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Questions and Answers
Which of the following hepatitis viruses is caused by a DNA virus that infects hepatocytes?
What is the primary mechanism believed to cause liver damage in Hepatitis A infections?
What is a significant characteristic of Hepatitis C virus infections?
Which hepatitis virus is known to be an incomplete viral particle that depends on another virus for its propagation?
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Which of the following proteins is expressed by Hepatitis B virus that triggers a cellular immune response?
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What is the appropriate action for treating acute Hepatitis E infection?
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Which of the following statements about Hepatitis C's laboratory diagnosis is true?
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In the context of Hepatitis B prevention, what is the primary purpose of passive immunization?
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What is the target outcome of treatment for chronic Hepatitis C infection?
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What is a significant component of the vaccination strategy for Hepatitis A?
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Which risk group should receive pre-exposure vaccination for Hepatitis B?
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For effective management of chronic Hepatitis E infection in transplant patients, what is a common approach?
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What is the recommended follow-up for individuals treated for chronic Hepatitis B?
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What should be avoided to prevent the spread of Hepatitis C?
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Which of the following best describes the prevention measures for Hepatitis A?
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What is the primary mode of transmission for Hepatitis A?
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Which of the following best describes the incubation period for Hepatitis E?
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What laboratory finding indicates the presence of replicating Hepatitis B virus?
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Which of the following symptoms is commonly seen during the prodromal phase of viral hepatitis?
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In which demographic are high levels of Hepatitis A antibodies most commonly found?
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What type of hepatitis virus is known to be vaccine preventable?
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Which group is at higher risk of Hepatitis B infection transmission?
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What is a common epidemiological characteristic of Hepatitis E?
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Which hepatitis virus is most closely associated with undercooked pork and shellfish?
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What does a positive Anti-HBs indicate?
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During the acute phase of hepatitis B infection, which marker would first appear?
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What is a notable complication associated with chronic hepatitis B infection?
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What causes dark urine in patients with viral hepatitis?
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Which serological marker is indicative of a current hepatitis B infection?
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In what scenario is a Hepatitis B patient considered most infectious?
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Study Notes
Hepatitis - Causes
- Inflammation of the liver
- Infectious:
- Viral: Hepatitis A, B, C, D (with B), E, Cytomegalovirus, Epstein Barr virus, Rubella, Yellow fever
- Bacterial
- Others
- Non-infectious:
- Drugs, Alcohol, Vascular, Autoimmune, Metabolic
Hepatitis A
- RNA virus (enteroviruses)
- Not cytopathic
- Cellular immunity can cause liver damage
- Humans only
- Virus shed in faeces
- Transmission:
- Faecal-oral route
- Contaminated food and water
- Incubation period: 30 days (15-50)
- Infectious period: 2 weeks before - 1 week after symptoms
- Worldwide
- High prevalence: developing countries
- Developed countries: travellers to endemic countries, household/sexual contacts, men who have sex with men, foodborne outbreaks
Hepatitis E
- RNA virus
