6. Hepatitis

Question 1

Is HepA RNA/DNA?

Answer 1

RNA

Question 2

Is HepB RNA/DNA?

Answer 2

DNA

Question 3

Is HepC RNA/DNA?

Answer 3

RNA

Question 4

Which types of hepatitis are enveloped?

Answer 4

Hep B and Hep C

Question 5

Which hepatitis types are transmitted by orofaecally (contaminated water/food)?

Answer 5

Hep A and Hep E

Question 6

Which hepatitis types are transmitted via infected blood?

Answer 6

Hep B, C, D & E

Question 7

How is Hep B transmitted?

Answer 7

• through body secretions (blood & genital) via
  1. perinatal 2. sexual 3. parenteral(blood)

Question 8

Symptoms of HepA?

Answer 8

• dark urine
• jaundice (sclera will be yellowish)
• tiredness & muscle ache
• nausea & vomiting
• abdominal pain
• loss of appetite
• mild fever

Question 9

Symptoms of HepC?

Answer 9

• mostly asymptomatic
• jaundice
• hepatitis, cirrhosis, hepatocellular carcinoma

Question 10

Symptoms of HepD?

Answer 10

• cirrhosis
• worsens hepatitis, esp fulminant (sudden) hepatitis

Question 11

Symptoms of HepE?

Answer 11

• acute hepatitis
• high mortality in pregnant women

Question 12

Risk groups of Hep B:

Answer 12

• regions of high endemicity
• babies of mothers w chronic hep b
• injecting drug users
• multiple sex partners
• haemophiliacs (inherited blood disorder where blood does not clot properly)
• healthcare personnel performing procedures
• haemodialysis patients
• blood & organ recipients

Question 13

Incubation period of HepA?

Answer 13

1-3 months

Question 14

Incubation of HepB:

Answer 14

Long incubation period of 3-6 months, compared to Hep A at 1-3 months

Question 15

Route of transmission of hepatitis viruses:

Answer 15

1. Waterborne (contaminated food or water, oral-faecal transmission)
   HAV & HEV
   - undercooked animal meats
2. Bloodborne
   HBV, HCV & HDV

Question 16

After you get Hep A…..

Answer 16

• u get lifelong immunity
• preventable by hep A vaccine (killed virus)

Question 17

Effects of boiling and freezing on Hep A:

Answer 17

Boiling/cooking at high heat (85 degrees celsius) kills the virus but freezing does not

Question 18

HEV becomes chronic in:

Answer 18

• immunocompromised patients
  E.g. haematology-oncology patients on chemo, HIV patients

Question 19

HEV is usually a _____________ illness

Answer 19

• self-limiting illness
• aka resolves itself, tends to go away on its own without treatment

(Except in pregnant women and immuno-suppressed patients)

Question 20

There are _ major genotypes of HEV

Answer 20

4 major genotypes
- Genotypes 1 & 2 more prevalent in developing countries w poor sanitation
- Genotypes 3 & 4 more prevalent in developed countries, transmitted zoonotically from animal reservoirs (like uncooked food)
(immunosuppressed patients often develop chronic infection for genotype 3)

Question 21

Brexit virus: what type of hepatitis

Answer 21

Brexit virus: new strain of HEV linked to pig farms
- due to poor sanitation + undercooking

Question 22

HBV genome consists of?

Answer 22

• small, circular, partly double stranded DNA w a reverse transcriptase

Question 23

Chances of getting infected w HBV upon exposure/pricked w infected blood?

Answer 23

25%

Question 24

Clinical outcomes of acute hepatitis B infection:

Answer 24

1. 90% resolution
2. 9% HBsAg+ for >6 months
   - which could lead to
   - 50% resolution
   - asymptomatic carrier state
   - chronic persistent hepatitis
   - chronic active hepatitis
3. Fulminant hepatitis

Question 25

Four clinical phases of acute hepatitis B:

Answer 25

1. Incubation period (3-6months) 2. Preictetic 3. Icteric 4. Convalescent period

Question 26

Symptoms of acute hepatitis B:

Question 27

Hepatitis G often found in patients w

Answer 27

Hep B or Hep A or HIV - we dont usually look for it cuz it seems not to cause hepatitis in humans (but scientific community doesnt know)

Question 28

Which disease has a high transmission in injecting drug users and renal haemodialysis patients and also causes liver cancer

Answer 28

Hep C