Hepatitis

Question 1

What is hepatitis?

Answer 1

Inflammation of the liver, often caused by viral infection or alcohol-related damage

Question 2

What are common causes of hepatitis?

Answer 2

Viral infections, alcohol abuse, drugs, autoimmune diseases, and metabolic disorders

Question 3

What causes alcoholic hepatitis?

Answer 3

Excessive alcohol consumption over time

Question 4

What is NASH?

Answer 4

Non-alcoholic steatohepatitis, linked to obesity and diabetes

Question 5

What is autoimmune hepatitis?

Answer 5

The immune system attacks liver cells mistakenly

Question 6

What causes drug-induced hepatitis?

Answer 6

Medications like paracetamol or prolonged antibiotic use

Question 7

What are common symptoms of viral hepatitis?

Answer 7

Abdominal pain, fatigue, flu-like illness, pruritus, muscle aches, nausea, vomiting, jaundice

Question 8

How is hepatitis A transmitted?

Answer 8

Faecal-oral route via contaminated food or water

Question 9

What virus family does hepatitis A belong to?

Answer 9

Picornavirus (naked RNA virus)

Question 10

How is hepatitis A diagnosed?

Answer 10

IgM antibodies to hepatitis A

Question 11

Is there a vaccine for hepatitis A?

Answer 11

Yes

Question 12

What is the treatment for hepatitis A?

Answer 12

Supportive care; usually resolves on its own

Question 13

What type of virus is hepatitis B?

Answer 13

Double-stranded DNA virus with reverse transcriptase activity

Question 14

How is hepatitis B transmitted?

Answer 14

Blood and bodily fluids, including sexual contact and vertical transmission

Question 15

What percentage of hepatitis B infections become chronic?

Answer 15

5–15%

Question 16

What are key viral markers for hepatitis B?

Answer 16

HBsAg, HBeAg, HBcAb, HBsAb, HBV DNA

Question 17

What does HBsAg indicate?

Answer 17

Active infection

Question 18

What does HBsAb indicate?

Answer 18

Past infection or vaccination

Question 19

What does HBeAg indicate?

Answer 19

High infectivity and active viral replication

Question 20

What is the treatment for chronic hepatitis B?

Answer 20

Tenofovir disoproxil, adefovir dipivoxil, lamivudine

Question 21

Is there a vaccine for hepatitis B?

Answer 21

Yes, given in 3 doses and part of the UK routine schedule

Question 22

What type of virus is hepatitis C?

Answer 22

Enveloped positive-strand RNA virus (Flaviviridae family)

Question 23

How is hepatitis C transmitted?

Answer 23

Blood and bodily fluids

Question 24

Is there a vaccine for hepatitis C?

Answer 24

No

Question 25

What percentage of hepatitis C infections become chronic?

Answer 25

About 75%

Question 26

Why is chronic hepatitis C called a “silent” infection?

Answer 26

It may show no symptoms for decades

Question 27

What can chronic hepatitis C lead to?

Answer 27

Cirrhosis and hepatocellular carcinoma

Question 28

What is the cure rate for hepatitis C with treatment?

Answer 28

Over 90%

Question 29

What are direct-acting antivirals (DAAs) used for?

Answer 29

To cure chronic hepatitis C

Question 30

Name a pan-genotypic DAA combination

Answer 30

Sofosbuvir + velpatasvir

Question 31

Which DAA is used for genotypes 1, 3, 4, 5, or 6?

Answer 31

Ledipasvir + sofosbuvir

Question 32

Which DAA is used for genotypes 1 or 4?

Answer 32

Elbasvir + grazoprevir

Question 33

What are alternative treatments if ribavirin is contraindicated?

Answer 33

Peginterferon alfa monotherapy

Question 34

What is Hepatitis D?

Answer 34

The most serious form of hepatitis, causing liver failure, cancer, or death

Question 35

What type of virus is Hepatitis D?

Answer 35

Negative-sense single-stranded RNA virus (Kolmioviridae family)

Question 36

How is Hepatitis D transmitted?

Answer 36

Through blood and bodily fluids

Question 37

Can Hepatitis D infect without Hepatitis B?

Answer 37

No, it requires Hepatitis B to propagate by attaching to HBsAg

Question 38

What is co-infection in Hepatitis D?

Answer 38

Simultaneous infection with Hepatitis B and D

Question 39

What is super-infection in Hepatitis D?

Answer 39

Hepatitis D infection after chronic Hepatitis B; often leads to chronic Hepatitis D

Question 40

What percentage of super-infections become chronic?

Answer 40

Up to 90%

Question 41

Where is Hepatitis D most common?

Answer 41

South America, Central Asia, Pacific Islands, and Russia

Question 42

What percentage of chronic Hepatitis B patients are affected by Hepatitis D?

Answer 42

About 5%

Question 43

What proportion of liver disease and cancer in HBV patients may be due to Hepatitis D?

Answer 43

Around 1 in 5 cases

Question 44

What is the standard treatment for Hepatitis D?

Answer 44

Pegylated interferon alpha for at least 48 weeks

Question 45

What is an alternative treatment for non-responders or those unsuitable for interferon?

Answer 45

Bulevirtide, if there is significant fibrosis

Question 46

What type of virus is Hepatitis E?

Answer 46

Naked, non-enveloped RNA virus (Caliciviridae family)

Question 47

How is Hepatitis E transmitted?

Answer 47

Faecal-oral route, usually via contaminated food or water

Question 48

Where was Hepatitis E first reported?

Answer 48

Indian subcontinent

Question 49

Where is Hepatitis E most common?

Answer 49

Asia, Middle East, Central/South America, Africa, Central Europe, and Russia

Question 50

Is Hepatitis E common in the UK?

Answer 50

No, it is very rare

Question 51

What is the typical course of Hepatitis E?

Answer 51

Mild illness that resolves within a month

Question 52

Who is at risk of chronic Hepatitis E?

Answer 52

Immunocompromised patients

Question 53

Is there a vaccine for Hepatitis E?

Answer 53

No