Podcast
Questions and Answers
What indicates that a patient has an acute Hepatitis B infection?
What indicates that a patient has an acute Hepatitis B infection?
- Negative anti-HBe
- Positive HBeAg
- Positive IgM anti-HBc (correct)
- Positive HBsAg
Which of the following characterizes chronic Hepatitis B infection?
Which of the following characterizes chronic Hepatitis B infection?
- Negative anti-HBc antibody
- Persistent elevation of liver enzymes
- Serum HBV DNA < 2000 IU/ml
- HBsAg positive for more than 6 months (correct)
When should treatment be initiated for patients who are HBeAg positive?
When should treatment be initiated for patients who are HBeAg positive?
- When HBV DNA < 20,000 IU/ml
- When anti-HBe is positive
- When HBV DNA > 20,000 IU/ml (correct)
- When ALT levels are normal
In which scenario should a patient be monitored every 3 months initially for 1 year?
In which scenario should a patient be monitored every 3 months initially for 1 year?
What is a characteristic of inactive HBV carrier state?
What is a characteristic of inactive HBV carrier state?
What does anti-HBe positivity indicate in HBV infection?
What does anti-HBe positivity indicate in HBV infection?
Which of the following is not part of the criteria for chronic Hepatitis B infection?
Which of the following is not part of the criteria for chronic Hepatitis B infection?
What is the goal of monitoring treatment for Hepatitis B?
What is the goal of monitoring treatment for Hepatitis B?
Which patient populations should receive HBV immune globulin plus vaccine after exposure?
Which patient populations should receive HBV immune globulin plus vaccine after exposure?
What is the primary mode of transmission for Hepatitis C?
What is the primary mode of transmission for Hepatitis C?
What is considered a virologic cure for Hepatitis C?
What is considered a virologic cure for Hepatitis C?
When is monitoring of the hepatic panel recommended for acute hepatitis C patients?
When is monitoring of the hepatic panel recommended for acute hepatitis C patients?
What should confirmatory testing follow if the initial screening for HCV is positive?
What should confirmatory testing follow if the initial screening for HCV is positive?
How frequently should HCV RNA be monitored in patients with chronic hepatitis C during treatment?
How frequently should HCV RNA be monitored in patients with chronic hepatitis C during treatment?
In which scenario is preexposure or postexposure prophylaxis for Hepatitis C recommended?
In which scenario is preexposure or postexposure prophylaxis for Hepatitis C recommended?
Which diagnostic method provides information about the fibrosis stage in chronic hepatitis C?
Which diagnostic method provides information about the fibrosis stage in chronic hepatitis C?
What constitutes a primary nonresponse in HBV treatment?
What constitutes a primary nonresponse in HBV treatment?
Which reverse transcriptase inhibitor is NOT preferred as first-line therapy due to resistance?
Which reverse transcriptase inhibitor is NOT preferred as first-line therapy due to resistance?
What must be monitored when using reverse transcriptase inhibitors?
What must be monitored when using reverse transcriptase inhibitors?
Which antiviral is preferred for patients with HBV and decompensated cirrhosis?
Which antiviral is preferred for patients with HBV and decompensated cirrhosis?
For HBeAg positive patients, what is the minimum duration of therapy with preferred oral agents?
For HBeAg positive patients, what is the minimum duration of therapy with preferred oral agents?
What is the post-exposure prophylaxis protocol for HBV?
What is the post-exposure prophylaxis protocol for HBV?
Who is indicated for HBV vaccination?
Who is indicated for HBV vaccination?
What constitutes multidrug resistance in HBV treatment?
What constitutes multidrug resistance in HBV treatment?
What is the primary component used in postexposure prophylaxis for hepatitis A in unvaccinated individuals?
What is the primary component used in postexposure prophylaxis for hepatitis A in unvaccinated individuals?
Which of the following groups should receive postexposure prophylaxis for hepatitis A?
Which of the following groups should receive postexposure prophylaxis for hepatitis A?
What is a major characteristic of acute hepatitis B virus infection?
What is a major characteristic of acute hepatitis B virus infection?
What type of immunity does the anti-surface antigen antibody confer?
What type of immunity does the anti-surface antigen antibody confer?
Which of the following transmission routes is NOT associated with hepatitis B?
Which of the following transmission routes is NOT associated with hepatitis B?
In which age group is the hepatitis A vaccine specifically indicated?
In which age group is the hepatitis A vaccine specifically indicated?
What is the initial test used to detect the presence of hepatitis B infection?
What is the initial test used to detect the presence of hepatitis B infection?
Which of the following should be avoided in patients with acute hepatitis A?
Which of the following should be avoided in patients with acute hepatitis A?
What is the primary goal of therapy for HCV?
What is the primary goal of therapy for HCV?
Which of the following is a common side effect of Ribavirin?
