viral hepatitis part 2 Flashcards
what are the different modes of HBV transmission ?
blood borne
perinatal - HBe antigen positive mothers
sexual - MSM and sex workers
parenteral - PWID
haemodialysis
transfusion
what is the incubation period of HBV ?
2-3 months and up to 6 months
what is the difference in presentation between acute and chronic HBV infection ?
acute - flu like symptoms and jaundice
chronic - usually have no symptoms
in serology of hepatitis what is an indicator of high viral replication ?
HBeAg
how is the viral load of Hep B evaluated ?
HBV DNA
what are the different indicators of acute and chronic infection using HBcAB ?
IgM - acute infection
IgG - chronic infection
what is the main endpoint off therapy of hep B ?
1- induction of long-term suppression of HBV DNA
2- avoid extrahepatic manifestation
3- avoid mother to child transmission
4- avoid hepatitis B reactivation
which HBV patients should be treated ?
( based on HBV DNA, serum ALT and severity of liver disease )
1- patients with HBV DNA > 2000 IU/ml , elevated ALT
and/ or at least moderate liver microinflammation or fibrosis
2- patient with cirrhosis, any detectable HBV DNA regardless of ALT level
what does the hepatitis B vaccine contain ?
HBsAg
what are the available drugs for hepatitis B patients ?
NUC (entecavir or Tenofovir )
PEG interferon-alpha
what is the strategy that Entecavir and tenofovir work by ?
inhibition of viral replication
what are considered special groups when it comes to Hep B infection ?
HIV co-infection
Delta ( hepatitis D virus )
HCV
Healthcare workers
Acute severe hepatitis
Pregnancy
Immunosuppressive therapy
what is the prophylactic treatment for HBV ?
active immunisation of high risk individuals
what is the post exposure prophylaxis ?
accelerated vaccine +/- HBIG
what are the two ways in which hepatitis D can exist with hepatitis B ?
Co-infection with HBV
Super-infeection of HBV ( worse prognosis )
