Hepatitis A & B Overview
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Questions and Answers

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?

  • 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 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?

    <p>Inactive HBV carrier with anti-HBe positive</p> Signup and view all the answers

    What is a characteristic of inactive HBV carrier state?

    <p>Serum HBV DNA &lt; 2000 IU/ml</p> Signup and view all the answers

    What does anti-HBe positivity indicate in HBV infection?

    <p>Reduced replication of the virus</p> Signup and view all the answers

    Which of the following is not part of the criteria for chronic Hepatitis B infection?

    <p>Negative anti-HBe antibody</p> Signup and view all the answers

    What is the goal of monitoring treatment for Hepatitis B?

    <p>Reduce liver function test values to normal range</p> Signup and view all the answers

    Which patient populations should receive HBV immune globulin plus vaccine after exposure?

    <p>Unvaccinated individuals with sexual contact with an HBV carrier</p> Signup and view all the answers

    What is the primary mode of transmission for Hepatitis C?

    <p>Bloodborne transmission</p> Signup and view all the answers

    What is considered a virologic cure for Hepatitis C?

    <p>Sustained virologic response at 12 weeks post-treatment</p> Signup and view all the answers

    When is monitoring of the hepatic panel recommended for acute hepatitis C patients?

    <p>At 2-4 week intervals</p> Signup and view all the answers

    What should confirmatory testing follow if the initial screening for HCV is positive?

    <p>HCV RNA test</p> Signup and view all the answers

    How frequently should HCV RNA be monitored in patients with chronic hepatitis C during treatment?

    <p>Every 4-6 weeks for 6-12 months</p> Signup and view all the answers

    In which scenario is preexposure or postexposure prophylaxis for Hepatitis C recommended?

    <p>Prevention is not recommended for HCV</p> Signup and view all the answers

    Which diagnostic method provides information about the fibrosis stage in chronic hepatitis C?

    <p>Liver biopsy</p> Signup and view all the answers

    What constitutes a primary nonresponse in HBV treatment?

    <p>Decrease in HBV DNA of less than 2 log after 24 weeks</p> Signup and view all the answers

    Which reverse transcriptase inhibitor is NOT preferred as first-line therapy due to resistance?

    <p>Lamivudine</p> Signup and view all the answers

    What must be monitored when using reverse transcriptase inhibitors?

    <p>Worsening liver function tests</p> Signup and view all the answers

    Which antiviral is preferred for patients with HBV and decompensated cirrhosis?

    <p>Tenofovir</p> Signup and view all the answers

    For HBeAg positive patients, what is the minimum duration of therapy with preferred oral agents?

    <p>1 year</p> Signup and view all the answers

    What is the post-exposure prophylaxis protocol for HBV?

    <p>Administer HBV vaccine or immune globulin within 7 days</p> Signup and view all the answers

    Who is indicated for HBV vaccination?

    <p>All infants born to HBsAg negative mother</p> Signup and view all the answers

    What constitutes multidrug resistance in HBV treatment?

    <p>Combine tenofovir and entecavir</p> Signup and view all the answers

    What is the primary component used in postexposure prophylaxis for hepatitis A in unvaccinated individuals?

    <p>Immune globulin</p> Signup and view all the answers

    Which of the following groups should receive postexposure prophylaxis for hepatitis A?

    <p>Close personal contacts of an infected individual</p> Signup and view all the answers

    What is a major characteristic of acute hepatitis B virus infection?

    <p>May require serological testing for proper diagnosis</p> Signup and view all the answers

    What type of immunity does the anti-surface antigen antibody confer?

    <p>Protective immunity</p> Signup and view all the answers

    Which of the following transmission routes is NOT associated with hepatitis B?

    <p>Fecal-oral route</p> Signup and view all the answers

    In which age group is the hepatitis A vaccine specifically indicated?

    <p>12 months to 40 years old</p> Signup and view all the answers

    What is the initial test used to detect the presence of hepatitis B infection?

    <p>HBsAg testing</p> Signup and view all the answers

    Which of the following should be avoided in patients with acute hepatitis A?

    <p>Hepatotoxic medications</p> Signup and view all the answers

    What is the primary goal of therapy for HCV?

    <p>Attain a sustained virologic response (SVR)</p> Signup and view all the answers

    Which of the following is a common side effect of Ribavirin?

    <p>Hemolytic anemia</p> Signup and view all the answers

    Which drug combination is indicated for all genotypes of HCV?

    <p>Sofosbuvir / velpatasvir</p> Signup and view all the answers

    What is the required duration of treatment for HCV therapy with Mavyret in patients without cirrhosis?

    <p>8 weeks</p> Signup and view all the answers

    Which monitoring test is essential at baseline for women taking Ribavirin?

    <p>Pregnancy test</p> Signup and view all the answers

    Which of the following is NOT categorized as a protease inhibitor?

    <p>Ribavirin</p> Signup and view all the answers

    Which medication is effective for HCV genotypes 1a, 1b, 4, and 5?

    <p>Ledipasvir / sofosbuvir</p> Signup and view all the answers

    What is monitored on therapy as part of HCV treatment?

    <p>Viral load and medication adherence</p> Signup and view all the answers

    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.

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