Hepatitis (GIT)

Question 1

What are the clinical signs of hepatitis?

Answer 1

Jaundice, fever, nausea and vomiting, malaise.

Question 2

Which hepatitis viruses cause acute and chronic infection?

Answer 2

Hep A and E cause actue disease.

Hep B, C and D can cause chronic illness in the immunocompromised.

Question 3

Describe transmission routes of Hep A and E and its diagnosis.

Answer 3

Hep A and E are transferred via the faecal oral route.

Diagnosis is similar for both - Detection of IgM in acute disease, and IgG in chronic cases.

Question 4

Differentiate between vaccination availability of Hep A and E.

Answer 4

Hep A has only one serotype - vaccine is very effective.

Hep E vaccines are not available in Australia, but Hep E is very uncommon.

Question 5

Can Hep E cause chronic hepatitis in immunocompetent people?

Answer 5

No - Hep E can however cause chronic hepatitis in the immunocompromised.

Question 6

What is the most prevalent hepatitis in developing countries and how is it transmitted?

Answer 6

Hep B - vertically transmission is significant.

Question 7

What are the clinical consequences of untreated HBV?

Answer 7

15%-25% will die from cirrhosis or HCC if not treated.

Question 8

What are the two high potency HBV antivirals used?

Answer 8

Entecavir

Tenofovir

Question 9

How common is it to cure hepatitis virus?

Answer 9

Uncommon - <10% of people achieve loss of HBsAg with treatment

Question 10

Describe the mechanism of the HBV vaccine.

Answer 10

HBV vaccine is universal for infants.

Subunit vaccine - HbsAg only.

Question 11

How can HBV be transmitted?

Answer 11

Parenteral: IVDU in developed countries

Vertically (5% risk for HCV positive mothers)

Sexual (BUT VERY LOW RISK)

Question 12

Approximately how many % of people will be symptomatic and asymptomatic upon HCV infection?

Answer 12

10% will develop acute hepatitis and 90% will be asymptomatic.

75% will develop chornic infection, and 25% will clear it.,