Viral Hepatitis Overview and Liver Functions
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Questions and Answers

What does a positive ALT and positive HCV antibody at baseline indicate?

  • Old infection (correct)
  • Acute infection
  • Recent exposure
  • No infection
  • At 1-3 months after exposure, if both ALT and HCV antibody test positive, what does this suggest?

  • Old infection
  • No infection
  • Chronic infection
  • Acute infection (correct)
  • Which method can be used to diagnose acute HCV infection within 4 weeks after exposure?

  • HCV antibody
  • HCV RNA (correct)
  • ALT only
  • ALT and HCV antibody
  • Which option is NOT a symptomatic treatment for acute viral hepatitis?

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

    In which condition is lichen planus likely to be associated with hepatitis C?

    <p>Erosive type</p> Signup and view all the answers

    Which virus is known to not cause chronic hepatitis?

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

    What should be done after accidental exposure to blood from an HBV positive patient if not vaccinated?

    <p>Receive both HBV vaccine and HBIG</p> Signup and view all the answers

    Which oral manifestation is associated with hepatitis C infection?

    <p>Sjögren's syndrome</p> Signup and view all the answers

    What is a common symptom of the icteric phase of hepatitis A?

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

    Which lab findings are expected in someone with acute hepatitis A?

    <p>Marked elevation of ALT and AST</p> Signup and view all the answers

    What is the primary mode of transmission for hepatitis A?

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

    What preventative measure is recommended after exposure to hepatitis A?

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

    What is the typical duration for complete recovery from hepatitis A?

    <p>1-2 months for types A and E, 3-4 months for types B and C</p> Signup and view all the answers

    How can hepatitis A be inactivated on surfaces?

    <p>Heating to 185°F (85°C) or higher for one minute</p> Signup and view all the answers

    What is a key characteristic of hepatitis A regarding chronic infection?

    <p>It does not cause chronic hepatitis or cirrhosis</p> Signup and view all the answers

    During what period does peak excretion of the hepatitis A virus occur?

    <p>During the prodromal phase, two weeks before jaundice</p> Signup and view all the answers

    What is the primary mode of transmission for HBV?

    <p>Through blood and infected bodily fluids</p> Signup and view all the answers

    What characterizes acute hepatitis?

    <p>The body clears the virus within 6 months.</p> Signup and view all the answers

    Which of the following types of hepatitis is known to be transmitted through fecal-oral route?

    <p>Hepatitis A</p> Signup and view all the answers

    Which factor increases the likelihood of a mother transmitting HBV to her child during childbirth?

    <p>Being HBeAg positive</p> Signup and view all the answers

    What percentage of adults is likely to develop clinical illness from HBV?

    <p>30-50%</p> Signup and view all the answers

    Which of the following statements about chronic hepatitis is true?

    <p>The infection lasts longer than 6 months.</p> Signup and view all the answers

    Which virus causes hepatitis that can be transmitted via blood and has a vaccine available?

    <p>Hepatitis B</p> Signup and view all the answers

    Which of the following is a chronic infection outcome associated with HCV?

    <p>Liver cirrhosis and hepatocellular carcinoma</p> Signup and view all the answers

    Which of the following is NOT a recognized risk factor for HCV transmission?

    <p>Consumption of alcohol</p> Signup and view all the answers

    In which phase of acute viral hepatitis might you first experience flu-like symptoms such as fever and fatigue?

    <p>Prodromal phase</p> Signup and view all the answers

    What is the primary marker used for diagnosing HBV infection?

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

    Which virus is associated with chronic infection but does not have a vaccination available?

    <p>Hepatitis C</p> Signup and view all the answers

    What is one of the liver's primary functions?

    <p>Storing sugar needed for energy</p> Signup and view all the answers

    What percentage of people with HCV are likely to develop chronic infection?

    <p>70-80%</p> Signup and view all the answers

    Which of the following hepatitis viruses is NOT hepatotropic?

    <p>Cytomegalovirus (CMV)</p> Signup and view all the answers

    Which option describes the nature of HBV as a virus?

    <p>Double-stranded circular DNA virus</p> Signup and view all the answers

    What does HBsAb indicate in a patient?

    <p>Recovery or immunity to HBV infection</p> Signup and view all the answers

    When does HBsAg typically become detectable after exposure to HBV?

    <p>4 weeks</p> Signup and view all the answers

    Which group is NOT advised to receive the Hepatitis B vaccine?

    <p>Persons under the age of 18</p> Signup and view all the answers

    What is the primary use of HCV-RNA testing?

