HepA-E

Question 1

What is type A hepatitis, and is it vaccine-preventable

Answer 1

1. fecal-oral transmission
2. Yes vaccine preventable

Question 2

What is type B hepatitis, and is it vaccine-preventable

Answer 2

1. sexual fluids & blood to blood
2. Vaccine preventable

Question 3

What is type C hepatitis, and is it vaccine-preventable

Answer 3

1. Blood to blood
2. Not vaccine preventable

Question 4

Describe the characteristics of Hep A

Answer 4

1. common in developing countries and rare in NS
2. Disease occurs on a sporadic and epidemic basis.
3. Ingested, replicates in the bowel wall and spreads via the blood stream to the liver
4. does not produce chronic carrier state and has no long-term sequelae

Question 5

What is Hep A

Answer 5

1. A picornavirus; single stranded, naked, icosahedra
2. spreads by fecal-oral spread (from one to another or contaminated food and water)

Question 6

what is the incubation period for Hep A

Answer 6

1. 2 - 4 weeks
2. Most cases are asymptomatic

Question 7

How do you prevent Hep A

Answer 7

1. Vaccine = for travelers, high risj individuals of hep A, outbreak setting
2. Immune globulin = post exposure –> instant protection

Question 8

what is Hep B

Answer 8

1. A double stranded Hepadnavirus
2. Transmitted by parenteral, perinatal and sexual routes

Question 9

what are the characteristics of Hep B

Answer 9

1. Patients who become carriers may develop
   chronic active or persistent hepatitis
2. Very infectious, app 30% of needle sticks result in infection in non-immune individuals
3. Chances of developing the carrier state depend on the
   age on infection (very high for neonates [>90%], app 5% for adults)

Question 10

what is type d and e hep

Answer 10

D: travels with B = incomplete virus and needs b (rare)
E: fecal-oral transmission (very rare in north america)

Question 11

Describe the progression of HBV

Answer 11

acute infection–> chronic infection –> liver cancer or cirrhosis or liver failure = death or liver transplant

Question 12

Describe th etype of prevention there is for hep B

Answer 12

1. post exposure prevention HBIG (needle stick) vaccination
2. vaccine = universal for kinds directed for others
3. Treatment with Lamivudine in patients with chronic hepatitis (newer agents Tenofovir and
   Entecavir)

Question 13

How do you diagnose hep B

Answer 13

1. molecular testing = detection of surface antigen or antibodies to hep b
2. liver biopsy

Question 14

Draw out the diagnosis hep b chart

Answer 14

HBsAg Anti-HBsAg Anti-HB core
1. pos neg pos
2. neg pos (>10IU) neg
3. neg pos (>10IU) pos
4. neg pos (<10IU) neg
Interpretation:
1. chrinic infection
2. vaccine induced antibodies = protected
3. previous natural infection and seroconversion = protected from future infection
4. vaccine induced antibodies = possible vaccine faliure = repeat vaccine series
must be HBsAg pos on two occasions at least 6 months apart

Question 15

Describe what Hep c is

Answer 15

1. Small enveloped RNA virus (Flavivirus).
2. Usually parenterally transmitted although
   less infectious than HBV (needle
   stick risk is 3% vs 30%)

Question 16

Describe the characteristics of Hep C

Answer 16

1. widely distributed
2. Occurs as sporadic disease in IV drug users and others without obvious (or admitted) source.
3. Sexual activity seldom transmits disease.
4. 75% are mild or asymptomatic

Question 17

what is the incubation period for hep c

Answer 17

Incubation period is 2-20 weeks

Question 18

what is the percentage of people that will recive an outcome/damage of hep c

Answer 18

1. 40-60% may get chronic liver disease (Note that this is much higher than for HBV )
2. 20% may develop cirrhosis.
3. Hepatocellular cancer may develop as a long term sequelae.

Question 19

what is the diagnosis of HCV

Answer 19

1. Screening - Antibody Test (EIA)
2. Confirmation testing = PCR –. Detects viral RNA levels or RIBA= Recombinant
   Immunoblot Assay