Viral infections of the GIT (2): Viral hepatitis

Question 1

What are causes of hepatitis

Answer 1

infective
toxic
autoimmune
metabolic
obstructive

Question 2

How does acute viral hepatitis present?

Answer 2

1-2 week prodrome
malaise, headache, anorexia, followed by jaundice, tender liver,
fever

Question 3

what diseases are caused by Hepatitis A virus

Answer 3

Infectious hepatitis , epidemic jaundice,

epidemic hepatitis, Type A hepatitis

Question 4

How is hepatitis a virus transmitted

Answer 4

Close personal contact
▪Household, child day care, sexual
▪Person to person 
▪Virus in stool before illness onset
▪ Contaminated food and water
▪Food handlers, raw shellfish
▪ Blood exposure

Question 5

What is the most common transmission of hepatitis virus a in developed countries?

Answer 5

Person to person

Question 6

What is the rarest transmission of hepatis a virus

Answer 6

blood exposure

Question 7

What is the management of acute Hepatitis a

Answer 7

▪ Supportive, self-limited infection
▪ No antivirals
▪ Check liver function, clotting, U&E
▪ Vomiting, dehydration, altered consciousness bad signs-admit
▪ Transplant for acute liver failure
▪ Notifiable disease

Question 8

What is the prevention of hepatitis a

Answer 8

• Avoid risk
• Hygiene (hand washing), clean water sources, travel
• Immunisation
• Active: Hepatitis A vaccine (pre and post exposure)
• Cell culture adapted virus, formalin inactivated
• Safe, highly immunogenic, highly effective
• Targeted use- injecting drug users, international travelers, persons
who have clotting factor disorders or chronic liver disease, men who
have sex with men
• Passive: HNIG (post exposure only)
• Infection control, public health advice (food handlers e.g.)

Question 9

What is the transmission of the acute hepatis e

Answer 9

consumption

of pork based products and HEV infection

Question 10

What is the management of hepatitis E

Answer 10

▪ Acute- supportive only, as for HAV
▪ Chronic (immunosuppressed)
▪Standardised testing algorithm for establishing chronic
infection and clearance
▪Reduce immunosuppressive drugs if possible
▪Ribavirin or interferon

Question 11

what is the prevention of hepatitis e?

Answer 11

▪Food hygiene measures
• Cook pork products particularly imported
• Vaccine – only available in China
• Organ donor screening
• Blood donation screening

Question 12

What is the transmission of the acute hepatis B

Answer 12

bloodborne viral hepatitis agents

Question 13

What is the transmission of the acute hepatis D

Answer 13

bloodborne viral hepatitis agents

Question 14

What is the transmission of the acute hepatis C

Answer 14

bloodborne viral hepatitis agents

Question 15

What is Hepatitis B Virus previosly known as?

Answer 15

Serum hepatitis

Question 16

Which is most common global chronic viral infection

Answer 16

Hepatitis B

Question 17

What is the management of hepatitis B?

Answer 17

• Acute- supportive, antivirals not usually given
• Check clotting, electrolytes; transplant for acute liver
failure
• Counsel regarding transmission; screen for other
bloodborne viruses, STDs
• Notifiable disease- trace, test, and immunise relevant
contacts
• Chronic- assess need for antiviral therapy; most should
be treated

Question 18

What is the management of chronic hepatitis B?

Answer 18

Therapy for Chronic Hepatitis B
• HBV infection cannot currently be completely
eliminated or “cured” – persists in host chromosome
• The clinical goal of HBV treatment is prevention or
reversal of complications and death resulting from
advancing severity of liver disease
• Achieved by reducing HBV DNA levels- nucleoside
antiviral drugs; immunomodulators

Question 19

What is the prevention of hepatitis B

Answer 19

Avoid/ reduce risk- safe sex, needle exchange,
infection control
• Screening- blood products, high risk groups,
pregnancy
• Treatment of chronic infections
• Vaccine
• Primary prevention- risk groups, childhood
schedule, post exposure
• Universal and targeted; active or passive (HBIG)