Hepatitis

Question 1

How many people have hep B, globally?

Answer 1

400 million

Question 2

How many people have hep C, globally?

Answer 2

200 million

Question 3

What is the prevalence of hep B in the UK?

Answer 3

1:1000 people

Question 4

What is the prevalence of hep C in the UK?

Answer 4

1:200

Question 5

What are the possible consequences of hepatitis if left untreated?

Answer 5

Liver cirrhosis and hepatocellular carcinoma

Question 6

What percentage of people with hep C develop liver cirrhosis as opposed to people with hep B?

Answer 6

Hep C - 80% develop it

Hep B - 10% develop it

Question 7

Define hepatitis

Answer 7

Inflammation of the liver

Question 8

What are some examples of systemic viruses that cause collateral liver damage?

Answer 8

EBV, VZV, CMV

Question 9

What are hepatitis viruses?

Answer 9

Viruses that replicate specifically in hepatocytes (hepatotrophic)

Question 10

How are hepatitis B and C transmitted?

Answer 10

Blood/sex

Also vertical for hep B

Question 11

What is the incubation period for hep B?

Answer 11

6wks to 6mnths

Question 12

What is the incubation period for hep C?

Answer 12

6-12 weeks

Question 13

What are some features of the hep B virus?

Answer 13

Ds DNA

Enveloped

Question 14

What are some features of the hep C virus?

Answer 14

Ss RNA

Enveloped

Question 15

What is likely to be seen on the LFT results of someone with hepatitis?

Answer 15

Raised bilirubin, raised ALT, raised AST, ALP, low albumin, higher PT

Question 16

Who is most at risk of getting hep B?

Answer 16

Vertical tranmission (75% cases globally)
Sexual contact, people who inject drugs, HCW via needlestick

Question 17

What are the symptoms of acute hep B?

Answer 17

Jaundice, fatigue, abdominal pain, anorexia, nausea, vomiting, arthralgia

Question 18

How would the AST/ALT levels look in a patient with acute hep B?

Answer 18

In 1000s (raised)

Question 19

What is the hepatitis B surface antigen?

Answer 19

HBsAg

Question 20

What comes after the hep B surface antigen?

Answer 20

HBeAG (e antigen - highly infectious)

Question 21

What is the first antibody to appear in hep B?

Answer 21

IgM (HBcAb)

Question 22

What antibody follows IgM in hepatitis B?

Answer 22

e antibody

Question 23

What is the last antibody to appear in hepatitis B?

Answer 23

Surface antibody

Question 24

What could you look for in hepatitis B serology?

Answer 24

HBsAg. HBeAg, HBcAb (IgM, IgG), HBV DNA, HBeAb, HBsAb

Question 25

What is the definition of chronic hep B infection?

Answer 25

Persistece of HBsAg after 6 months

Question 26

What percentage of chonic hep B infection leads to cirrhosis and what percentage leads to hepatocellular carcinoma?

Answer 26

25% - cirrhosis | around 5% - hepatocellular carcinoma

Question 27

What is included in the hep B vaccine?

Answer 27

Genetically engineered surface antigen (3 doses + boosters if required) - produces surface antibody response

Question 28

In acute hep B, what would be present in the blood?

Answer 28

HbsAg, HbcAb, HbsAb

Question 29

In a past, cleared hep B infection, what would be present in the blood?

Answer 29

No HbsAg HbcAb (core antibody) HbsAb (surface antibody)

Question 30

In a chronic hep B infection, what would be present in the blood?

Answer 30

HbsAg, HbcAb | No HbsAb

Question 31

In someone who has never been infected with hep B but is vaccinated, what would be present in the blood?

Answer 31

No antigen, no core antibody | HbsAb would be

Question 32

What percentage of people with hep C become chronically infected?

Answer 32

80%

Question 33

What percentage of people with hep C have no symptoms?

Answer 33

80%

Question 34

What are the vague symptoms that some people with hep C get?

Answer 34

Fatigue, anorexia, nausea, abdominal pain

Question 35

What is looked for in a blood test for hep C?

Answer 35

Anti-hep C antibody

Question 36

What tests can be done to diagnose hep C?

Answer 36

Blood test, viral PCR

Question 37

What is the risk of getting Hep C from a needlestick injury?

Answer 37

1/30

Question 38

What is the risk of getting Hep B from a needlestick injury?

Answer 38

1/3