Viral Hepatitis

Question 1

what is the main clinical manifestation of the hepatitis viruses?

Answer 1

causing liver disease

Question 2

what do you need to do if someone presents with hepatitis?

Answer 2

inform public health

Question 3

how is hepatitis A transmitted?

Answer 3

faeco-oral route

Question 4

what two things is spread of hepatitis A linked with?

Answer 4

poor hygiene

overcrowding

Question 5

in which groups of people might clusters of hepatitis A cases occur?

Answer 5

gay men

PWID

Question 6

is hepatitis A an acute or chronic infection?

Answer 6

acute

Question 7

when does peak incidence of symptomatic hep A occur?

Answer 7

in older children and young adults

Question 8

what two tests are done to confirm acute hep A infection?

Answer 8

clotted blood for serology

hepatitis A IgM

Question 9

how is spread of hep A controlled?

Answer 9

good hygiene

vaccine as prophylaxis (takes ten days to take effect, gives long term protection)

Question 10

where is hepatitis E most common?

Answer 10

in countries with tropical climates

Question 11

which is more common in the UK, hepatitis A or E?

Answer 11

E

Question 12

how can hepatitis E be transmitted?

Answer 12

faeco-oral route

zoonosis

Question 13

what is hepatitis D always foung alongside?

Answer 13

hepatitis B

Question 14

what is the clinical significance of hepatitis D?

Answer 14

exacerbates a hepatitis B infection

Question 15

how is hepatitis B transmitted?

Answer 15

sex
mother to child
blood

Question 16

what makes chronic hep B infection more likely?

Answer 16

being exposed to hep B during childhood

Question 17

what is present in the blood of all patients with hep B?

Answer 17

hep B surface antigen (HBsAg)

Question 18

how long is HBsAg present for in chronic infection?

Answer 18

over 6 months

Question 19

what is also usually present in highly infectious hep B patients?

Answer 19

hep B e antigen (HBeAg)

hep B virus DNA

Question 20

what is likely to be present in someone who has recently been infected with hep B?

Answer 20

hep B IgM

Question 21

what is given as post-exposure prophylaxis for hep B?

Answer 21

vaccine

HBIG (hyperimmune hep B immunoglobulin)

Question 22

which hepatitis virus most commonly leads to chronic infection?

Answer 22

hep C

Question 23

describe how hep C may present

Answer 23

asymptomatic for DECADES

develop signs of chronic liver disease

Question 24

what is given to manage chronic viral hepatitis?

Answer 24

antivirals

vaccinations for other hep viruses

Question 25

when should chronic hep B receive antivirals?

Answer 25

when ALT is raised

high HBV DNA

Question 26

when should chronic hep C receive antivirals?

Answer 26

ASAP

prioritised if they have advanced fibrosis or cirrhosis

Question 27

what drug is given for chronic hep infections?

Answer 27

interferon alfa

Question 28

how is interferon alfa administered?

Answer 28

injected as peginterferon

Question 29

what side effects can interferon alfa have?

Answer 29

flu like symptoms
thyroid disease
autoimmune disease

Question 30

what are the two treatment options for chronic hep B?

Answer 30

antivirals

peginterferon

Question 31

name two antivirals that may be given for chronic Hep B?

Answer 31

entecavir

tenofovir