General Medicine

Question 1

Whats HBV?

Answer 1

Hep B, transmitted by blood and sex.

Healthcare need to be vaccinated against it.

Question 2

This marker would indicate acute hBV infx???

Answer 2

HBsAg - detected within 4weeks.
Its the earliest marker.

NOT found in pts vaccinated against HBv

Question 3

Whats still present if patient is chronic HBV ie >6M?

Answer 3

HBsAg- still detected serum after acute HBV infx .

Majority of neonates will develop chronic.

Risk–> cirrhosis, LF, hepatocellular carcinoma

Question 4

How do u treat chronic hep B?

Answer 4

Interferon -a , pegintereferon -a2a, liver transplant

Question 5

High infectivity marker in chronic pt?? HBV

Answer 5

HBeAg in both acute and chronic.
In chronic suggest aggressive disease req tx.

In asia and middle east- some genes dont produce e Ag.

Also used to see if tx working.

Question 6

Marker that would indicate low infectivity in HBV?

Answer 6

HBcAb can be in both acute and chronic infx.
Formed against HBcAg which is only found in liver, so not detected in serology.

In acute infx its the 2nd early marker to be collected - within 4W .

In chronic infx: presence of high HbcAB and low HBeAg indicates low infectivity.

Better prognosis maybe

Question 7

HbsAb- when does it appear?

Answer 7

Antibody- The vaccine contains HBsAg against which the immune system produces HBsAb.

Also found in pts who had HBV in past. In this case, they will also have HBcAg core antigen- not present in those immunized before.