Week 3.3 - Hepatitis (Liver Symposium) Flashcards
what are the types of hepatitis and their causes?
A and E are enteric - acute self limiting
BCD are parenteral and cause chronic disease
What is the clinical course of HepA?
infection, asymptomatic until 2-4 weeks. children usually stay asymptomatic but may develop jaundice
What is the transmission of HepA?
feco-oral but may be by blood
How do you diagnose HepA and what antigens?
HepA antigen specific IgM in the blood
What is the prevelance of HepA? how do we battle it?
decreasing. we give vaccines to:
- hepB/C patients
- chronic liver disease
- travellers
- lab workers
- gay men,
What is the structure of HepB given its antigens?
- surface gene HBsAg suggests presence of virus
- core antigen HBcAg in tissue sugegests active replication
- hep e antigen HBeAg suggests active replication
- inner shell with DNA polymerase helps replication
What are the antibodies against HBV?
Anti-HBs - protection
IgM anti-HBc - acute infection
IgG anti-HbC - chronic infection
Anti-HBe - against e antigen
What is the go to therapy for HBV?
we only treat those with a very high viral load. oral antiviral drug tenofir and pegylated interferon
How do we approach HBV?
- check if virus present by checking surface antigen HBsAg
- check if its active by looking at HBcAg or HBeAg
- check for IgM - if present its acute, if not worry it is chronic (and 6 months)
What occurs in most people with acute HBV?
it clears and we can see IgM anti HBc antibodies
What occurs in individuals with chronic HBV?
- some have no progression,
- some cirrhosis,
- may lead to end stage liver failure or HCC (hepatocellular carcinoma)
What is the natural history/ outcome of HepC?
- 15% resolve, 85% chronic.
- of those 80% stable and 20% go to cirrhosis.
- of that 75% progress slowly and 25% get HCC and transplant/die
What are symptoms of HCV?
90% asymptomatic, 10% jaundice. most asymptomatic until cirrhosis. most have normal LFT’s. challenging to pick out.
How do we diagnose and treat HCV?
diagnose with anti HCV antibodies. treatment used to be aggressive interferon but now direct antivirals - 90% success rate.
what is HepD?
also known as delta virua. usually co-occurs with HBV and makes treatment difficult