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27 Cards in this Set
- Front
- Back
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What sort of virus is Hepatitis A?
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Picornaviridae (this is an enertovirus)
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-How does HAV mortality relate to age?
-What percent of kids are asymptomatic with HAV? -What is the percent of mortality from HAV in 40+? |
-mortality increases with age
-90% -30% |
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What are the symptomatic features of HAV? (4 points)
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1. sudden onset
2. Jaundice for 7-10 days, abdominal pain, itching, arthralgia 3. anorexia, nausea, fever 4. small risk for FHF and death in older adults. otherwise it is self-limiting |
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1. What is HAV treatment?
2. What is HAV diagnosis? |
1. supportive treatment
2. serology: IgM for 3-12 months after infection, IgG persists for life |
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Does immunity against hep B or C confer immunity to HAV?
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yes
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1. What type of virus is Hepatititis E?
2. How is it transmitted 3. Where in the world is it most common? |
1. Calcivirus, RNA virus
2. transmission is fecal-oral, often from contaminated water supplies. 3. India, C. Asia, N Africa, Mexico, sub-saharan Africa? (poor data) |
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Who is most at risk for HEV and pregnancy?
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1.fulminant hepatitis in many pregnant women and causes a high mortality, especially late in pregnancy
2. perinatal transmission with high mortality |
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Is serology useful in detecting previous exposure to HEV?
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No! antibodies decline rapidly after infection...this also means that repeat infections are possible since immunity isn't very good
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1. Is there a vaccine to HAV?
2. Is there a vaccine to HEV? |
1. yes (combined with HBV or typhoid Vi)
2. NO |
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How is HEV diagnosed?
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1. clinical/epidemiological
2. exclude Hep A/B/C, CMV, EBV 3. 24-34 nM particle in feces 4. serology is available |
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What sort of virus is HBV?
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1. Hepadnavirus, DNA virus
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How is HBV transmitted?
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1. vertical
2. horizontal (very close contact) 3. sexual 4. blood/blood producs ***very infectious |
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What are the possible clinical features?
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1. asymptomatic (kids especially)
2. acute hepatitis, jaundice, rarely fatal with virus elimination 3. chronic infections (5-10%): often leads to cirrhosis and liver failure 4. fuliment hepatitis (1%): often fatal |
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What are extrahepatic manifestations associated wit HBV?
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1. urticarial/maculopapular rash
2. polyarthritis 3. PAN and acute glomerulonephritis (rare_ |
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What is the clinical course?
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like HAV, only incubation is 6 weeks-6 months, the onset in insidious and course prolonged. Also extrahepatic manifestations
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What is the serological sequence in HBV chronic carriage
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Initially positive for envelopeAg, surfaceAg, anti-HBcore, HBV DNA
If they become low grade carriers when positive for anti-envelopeAg (fewer complications) If they resolve the infection they become anti-surfaceAg |
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What factor cause chronic infection?
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1. neonatal infection (90% risk)
2. child over 1 (10%) or adult (5%) 3. chonic illness 4. immunosuppression |
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What risk behaviours is HBV most associated with?
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IVDU
sexual transmission |
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What is the appearence of HBV serological markers?
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1. surface antigen (6 weeks=active illness)
2. anti core (IgM then IgG=begins with symptoms) 3. anti envelope 4. anti-surface (as surface antigen falls, indicates recovery and immunity) |
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What do the following indicate:
1. anti-HBs only 2. anti HBs and anti-HBc or only anti-HBc 3. HBs antigen, HBe antigen: 4. HBs antigen, HBe antigen and anti-HBc 5. Hbs antigen, anti-HBc, but negative HBe antigen |
1. immune due to vaccination
2. immune from prior infection 3. acute infection 4. high grade carrier 5. low grade carrier |
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What sort of virus is Hepatitis D? how does it infect? how is it spread? what is it's effect on mortality/disease?
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HBD is a delta virus RNA virus, that needs HBsAg to infect, therefore it must coinfect with HBV or superinfect a chronic HBV carrier. it is spread parenteral or sexually and has high mortality rate with increased HCC risk
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1. What are the clinical features of Hep D coinfection?
2. What are the clinical features of superinfection? |
1. severe acute disease, but low risk of chronic infection
2. usually develop chronic HDV and have a risk of sever chronic liver disease and may present with acute hepatitis |
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What sort of virus is Hepatitis C? how is it transmitted?
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Flavivirus, is blood borne and transmitted from dirty needles (IVDU or nosocmial), STI, vertically, from blood transfusion
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What are the clinical features of HCV?
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1. 70-80% asymptomatic
2. of symptomatic, 80% will progress to chronic hepatitis 3. 10-20% of chronic hepatitis will develop cirrhosis and 1-5% will develop HCC *incubation period: 6-7 weeks |
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how is HCV diagnosed?
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1. if asymptomatic: screen
2. serology with anti-HCV antibody (occurs up to 1/2 year after infection) 3. if serolgy is positive do PCR....positive PCR is a current infection and a negative PCR is a past infection |
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What other tests are done in HCV infection?
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1. ALT, coag, albumin
2. U/S 3 liver biopsy 4. test for HIV, HBV, HAV |
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1. Which hepatitis are transmitted fecal-oral?
2. Which hepatitis infections DO NOT have a chronic infection? 3. Which can be immunized against? 4. which are associated with risk behaviour? |
1. HAV, HEV
2. HAV, HEV 3. HAV, HBV, HDV 4. HCV, HDV |
