T2 - HEPATITIS .docx - HEPATITIS A Incubation Period 2-6...

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HEPATITIS A Incubation Period - 2-6 weeks Onset - usually ACUTE (Fever) Symptoms - N/V, FEVER , jaundice (50%), arthralgias (rare) Diagnosis - IgM and anti-HAV IgM (ACUTE) anti-HAV during the ACUTE HEP A- will decrease during several months Transmission - FECAL-ORAL (FOOD/WATER ) seafood ingestion , sexual, parental Sequelae - fulminant hepatitis- 0.1%, recovery- 99% Epidemics - food borne or water borne, post transfusion (rare) Prevention - ISG- immune serum globulin HEP A Notes: Hep A is due to low socioeconomic status, poor sanitation, poor access to clean drinking water, in developing countries. RNA virus, Never becomes chronic Hepatitis, a cause of Viral Hepatitis. Asymptomatic is most contagious, jaundice not contagious, inactivate virus by boiling 1 minute or uv rays. Suggested that CD4 T cells may play a role in immune clearance Hepatitis A immune globulin should be considered for travel that is going to be longer than 6 months
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HEPATITIS B – Worldwide ENDEMIC Incubation Period - 2-6 months Infectious 4-6 weeks before symptoms and for unpredictable time after symptoms Onset - usually insidious Symptoms - N/V, JAUNDICE (HBV ) (33%), arthralgias Diagnosis - HbsAg Positive HBsAb indicates immunity from vaccine or resolved infection Transmission - BLOOD, SEX, IV Sequelae - chronic carrier (5-10%), chronic active hepatitis (5%), fulminant hepatitis- 0.2-1%, recovery- 85-90% Epidemics - contaminated blood products, post transfusion- 5% Prevention - HB immunoglobulin vaccine Hep B Notes: Increased in Asia, Spread by vertical transmission mother to child, Increased risk of Cirrhosis, spread by sex contact, blood, HETEROSEXUAL SEX WITH INFECTED HBV PERSON IS #1 COMMON MODE OF TRANMISSION , health care workers such as nurses, surgeons HBV= JAUNDICE CAN OCCUR ESPECIALLY WITH HBV.
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HEPATITIS C - #1 cause of Cirrhosis Incubation Period - 2-22 weeks Infectious 4-6 weeks before symptoms and for unpredictable time after symptoms – Leads to chronic cirrhosis Onset - usually insidious Symptoms - N/V, jaundice (25%), arthralgias (rare) Diagnosis - Anti-HCV Positive HBsAb = indicates immunity from vaccine or resolved infection If viral load detectable then the patient is considered to have chronic HCV Transmission - sexual, parenteral, perinatal Sequelae - chronic carrier- 75%, chronic active hepatitis- 75%
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