Infection - Viral Hepatitis Flashcards

1
Q

What is hepatitis?

A

Inflammation of the liver due to replication of hepatitis viruses within hepatocytes resulting in their destruction

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2
Q

What is the incubation period for hep B?

A

6 weeks to 6 months

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3
Q

What is the incubation period for hep C?

A

6-12 weeks

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4
Q

What is the viral structure of hep B?

A

DNA, doubled stranded, enveloped

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5
Q

What is the viral structure of hep C?

A

RNA, single stranded, positive strand, non-enveloped icosahedral

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6
Q

How is bilirubin produced and transported to the liver?

A

In red blood cells, haemoglobin is converted into bilirubin and excreted into the bloodstream. It attaches to albumin and is transported to the liver where UDP glucuronyl transferase converts it to conjugated bilirubin. This may be excreted in urine or enter the small intestine to be excreted in faeces.

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7
Q

What are the three different types of jaundice?

A
  • prehepatic
  • intrahepatic cholestatic
  • extrahepatic cholestatic
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8
Q

What tests can be carried out to assess liver function?

A
  • bilirubin
  • liver transaminases
  • alkaline phosphatase
  • albumin
  • tests of coagulation
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9
Q

How is hep B transmitted/who is at risk?

A
  • vertical transmission
  • sexual contact
  • injected drug users
  • close household contacts
  • healthcare workers via needle stick injuries
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10
Q

What are the symptoms of acute hep B?

A
  • jaundice
  • fatigue
  • abdominal pain
  • anorexia/nausea/vomiting
  • arthralgia
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11
Q

Explain the sequence of antigens and antibodies present in a hep B infection

A
  • first is HBsAg, the surface antigen
  • next is HBeAg, the e-antigen which indicates that they are highly infectious
  • the core antibody (IgM) is the first antibody to appear
  • the e-antibody comes next, indicating disappearance of e-antigen and the infectivity of the patient
  • surface antibody is the last antibody to appear, which indicates clearance of the virus/recovery
  • core antibody IgG will be present for life
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12
Q

Define a chronic hep B infection

A

Persistence of HBsAg after 6 months

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13
Q

How is hep B treated?

A

There is no cure as it integrates into the host genome. Life-long antivirals can be given to suppress viral replication.

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14
Q

What is the hep B vaccine?

A

It is a genetically engineered surface antigen which produces the surface antibody response. It is effective in most people, but requires 3 doses and boosters

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15
Q

How is hep C transmitted/who is at risk?

A
  • injected drug users
  • sexual contact
  • vertical transmission
  • blood transfusion before 1991
  • needlestick injuries
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16
Q

Is hep C likely to be chronic?

A

Yes - 80% become chronically infected

17
Q

What are the possible complications of chronic liver disease/cirrhosis?

A
  • decompensated liver disease
  • hepatocellular carcinoma
  • transplant
  • death
18
Q

What are the symptoms of hep C?

A
  • 80% have no symptoms

- 20% have vague symptoms of fatigue, anorexia, nausea, abdominal pain

19
Q

Is there a vaccine for hep C?

A

Nah

20
Q

How is hep C treated?

A

Directly acting antiviral drug combination for 8-12 weeks can cure, but can get re-infected