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Definitions |
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Target Liver (Inflammation of Liver)Clinical Manifestations: -Jaundice-Dark Urine-Pale Feces
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This serological marker indicates acute infection in Hepatitis B and may indicate a greater infectivity
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HBeAg
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Persistent infection and chronic hepatitis are hallmark of what infection?
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hepatitis C
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True or False
ALT/AST is elevated 1-2w presymptoms in Hep A.
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True
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Hepatitis G (Flavivirus)
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-Transmitted by blood/semen-Similar to HCV: associated with chronic hepatitis-Single stranded RNA-NO vaccine-Persistent viremia for months-years-GB-A & GB-B are probably Tamarin Viruses-GB-C infects humans
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This type of infection that occurs following exposure to serum containing both HDV and HBV in which the HBV becomes established first.
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co-infection
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Regarding Hep C, Is it true that Ribavirin is an antiviral drug which cannot eleliminate HCV by itself but when combined with interferon it doubles its efficacy?
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Yes
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True or False
In treating Hep C, if HCV-RNA blood levels fall with the first dose of interferon and is zero by one month of tx the pt is curable.
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True
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True or False
The Hep B core antibody has two parts:
IgG
IgM
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True
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Medical Management for Hep C
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TX: Antiemetics
Increase fluid intake
Healthy Diet
Interferon & Ribovirin if lots of s/sx
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Increased levels of unconjucated(indirect) bilirubin indicated the problem is either...
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increased production or impaired uptake (including problmes w/ glucoronic acid)
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This Hep B serological marker indicates past infection
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IgG (total) anti-HBc
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What is Hepatitis?
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A descriptive term that refers to infection with any of the 6 hepatotrophic viruses.
A, B, C,D, E, & G.
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Is it true that there is no chronic disease state of Hep A?
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Yes.
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what is the morbidity rate of hepatitis?
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60-90% morbidity rate
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Hepatitis D (Delta Agent)
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-Responsible for 40% of fulminant hepatitis-UNIQUE: Hep-D uses Hep-B & targets cell proteins to replicate & produce its own (Even fleas have fleas)-HBsAG (Hepatitis B surface Antigen) is essential for the packaging of Hepatitis D virus-Defective single stranded RNA virus spread by blood-semen-NO vaccine-Needs prior or concurrent HBV infection-Delta Antigen limits replication of virus and hepatocyte destruction, but promote persistence of virus leading to Chronic Hepatitis!-Fulminant Hepatitis often develops (Fatal in 80% of cases)-No known specific treatment-HDV requires HBV for replication, so prevention/treatment of HBV helps/prevents HDV
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This serological marker is detectable at the time of Hep B and indicates it is an acute infection.
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Anti HBC IgM anti-HBc
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True or False
Hep B is the only one of the Hepatitis to be considered an STD.
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True.
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What is the tx for Hep A?
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Prevention:
Vaccine (2 inj. 6-12m apart)
avoid contaminated food
Post exposure: Immune globulin
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How long does a Hep B vaccine Last?
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vaccine lasts 5-10 years
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This is the best indicator of choleostatic disease and a value of greater than _____ indicates obstruction.
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Alkaline Phosphate (normal: 30-120 U/L)
> 5XUL = obstruction (>600 U/L)
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How does the onset of Hep C differ than that of A or B?
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Much slower, insidious onset.
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Elevated leves of conjugated bilirubin indicates the problem is due to
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obstruction of the biliary tract which impairs bile flow
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What is the incubation period of Hep A?
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15-45d (3w average)
Remember Hep A: abrupt onset
Hep B: gradual onset
Hep C: insidious onset.
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when should the hep A globulin be given?
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give within 2 weeks of exposure
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This is what is used to differentiated between chronic and acute hepatitis C? Give the cut offs.
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Acute infection: >10X ULN ATL (>350 U/L)
Chronic infection: <5X ULN ALT
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What is the Hep B surface antigen?
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lab that is positive in the acute stage of infection. Usually positive in the 4th-12th week.
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What is the post exposure tx for Hep B?
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Hep B panel first. then if needed..........
HBIG within 24-72h.
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who should be given the hep A globulin?
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anyone that came in contact such as family members and sexual contacts
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