5. Viral Hepatitis

Question 1

How is hepatitis A contracted?

Answer 1

Faecal-oral spread

Contaminated food and water

Question 2

How long is the incubation for hepatitis A?

Answer 2

30 days

Question 3

What are the risk factors for contracting hepatitis A?

Answer 3

Travel to endemic countries
Household and sexual contacts (especially MSM)
Food outbreaks

Question 4

How is hepatitis E contracted?

Answer 4

Undercooked pig and game
Processed pork, shellfish
Handling animals
Contaminated water

Question 5

What are the genotypes of hepatitis E?

Answer 5

1 and 2 in humans

3 and 4 in pigs, but spread to humans

Question 6

How long is the incubation period for hepatitis E?

Answer 6

40 days

Question 7

How are hepatitis B and C contracted?

Answer 7

Perinatally
Sexually
Parenterally

Question 8

What are the risk factors for hepatitis B?

Answer 8

IVDU
Haemodialysis
Sharing toothbrushes and razors
Needlestick injuries
Tattoos and piercings

Question 9

Which of the hepatitis viruses is a DNA virus?

Answer 9

Hep B

Question 10

What is the infectious part of the hep B virus known as?

Answer 10

Dane particle

Question 11

What is the incubation period for hep B?

Answer 11

1-6 months

Question 12

How long is the incubation period for hep C?

Answer 12

2 months

Question 13

Who is more likely to be asymptomatic in hepatitis A and B?

Answer 13

Younger, more symptomatic in adults

Question 14

What prodrome is associated with hepatitis A?

Answer 14

Fever
Appetite loss and nausea
Fatigue
RUQ pain

Question 15

What are the symptoms of hepatitis A acute infection?

Answer 15

Dark urine
Pale stools
Jaundice

Question 16

What are the symptoms of acute hepatitis E infection?

Answer 16

90% are asymptomatic

Genotype 1 can be fatal in pregnancy

Question 17

What patient group are more likely to have chronic hepatitis E?

Answer 17

Immunosuppressed

Question 18

What are risk factors for mortality in hepatitis E?

Answer 18

Liver transplant

Genotype 3

Question 19

What are the outcomes of acute hepatitis B infection?

Answer 19

Resolution
Liver failure
Chronic infection (especially in infant infections)

Question 20

How is chronic hepatitis B defined?

Answer 20

HBsAg present for over 6 months

Question 21

What complications are associated with chronic hepatitis B?

Answer 21

Cirrhosis
Hepatocellular cancer
Reactivation in immunosuppression

Question 22

What patient group gets hepatitis D?

Answer 22

Only those with hepatitis B

more severe acute disease and higher risk of cirrhosis

Question 23

In hepatitis C, what factors increase the risk of cirrhosis and hepatocellular carcinoma?

Answer 23

Alcohol, hep B, HIV

Question 24

What extrahepatic complications are associated with hep C?

Answer 24

Mixed cryoglobulinaemia
Diabetes
Thyroiditis
Rheumatological eg. PAN
Dermatological

Question 25

How is acute hep A infection diagnosed?

Answer 25

anti Hep A IgM | RNA in stool and serum

Question 26

How is hep A vaccination seen on serology?

Answer 26

anti Hep A IgG

Question 27

What will be present on serology if a person has a current hep B infection?

Answer 27

HBsAg

Question 28

What will be present on serology is a person has infectious hep B?

Answer 28

HBeAg | HBV DNA

Question 29

What will be present on serology if a person is vaccinated against hep B?

Answer 29

Anti-HBs

Question 30

How is hep A infection prevented?

Answer 30

Hygiene | Vaccine for travellers and close contacts

Question 31

What type of vaccine is the hep A vaccine?

Answer 31

Inactivated

Question 32

What is the treatment of hep E?

Answer 32

``` Acute= symptomatic Chronic= reduce immunosuppression and antivirals ```

Question 33

What is the treatment for chronic hep B?

Answer 33

Antivirals Monitor for liver cancer Transplant Education and vaccination

Question 34

What markers are used to see if antiviral therapy is effective in chronic hep B?

Answer 34

Hep B DNA is below detectable levels | e antigen seroconverted to e antibody

Question 35

What methods are used to monitor for liver cancer?

Answer 35

ultrasound | AFP

Question 36

What type of vaccine is the hep B vaccine?

Answer 36

Cloned surface antigen: HBsAg

Question 37

What is the goal of chronic hep C treatment?

Answer 37

Sustained virological response: no RNA detected at end of treatment or 12 weeks post treatment

Question 38

What does chronic hep C treatment depend on?

Answer 38

Genotype and co-infection

Question 39

What is the treatment for hep C?

Answer 39

Direct acting antivirals and interferon