of Hep C is similar to that of Hep B. TRUE/FALSE?
TRUE
- it is less readily transmitted by sex than Hep B
WHat percentage of Hep C infection becomes chronic? How long does it take for the infection to become chronic?
75%
- 6 months is considered chronic infection
There is no vaccine to prevent Hep C. TRUE/FALSE?
TRUE
What consequences can occur after Hep C infection and how long does this progression take?
Cirrhosis = >20 years
Hepatocellular carcinoma = >30 years
How is Hep C infection tested for?
Test for antibody to Hepatitis C virus
If positive: Test for virus RNA by PCR
If RNA Positive => active infection
If RNA neg. => past infection
Patients will only develop liver disease from Hep C if they have an active infection. TRUE/FALSE?
TRUE
- beware of PWIDs getting recurrent infections if they keep injecting
How is acute viral hepatitis managed?
- NO antivirals given
- Monitor for encephalopathy or resolution
- Notify Public Health
- Immunisation of contacts
- Test/ vaccinate against other infections if at risk
