Simple Viral Hepatitis

Question 1

What is Hepatitis A virus

Answer 1

RNA picornavirus

Question 2

HAV transmission

Answer 2

Faecal-oral trasmission
Associated with contaminated shellfish
Virus passes into BILE after replication within liver cells
Immune system is activated by this process and leads to necrosis predominantly in zone 3 of the hepatic lobule.

Question 3

In what organ does HAV replicate and where does it then go?

Answer 3

Liver (inside liver cells)

Virus passes into bile

Question 4

HAV incubation period

Answer 4

2-3 weeks

Question 5

Investigations for HAV

Answer 5

Anti-HAV IgM in serum

Question 6

Conservative treatment of HAV

Answer 6

Vaccine for travellers to endemic areas

Question 7

Medical treatment of HAV

Answer 7

Supportive since HAV is often self-resolving

Question 8

Complications of HAV

Answer 8

(rarely) acute liver failure

Question 9

What is Hepatitis B virus

Answer 9

a partially stranded, enveloped DNA virus

It has an e-antigen that indicates increased infectivity

Question 10

HBV transmission

Answer 10

Vertical transmission
Contaminated needles
Infected blood products
Sexual intercourse

Question 11

HBV incubation period

Answer 11

1-5 months

Question 12

Investigations of HBV

Answer 12

HBV DNA in serum, HBsAg, HBeAg, anti-HBc

HBsAg presents on histology with a ‘ground glass’ appearance

Question 13

Conservative treatment of HBV

Answer 13

Education and prevention of disease

Vaccine for at risk groups e.g. health workers

Question 14

Medical treatment of HBV

Answer 14

Antiviral medications e.g. pegylated alpha-2a interferon, adefovir, entecavir, lamivudine, tenofovir, telbivudine

Question 15

Complications fo HBV

Answer 15

Hepatic cirrhosis
Hepatocellular carcinoma (HCC)
Fulminant hepatitis B

Question 16

What is Hepatitis C virus

Answer 16

Single stranded, enveloped RNA virus and a member of the flavivirus family

Question 17

Transmission of HCV

Answer 17

Vertical transmission (occassionally)
Contaminated needles
Infected blood products

Question 18

Incubation period of HCV

Answer 18

Intermediate

6-9 weeks

Question 19

Investigations of HCV

Answer 19

Antibody to HCV in the serum

Question 20

Complications of HCV

Answer 20

Hepatic cirrhosis
Hepatocellular carcinoma
Liver failure

Question 21

Conservative treatment of HCV

Answer 21

Education and prevention of the disease

Question 22

**Medical treatment of HCV

Answer 22

Antiviral medications e.g. Pegylated alpha-2a interferon, Ribavirin
(taribavirin, telaprevir)

Question 23

What is Hepatitis D virus

Answer 23

Single stranded defective RNA virus that co-infects with hepatitis B virus
Co-infectivity with HDV leads to an increased chance of liver failure

Question 24

Transmission of HDV

Answer 24

Contaminated needles
Infected blood products
Sexual intercourse (rare)

Question 25

Incubation period of HDV

Answer 25

1-5 months

Question 26

Investigations of HDV

Answer 26

Serum IgM anti-D

Question 27

Treatment of HDV

Answer 27

Medical - Pegylated alpha-2a interferon (antiviral medication)

Question 28

Complications of HDV

Answer 28

Hepatic cirrhosis | Hepatocellular carcinoma

Question 29

What is Hepatitis E virus

Answer 29

Single stranded RNA virus

Question 30

Transmission of Hepatitis E virus

Answer 30

Faecal-oral transmission, associated with contaminated water

Question 31

Incubation period of HEV

Answer 31

2-3 weeks

Question 32

Investigations of HEV

Answer 32

IgG and IgM anti-HEV

Question 33

Treatment of HEV

Answer 33

Usually self-limiting

Question 34

Complications of HEV

Answer 34

High mortality of pregnant women (~20%)

Question 35

Name 2 scenarios where a patient is infected by HCV but gives a false negative blood result for HCV antibody

Answer 35

Immunosuppressed patients | Patients in acute infection stage

Question 36

Name a country that had a failed public health initiative which resulted in widespread hepatitis C

Answer 36

Egypt

Question 37

Why can a vaccine for HCV not be developed

Answer 37

Rapid mutations that rapidly change envelope proteins

Question 38

Prevention of HCV spread

Answer 38

Screen blood products | Protection and precaution with handling of bodily fluids