Hepatitis

Question 1

Transmission HAV

Answer 1

Faecal oral (parenteral)

Question 2

Transmission HBV

Answer 2

parenteral sexual, perinatal

Question 3

Transmission HCV

Answer 3

parenteral sexual, perinatal

Question 4

Transmission HDV

Answer 4

parenteral

Question 5

Transmission HEV

Answer 5

faecal-oral

Question 6

Incubation (days) HAV

Answer 6

28 10-50

Question 7

Incubation (days) HBV

Answer 7

90 40-160

Question 8

Incubation (days) HCV

Answer 8

60 150160

Question 9

Incubation (days) HDV

Answer 9

20-50

Question 10

Incubation (days) HEV

Answer 10

40 60-20

Question 11

Main populations at risk in the UK HAV

Answer 11

travellers to endemic areas
sewage workers
contacts of causes

Question 12

Main populations at risk in the UK HBV

Answer 12

immigrants from high prevelance areas
PWID
Multiple sexual partners
Infant of HBsAg positive mother
HCWs

Question 13

Main populations at risk in the UK HCV

Answer 13

PWID

recipients of unscreened blood products

Question 14

Main populations at risk in the UK HDV

Answer 14

PWID

Question 15

Main populations at risk in the UK HEV

Answer 15

travellers to endemic areas
sporadic
exposure to undercooked pig products

Question 16

Risk of chronic infection HBV

Answer 16

<0.5% of UK population

5-10% of those with acute infection as an adult

Question 17

Risk of chronic infection HCV

Answer 17

60-80%

Question 18

Risk of chronic infection HDV

Answer 18

with HBV

Question 19

Risk of chronic infection HEV

Answer 19

yes if immunocompromosed

Question 20

Immunoglobulins present HAV

Answer 20

IgM, IgG

Question 21

Immunoglobulins present HBV

Answer 21

IgM, IgG

Question 22

Immunoglobulins present HCV

Answer 22

IgG

Question 23

Immunoglobulins present HDV

Answer 23

IgM, IgG

Question 24

Immunoglobulins present HEV

Answer 24

IgM, IgG

Question 25

What types of active immunisation are available and for what types?

Answer 25

``` HAV - inactivated vaccine HBV - recombinant vaccine HCV - none HDV - Hep B vaccine HEV - only available in China ```

Question 26

For what types is passive immunisation available? and what?

Answer 26

HAV - HNIG | HBV - HBIG

Question 27

Virus type and nucleic acid HAV

Answer 27

Picornavirus | RNA

Question 28

Virus type and nucleic acid HBV

Answer 28

Hepadnavirus | DNA

Question 29

Virus type and nucleic acid HCV

Answer 29

Flavivirus | RNA

Question 30

Virus type and nucleic acid HDV

Answer 30

Defective virus | RNA

Question 31

Virus type and nucleic acid HEV

Answer 31

Hepeivirus | RNA

Question 32

What prenatal viruses can cause hepatitis in the neonate?

Answer 32

Rubella | cytomegalovirus

Question 33

What perinatal viruses can cause hepatitis in the neonate?

Answer 33

CMV Herpes simplex parechonvirus enterovirus

Question 34

In children and adults what viruses can cause viral hepatitis like syndromes?

Answer 34

CMV | EBV

Question 35

What non viral infections can cause hepatiitis?

Answer 35

Leptospirosis Q fever Psittacosis/Ornthiosis

Question 36

Clinical features of HAV

Answer 36

mild and subclinical in <5s | fever, malise, anorexia, nausea, vomiting, upper abdo pain, jaundice

Question 37

Clinical features of acute HBV

Answer 37

``` anorexia lethargy nausea fever abdo pain arthralgia urticarial skin lesions ```

Question 38

Describe the serological profile of acute HBV infection

Answer 38

See notes

Question 39

define chronic HBV infection

Answer 39

persistence of HBsAg in serum for >6months

Question 40

In what patients is chronic HBV infection more common?

Answer 40

Male | Immunodeficient

Question 41

Chronic sequelae HAV

Answer 41

None

Question 42

Chronic sequelae HBV

Answer 42

chronic hepatitis cirrhosis hepatoma membranous glomerulonephritis and polyarteritis nodasa (rare)

Question 43

Chronic sequelae HCV

Answer 43

Chronic hepatitis cirrhosis hepatoma

Question 44

Chronic sequelae HDV

Answer 44

chronic hepatitis | cirrhosis

Question 45

Chronic sequelae

Answer 45

persistant hepatitis and cirrhosis if immunocompromised

Question 46

Indications for antiviral therapy in HBV

Answer 46

Two of: HBV DNA >2000 IU/ml Raised ALT Significant liver inflammation or fibrosis

Question 47

Treatment of HBV

Answer 47

long acting peg-alpha interferon SC, weekly for 12 months | Nucleoside analogues

Question 48

Name nucleoside analogues

Answer 48

lamivudine, adefovir, dipivoxial, telbivudine, entecavir, tenofovir

Question 49

Clinical features of HCV

Answer 49

``` Ususally subclinical or mild malaise anorexia fatigue severe hepatitis with jaundice fulminant HCV ```

Question 50

with what infection is HDV always associated with?

Answer 50

HBV