hepatitis Flashcards
(25 cards)
hep A
benign, self limiting
serious outcome = rare
doesnt cause chronic disease
RNA picornavirus
hep A incubation period
2-4wks
hep A transmission
faecal oral spread
(often in institutions)
hep A features
flu-like prodrome
abdo pain - right upper quad
tender hepatomegaly
jaundice
deranged LFTs
hep A complications
rare + no increased risk of hepatocellular cancer
who should get hep A vaccine
people travelling or living in areas of high/mod prevalence if >1y/o
occupational risk -
- lab worders
- staff at large residential institutions
- sewage workers
- people who work with primates
chronic liver disease
haemophilia
men who have sex with men
injecting drug users
hep B
double stranded DNA hepadnavirus
(complications commoner)
how is hep B spread
exposure to infected;
- blood
- body fluids
vertical transmission from mother to child
incubation period of hep b
6-20wks
complications of hep B
chronic hepatitis
–> groud glass hepatocytes on light microscopy
fulminant liver failure
hepatocellular carcinoma
glomerulonephritis
polyarteritis nodosa
cryoglobulinaemia
who gets vaccinated against hep B
- kids at 2, 3, 4 months of age
- at risk groups - IV drug, sex workers, family contacts, those getting reg blood transfusions, CKD, prisoners, chronic liver disease
(10-15% dont respond to vac - obese, smoking, alcohol lots, immunosupress = RF)
management of hep B
1st = pegylated interferon-alpha
other antivirals - tenofovir, entecavir
can hep B be transmitted via breastfeeding
NO !
(in contrast to HIV)
Hep B and pregnancy
all pregnant woman are offered screening for hep B
babies born to mothers who are chronically infected with hep B or who’ve had acute hep B during pregnancy should receive a complete course of vaccination + hepatitis B immunoglobulin
hep C at risk groups
IV drug users
pts who received blood transfusion prior to 1991 (e.g haemophiliacs)
incubation period and virus type in Hep C
RNA flavivirus
incubation period = 6-9wks
hep C transmission
contact with infected blood
- needle stick injury - 2%
- vertical transmiss - 6% (risk is higher if coexistant HIV)
- through sex - <5%
after exposure to hep C, only 30% will develop features
hep C presentation
a transient rise in serum amonotransferases/jaundic
fatigue
arthralgia
hep C investigations
HCV RNA - dx acute
even those who clear virus will still have anti-HCV antibodies (15-45%), most, develop chronic hep C
no vaccine for hep C
chronic hep C
persistence of HCV RNA in blood for 6 months
complications of chronic hep C
rheum - arthralgia, arthritis
sjogrens
cirrhosis
hepatocellular cancer
cryoglobulinaemia
porphyria cutanea tarda
membranoproliferative glomerulonephritis
cryoglobulinaemia
a condition where the blood contains high levels of cryoglobulins, which can cause blood to gel at low temperatures.
It can be assoc with other diseases - leukemia, multiple myeloma, and certain types of pneumonia
management of chronic hep C infection
a combo of protease inhibitors
–> daclatasvir + sofosbuvir or sofosbuvir + simeprevir
(with/without ribavirin)
aim of mx = sustained virological response (SVR), undectable serum HCV RNA 6 months after end of therapy
ribavirin side effects
haemolytic anaemia
cough
teratogenic - should not become preg within 6 months of stopping
