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20 Cards in this Set
- Front
- Back
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What are 3 phases of chronic hepatitis?
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1) Replicative
2) Inflammatory 3) Inactive phase |
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Describe features of the Replicative phase. (HepB)
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1) HBeAg is positive
2) HBV-DNA positive, indicating high levels of viral replication 3) Aminotransferases are normal or near normal 4) Liver biopsy is relatively inactive |
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Describe features of the Inflammatory phase. (HepB)
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1) May enter the inflammatory phase for unknown reasons
2) The immune system now recognizes those hepatocytes harbouring virus and begins to attack them 3) Aminotransferase becomes elevated 4) Biopsy shows chronic hepatitis 5) Level of viral replication (HBV-DNA) will decline |
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Describe features of the Inactive phase. (HepB)
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1) When the patient has successfully cleared viral replication
2) Normalization of aminotransferases 3) Relative inactivity on the liver biopsy 4) HBeAg will be cleared 5) Anti-HBe will form (seroconversion) |
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What percent of adults infected with HepB go on to suffer from chronic HepB?
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1-5%
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What percent of adults infected with HepC go on to develop Chronic Hepatitis C?
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85%
(40% of which develop severe hepatitis, the other 45% only minimal/slow progressing hepatitis) |
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What percent of patients with chronic HepB will go on to develop cirrhosis?
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20-30%
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What percent of patients with chronic HepC will go on to develop cirrhosis?
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20% within the first 25 years, 1% per year thereafter.
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With both chronic HepB and HepC, patients are at a much higher risk to develop _________?
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hepatocellular carcinoma
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Name 3 Hepatitis B, high risk groups.
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1) Immigrants from endemic areas
2) Men who have sex with men 3) IV drug users. |
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Geographically, what part of the world has the highest pervalence of HepB?
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Southeast Asia and the sub-sarahan
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List major risk factors for infection of HepC?
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- IV drug use
- Blood transfusion - Intranasal cocaine - Tattoo's/piercings - High-risk sexual behaviour |
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What does 'HBsAg positive' indicate?
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HBV infection, may be acute or chronic
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What does 'HBsAb positive' indicate?
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Exposure to HBV, may be natural immunity through exposure or following vaccination
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What does 'HBcAb-IgM positive' indicate?
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Acute HBV infection
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What does 'HBeAg positive' indicate?
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High infectivity, acute viral replication
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What does 'HBeAb positive' indicate?
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Low or no infectivity, measured only in chronic HBV
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The elevated aminotransferase pattern seen after Hepatitis C infection may be monophasic or multiphasic. What does a multiphasic pattern suggest?
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Multiphasic aminotransferase pattern suggests chronicity (80% of cases)
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If a patient has a positive HepC ELISA test, what must be done next?
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Positive ELISA tests must be confirmed with RIBA (recombinant immunoblot assay), a different ELISA, or an HCV-RNA determination (using PCR) to be diagnosed.
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How does the hepB virus replicate?
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Through reverse transcription
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