Hepatitis Flashcards
(17 cards)
Spread of Hepatitis A
Faecal Oral - Seafood Over Seas
Presentation of Hepatitis A
Prodrome: Fever, Malaise, Arthralgia, Nausea, Anorexia, Distaste for Cigarettes
Icteric: Jaundice, HSM, Lymphadenopathy, Cholestasis
Investigation of Hepatitis A
IgM = Recent or Current infection (high for 25 days post exposure)
IgG = Past infection - raised for life
Rx of hepatitis A
Supportive, Avoid Alcohol, INF-alpha
Prevention of Hep A
Passive Ig <3mo for travellers
Can Vaccinate
Spread of Hep B
REMEMBER THE Bs
Blood, Body Fluids, Babies (vertical)
Presentation of Hep B
Prodrome - Fever, malaise, Arthralgia, Anorexia, Nausea, Distaste for cigarettes
Icteric - Jaundice, HSM, Lymphadenopathy, Cholestasis
Investigations of Hep B
HBs-Ag = Current infection HBe-Ag = Highly infective Anti-HBc IgM = Recurrent Infection Anti-HBc IgG = Past infection Anti-HBs = Cleared or vaccinated
Jakes Explanation
HBs-Ag is the surface antigen that becomes positive when you get an HBV infection
HBe-Ag is the positive marker of Extreme (e for Extreme) infectivity - easily transmittable
Anti-HBc IgM - IgM raises in an acute state and so these are the antiboies present when yu have had an infection before and it has come back
Anti-HBc IgG - means you have had the infection and these are the immune cells that have hung around
Anti-HBs is the antibody to the surface antigen and so it will be positive if you have had an infection that has cleared OR you have been vaccinated.
you can differentiate between cleared and vaccinated by looking at anti-HBs and Anti-HBc IgG together. both are raised you can assume it is a past infection that has cleared.
if ONLY anti-HBs is raised, pt has been vaccinated
Rx of Hep B
PEG-INF-alpha2B
Spread of Hep C
Mainly via Blood - Some Vertical transfer but less common
Presentation of Hep C
most initial infection is asymptomatic 25% have acute icteric phase 85% progress to chronic disease 25% develop cirrhosis w/in 20 years increases risk of hepatocellular carcinoma
Investigation of Hep C
Anti - HCV Abs
HCV PCR
if PCR is positive –> Liver Biopsy to assess damage and need for treatment
HCV genotyping
Rx of Hep C - indications
Fibrosis
increased ALT
chronic disease state
Rx of Hep C
PEG-INF alpha2B
Efficacy of treatment worse if Genotypes 1, 4, 5 or 6 Older Black Male
What is Hep D
Incomplete RNA virus that cna only exist with Previous Hep B infection
increases risk of hepatic failure and cirrhosis
What is Hep E
The Hep A of the developing world - get it from pork too.
