Viral Hepatitis

Question 1

Acute Viral Hepatitis

• S/S
• LabDx
• Tx

Answer 1

• S/S: Gen “B” flu-like
• LabDx: AST/ALT 1000-2000; ALT>AST; INC Bili
• Tx: Rest + Fluids

Question 2

Hepatitis A

• Transmission
• Outlook
• LabDx
• Tx

Answer 2

• Tran: Fecal-Oral; NO Prenatal; Not usually sexual
• 99% self-limited; 1% fulminant
• LabDx: AST/ALT > 1000; Alk Phs < 400; Bili < 10; anti-HAV IgM
• Tx: Rest + Fluids; Vaccine available

Question 3

Hep B

• Transmission
• Outlook
• S/S
• Tx

Answer 3

• Tran: Vertical; PArenteral; Sexual
• Outlook: 70% subclinical; 30% icteric; 1% fulminant
• S/S: Bad Flu “B” symptoms; Jaundice, malaise, anorexia; Serum Sickness-like syndrome - Fever, rash, painful swollen joints
• Tx: Fluids, rest, time, + reassurance; admit if unable to take fluids

Question 4

Acute HBV Serologic Tests timeline

Answer 4

• HBsAg (Surface) spikels at S/S onset and declines untill wk 24
• anti-HBs Abs produced at Week 32
• Anti-HBc (core) produced after start of S/S (about wk 6) and continue to decline until week 32

Question 5

Who is at most risk for chronic hepatitis?

Answer 5

Neonates - 90%
Children - 20-50%
(Adults only 5%)

Question 6

What determines contagious HBV

Answer 6

• HBeAG - contagious

- Anti HBe - prob not contagious

Question 7

Chronic HBV Tx

Answer 7

Entecavir
Tonofovir
Life-long monitoring HCC

Question 8

Prevention of vertical HBVC transmission

Answer 8

H-BIG + HepB Vaccine

Question 9

HepC

• Transmission
• Outlook
• S/S
• LabDx

Answer 9

• Tran: Parenteral (Blood-blood)
• Outlook: Acute <25% have S/S; 85% become Chronic
• S/S: Fatgue, N/V; arthralgia/myalgia, WL, weakness
• LabDx: Mild ALT/AST elevation; Anti-HCV Ab; HCVC RNA Load -> Active chronic infx -> Genotyping + Fibroscan.

Question 10

HCV Tx

Answer 10

• Genotype-based Complex treatments; Does NOT get inserted into host DNA