Hepatitis B

Question 1

acute hepatitis

Answer 1

• Incubation 6wks- 6months
• AST/ALT in 100s
• 50% have no symptoms
• Clear infection within 6 months

x

Question 2

Only becomes chronic in

Answer 2

<10% of infected adults (90% of infected in infancy)

Question 3

chronic hepatitis

Answer 3

Persistence of HBsAg after 6 months

25% chronic infection leads to cirrhosis and 5% will develop hepatocellular carcinoma

Question 4

HepB virus

Answer 4

DNA

Enveloped

Question 5

acute symptoms

Answer 5

• Jaundice
• Fatigue
• Abdominal pain
• Anorexia/ nausea/ vomiting
• Arthralgia- pain in joints

Question 6

patient risk factos and mechanism of infection

Answer 6

• Vertical transmission (75%)
• Sexual contact
• People who inject drugs
• Close household contacts- significant blood exposure
• HCW via needlestick injury

Question 7

diagonis of infection

Answer 7

1. HBsAg (surface antigen) appears first
2. Next HBeAg (e-antigen) appears – highly infections
3. Then first antibody produced- HbecAg (core)
   
   • IgM- early
   • IgG-later on
4. Followed by e-antibody HBeAb
5. Lastly Surface antibody HBsAg appears
   
   • Clearance of virus
6. Core antibody HBc persists for life

Question 8

Antigne and antibody pattern for the type of infection

Answer 8

Question 9

other diagnostic test

Answer 9

can also do HBV DNA (PCR)

Question 10

Treatment of chronic HepB

Answer 10

• Life-long anti-virals to suppress viral replication
• Not required for everyone e.g. inactive carrier
  
  • Low VL
  • Normal LFTs
  • No liver damage

Question 11

Prevention e.g. Vaccination

Answer 11

• Genetically engineered surface antigen
• 3 doses + booster if required
• Effective in most people
• Produces surface antibody response
• >10 adequate
• >100 long-term protection

Question 12

Outcome of infection

Answer 12

• Can persist to a chronic illness
• No cure- integrates into host genome