Viral hepatitis Flashcards
(20 cards)
Councilman bodies
Dead hepatocytes
Hepatitis
Fecal-oral
Acute only
Traveller
Vaccine available
Hepatitis A Diagnose serology (IgM active, IgG recovered/vaccinated)
Fecal-oral
Acute only
Fulminant hepatitis in pregnancy
No vaccine
Hepatitis E Diagnose serology (IgM active, IgG recovered)
Blood, sex + childbirth
Acute, 60-80% to chronic
No vaccine
Hepatitis C
Diagnose HCV RNA - low = recovery, not low = likely chronic
Blood, sex + childbirth
Sub-Saharan Africa
Acute, sometimes to chronic (95% in babies, 20% in adults)
Vaccine available
Hepatitis B
HepB serology interpretation!!
Co-infects or super-infects with Hepatitis B
Hepatitis D
Vaccines available
AB
Chronic
> 6m
Tx Hepatitis A+E
Supportive
Tx Hepatitis B
If you think you’ve been infected: emergency HepB IVIG
If chronic: Peginterferon alpha-2a injection 1x pw for 48w; if fails NRTI anti-virals (tenofovir or econovir)
Tx Hepatitis C
Direct-acting antivirals (DAAs)
HBeAg
Marker of infection
‘Eek I’m infectious’
HBsAg
Current infection (acute or chronic)
Anti-HBcAg (IgM)
Acute infection
Anti-HBsAg (IgG)
Successful clearance or vaccination
Anti-HBcAg (IgG)
All Anti-HBcAg IgM becomes IgG after 2-6m regardless of clearance
Peginteferon-alpha2a
Peg - polyethylene glycol group to increase half life
Interferon-alpha acts on JAK-STAT pathway - phopshorylates STAT1/2 - IRF9 complex
- HBsAg positive
- Anti-HBsAg negative
- HBeAg positive
- Anti-HBc IgM negative
- Anti-HBc IgG positive
Acute infection, very infectious
- HBsAg negative
- Anti-HBsAg positive
- HBeAg negative
- Anti-HBe negative
- Anti-HBcAg IgM negative
- Anti-HBcAg IgG negative
Vaccinated
Anti-HBcAg vs. Anti-HBsAg
Antibody against core means they must have been infected
Antibody against surface means they may cleared or been vaccinated (think of vaccination as being ‘superficial’ immunity)
