Viral Hepatitis Flashcards
1
Q
Presentation?
A
- usually asymptomatic
- abdo pain
- fatigue / malaise
- fever
- jaundice
- pruritus
- muscle & joint aches
- N&V
2
Q
Ix?
A
- raised transaminases
- mildly raised ALP
- may be raised billirubin
3
Q
Hepatitis A
- Core? DNA or RNA
- Transmission
- Ix
- Mx
- Prognosis
- Public Health
A
- RNA virus
- Transmission by foecal-oral route
- contaminated water or food
- Ix
- HAV IgM
- Mx
- supportive
- Prognosis
- resolves without treatment in 1-3months
- Public Health
- vaccine available & must notify public health
4
Q
Hepatitis B
- Core? DNA or RNA
- Transmission
- Ix
- Mx
- Prognosis
- Public Health
A
- DNA virus
- Transmission by blood-borne, vertical and parenteral
- sexual, sharing needles, via mouth
- Ix- next card
- Mx
- screen for other BBV
- Refer to Gastro
- education about reducing transmission & informing potential at risk contacts
- testing for complications ie cirrhosis
- anti-viral medication –> slows progression of disease & reduces infectivity
- liver transplant for end stage liver disease
- Prognosis
- 10-15%- chronic Hep B
- Public Health
- notify public health
- vaccination available
- injecting HbsAg
- test for HbsAb to confirm response to vaccine
- requires 3 doses at 3 different intervals
5
Q
Ix for Hep B?
A
- Antigens
- Surface antigen – HbsAg
- Active infection (acute or chronic)
- E antigen HbeAg
- Current infection (highly infectious)
- If present = acute phase where virus replicating quickly
- Levels correlate with infectivity
- Core antigen HbcAg
- Surface antigen – HbsAg
- Antibodies
- Surface Ab – HbsAb
- Immune response to HbsAg
- If +ve= person vaccinated or infected
- E antibody HbeAb
- If +ve= been through active infection
- If +ve but HbeAg –ve: been through acute phase and now less infectious
- Core antibody HbcAb
- Indicator of past or present infection
- IgM & IgG measured
- IgM- acute infection
- IgG-lingers after infection
- Surface Ab – HbsAb
6
Q
Hepatitis C
- Core? DNA or RNA
- Transmission
- Ix
- Mx
- Prognosis
- Public Health
A
- RNA virus
- Transmission by blood & bodily fluids
- Ix
- screening: HCV antibody
- confirm diagnosis: Hep c RNA testing on PCR
- Mx
- as Hep B
- Pegylated interferon & ribavarin (90% cure rate)
- Prognosis
- 75% becomes chronic if not treated
- Public Health
- notify
- no vaccine available
7
Q
Hepatitis D
- Core? DNA or RNA
- Transmission
- Ix
- Mx
- Prognosis
- Public Health
A
- RNA virus
- Can only survive in pts with Hep B virus
- Mx: supportive
- Public Health
- notify
- no vaccine
8
Q
Hepatitis E
- Core? DNA or RNA
- Transmission
- Mx
- Prognosis
- Public Health
A
- RNA virus
- Transmission: faecal-oral route
- Mx: virus cleared within a month, no treatment required
- Prognosis: rarely progresses to chronic hepatitis & liver failure
- Public Health
- no vaccine
- notify piblic health
9
Q
so in summary: viruses that may progress to chronic hepatitis?
A
B,C & E
