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Flashcards in Viral Hepatitis Deck (53)
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1

Besdies the hepatitis viruses, what other viruses can cause hepatitis?

CMV
EBB
HSV
Parvovirus B19

2

Describe the presentation of Hep A?

aself limited illness with jaundice, fatigue, fever, anorexia, diarrhea, dark urine, pale stools, abdominal pain

3

How is the spread of Hep A?

fecal-oral

4

How long is the incubation for Hep A?

15-50 days

(2-6 wks)

5

Why has Hep A incidence declined since the 1990s?

a vaccine became available

only 1200 cases in the US in 2014

6

What are the appropriate serologic tests for HAV?

Total Anti-HAV antibody (indicates acute, previous infections or immunization)

IgM Anti-HAV (indicates acute infection)

7

Who shoul dbe vaccinated for hep A?

all kids at 1 yo
kids 2-18 yo where routien vacc is implemented
travelers to high prevalence areas
Men who sleep with men
high risk: drug users, occupational exposures
chronic liver disease patients
patients receiving clotting factors

8

What percentage of the 3-4 million people in the US with hep C are diagnosis?

only 25-50%

9

What is the rate of chronic hep C infection?

75-85%

10

What is the rate of chronic liver DISEASE?

60-70%

11

What is the rate of cirrhosis in the next 20-30 yrs?

5-20%

12

When can you start to detect viral hep C RNA in the blood?

1-3 weeks post exposure

13

When can you start to detect hep C antibodies?

can take 20-150 days before you can see the antibodies

14

Who's more likely to clear the hep C virus - people who get acutely sick or people who are asymptomatic?

symptomatic patients more likely to seroconvert

so you want to get sick

15

What are the HCV modes of transmission?

percutaneous exposure to infected blood

sexual transmission (less common)

mother to child (4% risk of trans in preg/labor)

16

What are the lab test options for HCV?

1. screening with EIA/CIA
2. Molecular assays (quantitative and genotyping)
3. liver biopsy not usually needed

17

Positive antibody screens for HCV should be confirmed by what? Unless?

usually RNA detection

unless their titer is super high, then you can just go on th eone test

18

What are the ost common genotypes of HCV in the US?

1a and 1b

(2 and 3 less common)

19

What are some reasons for false negative results?

immunosuppression
low levels of anti-HCV Ab
Absence of antibodies against antigens in the test (if they're directed at a different part of the virus than the test is looking for)
testing in the "window period" - before 11 wks

20

Is it possible using the antibody screening test for HCV to determine acute, chronic or resolved infection?

no

that's why you look for the RNA confirmation - is there actually virus in the patient's blood?

21

Who should be screened for He pC?

- people born between 1945-1965 (baby boomers)
- hx of IVDU
- Recipients of clotting factor concentrates made before 1987
- recipients of blood transfusions/solid organ transplants before 1992
- Patient who have ever received long-term hemodialysis treatment
- known exposure
- w/ HIV
- kids with HCV moms

22

What is the goal for treatment HCV?

sustained virologic response (indetectable viral RNA 24 wks after therapy completed) - basically cure now

23

Is hep B a DNA or RNA virus?

DNA

24

How does age of infection with HBV affect severity and chronicity?

younger, more likely to go on to chronic

older - more likely to be acutely sicker

25

Who should be vaccinated for HBV?

everyone udner 18
everyone over 18 with increased risk

26

What kind of vaccine is used for HBV now?

recombinant form of hBsAg

27

WHat's the transmission for Hep B?

contact with infected blood or mucosal membranes (sex, IVDU,sick mom, needle sticks, etc)

28

What is the incubation for hep B?

60-150 days

(2-6 mp)

29

What is the first serologic marker for HBV to appear?

HBsAg

surface antigen

30

WHen does surface antigen disappear?

1-3 months after the ajundice (when you get anti-HBs)

if it doesn't clear = chronic infection