- 4 genotypes
- Infects animals and humans
- Genotypes 1 & 2: Humans, transmitted via faecally-contaminated water in developing countries
- Genotypes 3 & 4: Humans, pigs and others, transmission:
- Undercooked or raw meat
- Processed pork and shellfish
- Direct contact with animals
- Contaminated water
- Incubation period: 30-40 days
Hepatitis B
- DNA virus - infects hepatocytes
- Expresses viral proteins on surface triggering the cellular immune response
- 3 forms: Dane particle, Spherical form & filaments
- Dane particle: Infectious
- Filaments & Spheres: Contain HBsAg, but lack DNA
- Transmission:
- Perinatally
- Sexually
- Parenterally
Hepatitis D
- Incomplete viral particle
- Defective RNA virus
- Uses hepatitis B surface antigen for propagation
Hepatitis C
- RNA virus (flavivirus)
- 6 genotypes
- No cross-protection
- Transmission:
- Sharing equipment used by injecting drug users
- Haemodialysis
- Non-sterile glucometer equipment
- Sharing personal care items
- Needle stick injuries
- Ear-piercing, tattooing, acupuncture
Hepatitis B vs C
- Hepatitis B: Vaccine-preventable
- Hepatitis C: No vaccine
- Incubation period:
- Hepatitis B: 1-6 months
- Hepatitis C: 8 weeks
- Hepatitis B:
- Low prevalence areas: Acute infection sporadic
- High prevalence areas: Acute infection in infants & young children
Clinical Presentation of Viral Hepatitis
- Asymptomatic
- Symptomatic:
- Prodromal symptoms (fever, appetite loss, nausea, fatigue, RUQ abdominal pain)
- Dark urine
- Pale greasy stools
- Jaundice
Clinical Findings for Viral Hepatitis
- Abnormal Liver Function Tests (LFTs):
- AST 
- ALT 
- Bilirubin 
Acute Infection
- Asymptomatic in children
- Risk increases with age and co-infection
- Prodromal symptoms for 1-2 weeks
- Fulminant disease unusual
- 6 months = potential chronic infection
Hepatitis B Markers:
- HBsAg (Surface antigen): Positive = current infection (acute or chronic)
- HBeAg (e antigen): Detectable when virus actively reproducing, present in acute and chronic infection
- HBcAb (core antibody): First detectable antibody, HBcAb (IgM) = acute infection, HBcAb (IgG) = usually positive for life.
- Anti-HBs (surface antibody): Usually the last antibody to appear, positive = usually indicates resolved infection.
Hepatitis C Laboratory Diagnosis
- Hepatitis C antibody (Anti-HCV): Positive at 2-6 months post-exposure, remains positive even if infection cleared
- Hepatitis C antigen (HCV ag): Positive in acute and chronic infection
- Hepatitis C virus (HCV) RNA: Positive in acute and chronic infection
Hepatitis A Treatment & Prevention
- Treatment: Supportive care
-
Prevention:
- Hygiene
- Sanitation
- Vaccination
- Travel advice
-
Vaccination:
- Inactivated vaccine
- Post-exposure: Contacts of cases, outbreak control
- Pre-exposure:
- Travellers to endemic countries
- Chronic liver disease
- Injecting drug users
- Men who have sex with men
- Workers exposed to raw sewage
-
Passive Immunization (Immunoglobulin): Post-exposure prophylaxis, within 2 weeks
- Persons aged over 60 years
- Immunosuppressed patients
- Those with chronic liver disease
Hepatitis E Treatment & Prevention
- Acute infection: Self-limiting, symptomatic treatment
- Chronic infection (transplant patients): Reduction in immunosuppression, antivirals
- Vaccine: developed, but only licensed in China
Hepatitis B Treatment & Prevention
- Acute: Supportive therapy
-
Chronic:
- Patient education
- Vaccination
- Antiviral therapy
- Monitor for liver cancer
- Transplant (Fulminant hepatitis, end-stage chronic hepatitis)
-
Prevention:
- Standard precautions: Safe sex, screen blood products, clean needles, hand hygiene, safe disposal of sharps
- Passive immunization (immunoglobulin): Post-exposure prophylaxis
- Pre-exposure prophylaxis: Vaccination
Hepatitis C Treatment & Prevention
- Acute: No post-exposure prophylaxis
-
Chronic:
- Goal: Cure = sustained virological response
- Treatment regimens: Depend on genotype, co-infections, past treatment, degree of fibrosis
- Directly-acting antivirals: Cure rate >95%
- Give hepatitis A & B vaccines
-
Prevention:
- Standard precautions: Safe sex, screen blood products, clean needles, hand hygiene, safe disposal of sharps
- No vaccine / immunoglobulin available
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Description
Test your knowledge on hepatitis, its causes, and the various types of viruses, including Hepatitis A and E. This quiz will cover transmission methods, epidemiology, and the impact of infectious vs. non-infectious factors on liver health. Dive into the world of liver inflammation and enhance your understanding of this critical health topic.
