Week 3.3 - Hepatitis (Liver Symposium) Flashcards

1
Q

what are the types of hepatitis and their causes?

A

A and E are enteric - acute self limiting
BCD are parenteral and cause chronic disease

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2
Q

What is the clinical course of HepA?

A

infection, asymptomatic until 2-4 weeks. children usually stay asymptomatic but may develop jaundice

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3
Q

What is the transmission of HepA?

A

feco-oral but may be by blood

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4
Q

How do you diagnose HepA and what antigens?

A

HepA antigen specific IgM in the blood

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5
Q

What is the prevelance of HepA? how do we battle it?

A

decreasing. we give vaccines to:
- hepB/C patients
- chronic liver disease
- travellers
- lab workers
- gay men,

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6
Q

What is the structure of HepB given its antigens?

A
  • 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
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7
Q

What are the antibodies against HBV?

A

Anti-HBs - protection
IgM anti-HBc - acute infection
IgG anti-HbC - chronic infection
Anti-HBe - against e antigen

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8
Q

What is the go to therapy for HBV?

A

we only treat those with a very high viral load. oral antiviral drug tenofir and pegylated interferon

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9
Q

How do we approach HBV?

A
  • 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)
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10
Q

What occurs in most people with acute HBV?

A

it clears and we can see IgM anti HBc antibodies

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11
Q

What occurs in individuals with chronic HBV?

A
  • some have no progression,
  • some cirrhosis,
  • may lead to end stage liver failure or HCC (hepatocellular carcinoma)
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12
Q

What is the natural history/ outcome of HepC?

A
  • 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
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13
Q

What are symptoms of HCV?

A

90% asymptomatic, 10% jaundice. most asymptomatic until cirrhosis. most have normal LFT’s. challenging to pick out.

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14
Q

How do we diagnose and treat HCV?

A

diagnose with anti HCV antibodies. treatment used to be aggressive interferon but now direct antivirals - 90% success rate.

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15
Q

what is HepD?

A

also known as delta virua. usually co-occurs with HBV and makes treatment difficult

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16
Q

what is HepE?

A

self limiting in majority of people except pregnant women. no treatment or vaccine.

17
Q

What is the genome of hepatitis?

A

all RNA except HBV - DNA