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Tropical Viruses > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

What are the WHO targets to eliminate hepatitis by 2030?

A

Sustainable development goal to combat viral hepatitis
Vaccinate infants
Reduce MTCT
Blood and needle safety in healthcare
IVDU harm reduction
Increase diagnosis of Hep B+C (target at risk groups)
Increase Tx of HepB+C

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2
Q

Globally what is the most common cause of hepatitis?

A

Hepatitis E

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3
Q

What is the leading cause of HCC worldwide?

A

Hep B

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4
Q

What are the relative risks of BBV transmission from needlesticks?

A

Hep B 30%
Hep C 3%
HIV 0.3%

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5
Q

How is hepatitis A transmitted?

A

Faecal-oral- outbreaks

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6
Q

What are the features of hepatitis A infection

A

Acute but mild
Children often asymptomatic
Leads to immunity

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7
Q

How do you diagnose hepatitis A

A

PCR

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8
Q

What is the vaccination schedule for hep A

A

2 doses leading to 10yr immunity

Inactivated virus

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9
Q

How is Hepatitis E transmitted?

A

Faecal-oral

Undercooked sausage/shellfish

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10
Q

What are the features of hepatitis E infection?

A

Can become chronic if Immunosuppressed

Can get fulminant if pregnant with high mortality

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11
Q

How do yo diagnose hepatitis E

A

PCR

IgG and IgM

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12
Q

How do you manage hepatitis E

A

Supportive

Can give ribavarin

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13
Q

How is hepatitis B transmitted

A

Mother to child - high in SE Asia and Africa
IVDU
Sexually

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14
Q

What are the features of hepatitis B

A

Prodrome
Acute hepatitis (ALT>10,000)
Chronic hepatitis (95% if vertical transmission)
HCC

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15
Q

How do you diagnose hep B

A

HBsAg- have HepB
HBeAg-infectious
HBV DNA

HbsAb- vaccinated or have HepB
HbcAb- have or had HepB

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16
Q

How do you manage hep B

A

Check HIV- tenofovir and lamivudine
If cirrhosis : tenofovir or entecavir(kids)
If over 30, persistently abnormal ALT and HBV DNA >20,000: tenofovir or entecavir

17
Q

How do you monitor HepB

A

Detection of HCC every 6months

ALT, HBV DNA, HBeAg, renal function every 12 months

18
Q

When can you stop HepB treatment?

A

No cirrhosis and
HbeAg loss and conversion to anti-HBe after completion of at least one additional year of Tx
And persistently normal ALT
And persistently undetectable HBV DNA

19
Q

What is the vaccination for hep B

A

3 doses inactivated HBsAg

If born to HBV +ve mum then first dose should be at birth

20
Q

What is the management of pregnant women with HepB?

A

Tenofovir in T3

21
Q

How is hepatitis C transmitted?

A

Blood
MSM
MTC

22
Q

What are the features of hep c?

A

1/5 will clear infection
4/5 will become chronic, 20%cirrhosis
HCC

23
Q

How do you diagnose hepC

A

HCV RNA
HCcAg

HCV Ab- previous exposure

24
Q

How do you manage hep C?

A

Sofosbuvir/velpatasvir for 12 weeks
Assess for cure (HCV RNA) 12 weeks post Tx
Monitor for HCC every 6months in those with cirrhosis
Don’t treat in pregnancy, baby will have HCV RNA test at 18months

Tropical Viruses (19 decks)

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