Hepatitis with fecal-oral transmission
A, E
vowels hit your bowels yo
contaminated food
Sexually Transmitted Hepatitis
B, C, D
Common Presentation (Hep)
fever, jaundice, inc ALT/AST, RUQ pain
HAV (short)
Asymptomatic, Acute, Alone (no carriers)
HBV (short)
Blood, Baby-making, Birthing
HCV (short)
Chronic, Cirrhosis, Carcinoma, Carrier
HDV (short)
Defective virus, Dependent (on HBV)
superinfection means poor prognosis
HEV (short)
Enteric, Expectant mothers (high mortality), Epidemic
HBsAg
ABeAg
Anti-HBc IgM
Acute HBV infection
HBsAg
HBeAg
Anti-HBc IgG
Chronic HBV with high infectivity
HBsAg
Anti-HBe
Anti-HBc IgG
Chronic HBV with low infectivity
Anti-HBs
vaccinated for HBV
HBV incubation period test
HBsAg
HBV prodrome, acute disease test
HBSAg (anti-HBc)
HBV early convalescence
Anti-HBc
HBV late convalescence
Anti-HBs (anti-HBc)
Viral hepatitis vs. alcoholic hepatitis liver tests
viral: ALT>AST
alcohol: AST>ALT
Which Hepatitis lead to chronic infection?
B,C,D
Which Hepatitis are we immunized against?
A,B
Which hepatitis usually resolves when infected as a healthy adult but almost always (90%) transform to chronic when transmitted at birth?
HBV
Icteric phase of hepatits presentation
dark urine- Coca Cola light feces jaundice pruritis 7-28 days after
Acute hepatitis lab test always shows what?
increased aminotransferases
look at INR for marker of severity
Most common Hep viruses in USA
B > A > C
Fulminant Hepatitis
hepatic failure within 8 weeks of onset of acute hep
hepatic encephalopathy and prolonged PT
hepatic necrosis on histo
Chronic viral hepatitis definition
elevated aminotransferase and/or viral markers present for >6 months
liver firbosis, cirrhosis, hepatocellular carcinoma
HBV disease progression
Chronic Cirrhosis Liver Failure Liver Cancer Need transplant or die
HBV disease progression
Chronic Cirrhosis Liver Failure Liver Cancer Need transplant or die
HAV treatment
supportive care- 3 months till improvement
PREVENT with immune globulin pre-post exposure
vaccine
For which Hepatitis should you be concerned about genotype?
HCV
Hepatitis extrahepatic complication
cryoglomulinemia
autoimmune disease- thyroid
glomerular disease
Hepatitis superinfection
previouslt infected with HBV then superinfected with HDV
high risk for severe chronic liver disease
HEV complications
Neuro- GBS, parsonage tuner syndrome, mononeuropahty
asymptomatic
HEV treatement
ribavirin for symptoms otherwise monitor
signs of icteric phase
dark urine
light feces
jaundice
pruritis
what is fulminant hepatitis?
hepatic failure within 8 weeks of acute hepatitis
diagnose by presence of hepatic encephalopathy and prolonged PT
for which hepatitis can immune globulin be give prophylactically for travelling or personal contacts?
HAV
chronic active vs. persistent hepatitis
active: HCC, ESLD, cirrhosis
persistent: polyarteritis nodosum, glomerulonephritis