Questions and Answers
What is the primary mechanism behind inflammation of the liver and liver damage in Hepatitis?
Which of the following is NOT a common symptom of Hepatitis?
What is the gold standard for diagnosing HCV infection?
What is the significance of HAV IgG in Hepatitis A?
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Which type of Hepatitis is often associated with Diabetes Mellitus and Metabolic Syndrome?
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What is the significance of IgM anti-HBc in Acute Hepatitis B infection?
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What is the term for the scarring of the liver that can occur in Chronic Hepatitis?
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What is the term for the inflammation of the liver characterized by giant cells?
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What is the term for the increased production of bilirubin in the blood, leading to yellowing of the skin and eyes?
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What is the term for the chronic liver failure that can occur in Chronic Hepatitis?
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What is the mechanism of action of Ribavirin?
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What is the primary indication for Pegylated Interferon?
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What is the characteristic of Sofosbuvir that makes it a preferred treatment option?
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What is the difference between Sofosbuvir and Ledipasvir?
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What is the treatment approach for Hepatitis A?
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What is the effectiveness of Sofosbuvir with Ribavirin and Interferon in treating HCV genotype 1?
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What is the primary indication for Elbasvir + Grazoprevir (Zepatier)?
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What is the contraindication for Ribavirin?
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What is the characteristic of Pegylated Interferon?
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What is the cost of Sofosbuvir?
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Study Notes
Hepatitis
- Inflammation of the liver, characterized by inflammatory cells in liver tissue
- Often asymptomatic, leading to jaundice, poor appetite, and malaise
- Acute hepatitis lasts less than 6 months, while chronic hepatitis lasts more than 6 months
Chronic Hepatitis
- May initially have no symptoms
- Progresses to fibrosis (scarring) and cirrhosis (chronic liver failure)
- Increases the risk of hepatocellular carcinoma
Causes of Hepatitis
- Viral hepatitis (most common cause of liver inflammation worldwide)
- Alcoholic hepatitis
- Toxic/drug-induced hepatitis
- Autoimmune hepatitis
- Non-alcoholic fatty liver disease (often associated with diabetes and metabolic syndrome)
- Ischemic hepatitis (often associated with heart failure)
- Giant cell hepatitis (rare, affecting newborns and children)
Pathophysiology
- Virus targets hepatocytes, causing them to express abnormal proteins on their surface
- Immune cells destroy infected hepatocytes
- Main mechanism behind liver inflammation and damage
Symptomatology
- Fever, malaise, and nausea due to immune system response
- Hepatomegaly and transaminase leakage into blood, causing increased serum transaminases (ALT > AST)
- Atypical lymphocytosis common due to viral antigen stimulation
- Jaundice, increased bilirubin (conjugated and unconjugated), and increased urobilinogenuria
HAV Serology
- HAV IgM indicates active infection
- HAV IgG indicates protective antibody, recovery, or previous vaccination
HCV Serology
- HCV RNA testing using PCR is the gold standard
- Detects virus early, even 1-2 weeks after infection
- Detects levels of viral RNA in the blood
- Decrease in levels indicates recovery, while no change indicates chronic HCV
Treatment of Hepatitis
Treating HAV
- Maintain nutrition and hydration
- Practice good personal hygiene to prevent spread
- No antiviral medications indicated due to spontaneous resolution in almost all patients
- Post-exposure prophylaxis with Hepatitis A vaccine or immunoglobulin for unvaccinated individuals
Treating HCV
- Antiviral medication treatment recommended for all people with chronic HCV
- Initial treatment depends on genotype of HCV identified
Effectiveness of Treatments
- Sofosbuvir (Sovaldi) with ribavirin and interferon is 90% effective for genotypes 1, 4, 5, or 6
- Sofosbuvir with ribavirin is 70-95% effective for genotypes 2 and 3
- Ledipasvir (Harvoni) with sofosbuvir is 93-99% effective for genotype 1, but expensive
- Ribavirin and peginterferon is 60-90% effective for genotype 6
Anti-HBV Drugs
- Lamivudine (3TC)
- Adefovir (Hepsera)
- Entecavir (Baraclude)
- Telbivudine (Tyzeka)
- Tenofovir (Viread)
- Peginterferon (first-line agents for treating HBV)
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Description
This quiz covers the definition, symptoms, and causes of Hepatitis, including chronic Hepatitis and its complications such as fibrosis, cirrhosis, and hepatocellular carcinoma.