What type of virus causes Hepatitis A?
RNA picornavirus.
How is Hepatitis A transmitted?
By faecal-oral spread, often in institutions (contaminated water/food)
What are the typical clinical features of Hepatitis A?
- Flu-like prodrome
- RUQ abdominal pain
- jaundice, dark urine, pale stools
- deranged LFTs
How is hepatitis A managed
Usually self-limiting, management is supportive with basic analgesia
What type of virus is Hepatitis B?
A double-stranded DNA hepadnavirus.
How is Hepatitis B transmitted?
Through infected blood or body fluids:
* vertical transmission from mother to child
* sex
* sharing needles
What are common clinical features of Hepatitis B?
Fever, jaundice, and elevated liver transaminases.
What percentage of Hepatitis B infections become chronic?
5–10%.
What histological finding is seen in chronic Hepatitis B?
‘Ground-glass’ hepatocytes may be seen on light microscopy
Complications of hepatitis B
- fulminant liver failure
- hepatocellular carcinoma
- polyarteritis nodosa
- cryoglobulinaemia
- glomerulonephritis
What does the presence of HBsAg (Hepatitis B surface antigen) usually indicate?
- first marker to appear in Hepatitis B infection
- indicates Acute infection (present for 1–6 months).
What does HBsAb indicate
demonstrates an immune response to HBsAg, implies vaccination/ past/ current infection
* will be negative in chronic infection
What does HBcAb (core Ab) indicate?
past or current infection
* IgM: Acute/ recent infection - high titre for acute, low titre for chronic
* IgG: past exposure (HBsAg -ve)
What does HBeAg indicate?
Active viral replication and high infectivity — it’s a breakdown product of core antigen.
What serology is done to determine hepatitis B viral load
HBV DNA
What serology profile indicates previous Hepatitis B immunisation?
HBsAb positive, all other markers negative
What serology profile indicates past Hepatitis B infection, now recovered and not a carrier?
HBcAb positive, HBsAg negative.
Which types of hepatitis have a vaccine
Hepatitis A and B
Who should be vaccinated against hepatitis A
- people with chronic liver disease
- patients with haemophilia
- men who have sex with men
- injecting drug users
- individuals at occupational risk
What is the Hepatitis B vaccine made from?
HBsAg adsorbed onto aluminium hydroxide
When is the Hepatitis B vaccine given in the UK routine immunisation schedule?
2, 3, and 4 months of age.
Who should receive the Hepatitis B vaccine?
- Healthcare workers
- IV drug users
- sex workers
- close contacts of HBV patients
- transfusion recipients
- CKD and CLD patients,
- prisoners
What factors reduce response to Hepatitis B vaccination?
Age > 40, obesity, smoking, alcohol excess, and immunosuppression.
How is hepatitis B managed
- antivirals: Pegylated interferon-alpha,tenofovir, entecavir
- contact tracing
- screen for other infections
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Biliary tract disorders30
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Pancreatic disorders23
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Hepatitis47
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Colorectal & Anorectal Disorders59
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Oesophageal disorders27
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Stomach & Duodenal Disorders23
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Coeliac disease and Malabsorption27
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acute abdominal pathologies12
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Hepatic disorder (exc hepatitis)31
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malnutrition0
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IBS and IBD78
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Intestinal obstruction and ileus21
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GI Cancers25
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Hernias26
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Peritonitis8
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Genetic conditions17
