Hepatitis Flashcards
What are some symptoms of Hepatitis?
Jaundice with Feve
RUQ tenderness
What are the main infective causes of jaundice in the UK?
Hepatitis A Hepatitis B Hepatitis C Hepatitis D Hepatitis E
How is Hepatitis A commonly transmitted?
Faecal-oral route from contaminated food and water in places where sanitation is poor.
+ abdo pain and bowel disturbance
How is Hepatitis B commonly transmitted?
Sexual or blood transmission
How is Hepatitis C commonly transmitted?
Vertical: mother to child
Iatrogenically
Sexually
(Rarely presents with jaundice in acute presentation)
How is Hepatitis D commonly transmitted?
Only causes disease in those affected with Hepatitis B
How is Hepatitis E commonly transmitted?
Consumption (E=EATING) of under-cooked meat and shellfish
What organism causes Hep B?
Enveloped DNA virus of the hepadnaviridae family.
How can Hep B be transmitted?
Vertical: mother to baby
Horizontal: Sexual, blood transfusion if unsafe, re-use of needles and sharps, household transmission (shared razors or toothbrushes).
What test is used for the diagnostic confirmation of current hepatitis B infection?
Hepatitis B surface antigen (HBsAg)
Antigens of clinical importance of surface antigen and envelope antigen
What is the treatment of Acute hepatitis B infection?
No indication as is self-limiting. However, can cause liver failure and may require transplant.
What is the treatment of Chronic Hepatitis B infection?
Name of drugs?
(>6 months)
Important to identify before complications of cirrhosis or cancer occur
No cure, treatment controls rate of replication and reduces inflammation
Pegylated interferon alpha (stimulates immune system) or Tenofovi on Entecavir (acute, antivirals)
What is the typical natural history of the infection after it presents acutely?
Approximately 95% of patients will clear the virus naturally. Others may develop chronic Hep B.
There is a risk of re-activation with immunosuppresion and chronic infection is more common in immunosuppressed adults.
What complications are seen in chronic Hep B infection?
Hepatocellular carcinoma
Cirrhosis –> Decompensated cirrhosis:
Jaundice, ascites, encephalopathy, coagulopathy, hypoalbuminaemia, variceal bleeding.
What advice should be given to a patient with Hep B and their family?
Cuts and scratches should be carefully cleaned and covered with plasters
Family members should not share toothbrushes or razors
Do not donate blood or organs
Partners should practice safe sex and use a condom
All household contacts should be vaccinated
The patient should avoid alcohol
