11.4 - Liver - Hepatitis Flashcards
Causes of viral hepatits?
Hepatitis virus
AND EBV and CMV!
Acute hepatitis presentation:
- jaundice (due to CB and UCB)
- dark urine (CB)
- fever
- malaise
- nausea
- elevated liver enzymes (ALT>AST or BOTH > 1000)
- last < 6 months
Mechanism of hepatocyte destruction in acute hepatitis?
Cell mediated via cytotoxic T-cells (MHC class 1 shows internal viral proteins on surface of cell)
Chronic hepatits
- how classified?
- risk?
- symptoms > 6months
- cirrhosis!
What is mostly affected with chronic hepatitis?
PORTAL TRACTS DESTROYED
HAV
- transmission?
- commonly acquired by who/how?
- Fecal oral
- commonly acquired by travelers
HEV
- transmission?
- commonly acquired by who/how?
- fecal oral
- contaminated water or under-cooked seafood
HBV
-transmission?
parenteral/close contact
HCV
-transmission?
parenteral/close contact
HDV
-transmission?
need co-infection with HBV or need previous HBV and now get HDV -superinfection
HAV and HEV
- acute or chronic hep?
- what marks active infection?
- immunization?
- only acute - no chronic
- Anti-virus IgM = active infection
- IgG is protective only for HAV (VACCINE ONLY FOR HAV)
in pregnant women HEV = fulminant hepatitis –> liver failure and death
special HEV detail?
in pregnant women HEV = fulminant hepatitis –> liver failure and death
HBV
- acute or chronic hep?
- immunization?
- BOTH ACUTE AND CHRONIC (IN 20%)
- vaccine YES!
HCV
- acute or chronic?
- confirmation of disease?
- BOTH - most people get chronic
- HCV RNA test confirms infection and can indicate recovery (no RNA detected) or chronic disease
What is more severe for HDV - coinfection or superinfection with HBV?
Superinfection!