Which of the following is a common side effect of Ribavirin?
Which drug combination is indicated for all genotypes of HCV?
Which drug combination is indicated for all genotypes of HCV?
What is the required duration of treatment for HCV therapy with Mavyret in patients without cirrhosis?
What is the required duration of treatment for HCV therapy with Mavyret in patients without cirrhosis?
Which monitoring test is essential at baseline for women taking Ribavirin?
Which monitoring test is essential at baseline for women taking Ribavirin?
Which of the following is NOT categorized as a protease inhibitor?
Which of the following is NOT categorized as a protease inhibitor?
Which medication is effective for HCV genotypes 1a, 1b, 4, and 5?
Which medication is effective for HCV genotypes 1a, 1b, 4, and 5?
What is monitored on therapy as part of HCV treatment?
What is monitored on therapy as part of HCV treatment?
Study Notes
Hepatitis A
- Transmission:
- Fecal-oral route
- Contaminated food and water
- Direct contact with an infected person
- Clinical Manifestations:
- Nausea
- Fatigue
- Abdominal pain
- Jaundice
- Dark urine
- Clay-colored stools
- Diagnosis:
- Serological testing for anti-HAV antibodies (IgM) and HAV antigen
- Treatment:
- Supportive care
- Rest
- Hydration
- Avoid hepatotoxic medications (e.g., acetaminophen)
- Prevention:
- Vaccination
- Good hygiene practices (handwashing)
- Postexposure prophylaxis:
- Immune globulin for previously unvaccinated individuals within 2 weeks of exposure
- HAV vaccine for individuals aged 12 months to 40 years
Hepatitis B
- Transmission:
- Parenteral (IV drug use, needlestick, transfusion)
- Body fluids (saliva, semen, vaginal fluid)
- Sexual contact
- Perinatal (mother to child at birth)
- Clinical Manifestations:
- Nausea
- Fever
- Abdominal pain
- Jaundice
- Dark urine
- Clay-colored stools
- Fatigue
- Diagnosis:
- Clinical signs and symptoms
- Serological tests (HBsAg, anti-HBs, anti-HBc, anti-HBe, HBV DNA)
- Chronic Hepatitis B Infection:
- HBsAg positive for more than 6 months
- Serum HBV DNA > 20,000 IU/mL
- Persistent or intermittent elevation of AST and ALT
- Inactive HBV Carrier State:
- HBsAg positive for more than 6 months
- HBeAg negative and anti-HBeAg positive
- Serum HBV DNA < 2000 IU/mL
- Normal AST and ALT
- Treatment:
- Treatment of acute infection is not usually recommended
- Treatment for chronic infection is recommended for patients with high HBV DNA levels and abnormal liver function tests
- Medications include:
- Tenofovir
- Entecavir
- Lamivudine
- Telbivudine
- Monitoring:
- Liver function tests
- HBV DNA levels
- Response to treatment
- Preexposure Prophylaxis:
- Vaccination (recommended for infants born to HBsAg positive mothers, hemodialysis patients, household contacts, international travelers, injection drug users)
- Postexposure Prophylaxis:
- HBV vaccine or immune globulin within 7 days of exposure
Hepatitis C
- Transmission:
- Primarily bloodborne
- High risk factors include IV drug use, hemodialysis, and blood transfusions before 1992
- Clinical Manifestations:
- Nausea
- Abdominal pain
- Jaundice
- Fatigue
- Dark urine
- Clay-colored stools
- Diagnosis:
- Serological testing for anti-HCV antibodies
- HCV RNA testing (viral load)
- Liver biopsy (to assess fibrosis stage)
- Genotyping (six genotypes exist)
- Monitoring:
- Liver function tests
- HCV RNA levels
- Response to treatment
- Treatment:
- Treatment of acute and chronic infection is generally recommended
- Goal is to achieve sustained virologic response (SVR)
- Medications are used in combination, not monotherapy
- Medications include:
- Ribavirin
- Protease inhibitors (e.g., previr, asvir, buvir)
- Glecaprevir/pibrentasvir (Mavyret)
- Sofosbuvir/velpatasvir (Epclusa)
- Ledipasvir/sofosbuvir
- Elbasvir/grazoprevir
- Duration of treatment:
- Typically 12 weeks for most medications
- 8 weeks for Mavyret if no cirrhosis
- Monitoring:
- Baseline: HCV RNA, LFTs, pregnancy test for women taking ribavirin
- On therapy: Medication adherence, HCV RNA
- Post treatment: HCV RNA at 12 weeks to assess for SVR (sustained virologic response)
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Description
This quiz covers essential information about Hepatitis A and B, including their transmission routes, clinical manifestations, diagnosis, treatment, and prevention strategies. Test your knowledge on how these viruses affect individuals and the appropriate responses to exposure.