    <p>To diagnose HCV infection in the acute phase</p> Signup and view all the answers

    What is the recommended action after accidental exposure to HCV?

    <p>Wash the wound with soap and water</p> Signup and view all the answers

    Which of the following correctly describes the role of HBeAg?

    <p>Indicates active replication of HBV virus</p> Signup and view all the answers

    Which of the following statements about the Hepatitis C vaccine is true?

    <p>No vaccine is available for prevention of HCV infection</p> Signup and view all the answers

    What is the function of Hepatitis B Immunoglobulin?

    <p>To provide passive immunity after exposure to HBV</p> Signup and view all the answers

    Study Notes

    Viral Hepatitis Overview

    • Viral hepatitis is an inflammation of the liver
    • Types include acute and chronic hepatitis
    • Acute hepatitis is short-term, with the body's immune system clearing the virus within 6 months
    • Chronic hepatitis is long-term, lasting more than 6 months due to the body's immune system failing to clear the virus. The duration of the infection is the defining characteristic, not the illness severity.
    • Potential outcomes from acute hepatitis include recovery, chronic inflammation, cirrhosis, or HCC (hepatocellular carcinoma)

    Liver Functions

    • Stores sugar for energy
    • Breaks down toxins and drugs
    • Creates proteins to build and repair tissue
    • Produces bile to aid fat digestion
    • Synthesizes blood clotting factors (V, VII, IX, X, prothrombin, fibrinogen)

    Causes of Acute Hepatitis

    • Viral (hepatotropic): Viruses A, B, C, D, E, G, and non-hepatotropic viruses (CMV, EBV, herpes, HIV)
    • Drug-induced hepatitis: Paracetamol, alcohol, halothane

    Hepatitis A (HAV)

    • Transmission: Fecal-oral
    • Incubation period: 15-50 days
    • Peak excretion in stool occurs two weeks before the onset of jaundice (during the prodromal phase)
    • Risk factors include close personal contact (e.g., households, daycares), contaminated water or food, and travel to endemic regions
    • HAV survives hours on fingertips/hands and up to two months on dry surfaces
    • Inactivated by heating to 185°F (85°C) or higher for one minute, or by disinfection with a 1:100 dilution of sodium hypochlorite
    • Diagnosed by detecting HAV IgM
    • No known chronic carrier state; does not cause chronic hepatitis or cirrhosis
    • Prophylaxis: Improve hygiene, passive immunity, and vaccination

    Hepatitis B (HBV)

    • Transmission: Blood and bodily fluids (semen, vaginal fluids)
    • Risk factors: Blood transfusion (before 1992), hemophilia, intravenous drug use, multiple sexual partners, hemodialysis, infected mothers transmitting to newborns (high HBeAg levels)
    • Diagnosed by HBsAg (general marker), HBsAb (recovery/immunity), HBcAb (IgM or IgG- acute or chronic), HBeAg (active replication), and HBV-DNA (monitoring response to therapy)
    • HBsAg is detectable in infected blood on average 4 weeks (1-9 weeks) after infection
    • Preventable by passive and active immunity (vaccination)

    Hepatitis C (HCV)

    • Transmission: Percutaneous exposures to infected blood (e.g., needles, blood transfusions)
    • Risk factors include blood transfusions (before 1992), needle sticks, intravenous drug use, hemodialysis, and sexual contact (less efficient transmission)
    • Diagnosed using HCV antibody (less useful during acute infection), HCV-RNA PCR (needed for acute diagnosis).
    • No vaccine is available.

    Hepatitis D (HDV)

    • Requires HBV to replicate
    • Classified as a coinfection if HBV infection develops simultaneously, or as a superinfection if HDV infection develops after chronic HBV infection.
    • Diagnosed by detecting HDV antibodies

    Hepatitis E (HEV)

    • Transmission: Fecal-oral
    • Diagnosed by detecting HEV antibodies

    Clinical Stages of Viral Hepatitis (Acute)

    • Incubation period (varies by virus)
    • Prodromal (preicteric) phase: Flu-like symptoms (fever, sore throat, cough, headache, anorexia, malaise, nausea, vomiting, abdominal pain)
    • Icteric phase: Jaundice (yellowing of skin, eyes, and mucous membranes), resolution of fever, and pruritus (itching). Liver enlargement and tenderness, splenomegaly (enlarged spleen) in some cases.
    • Convalescence: Resolution of symptoms, complete recovery (duration varies by virus)

    Laboratory Diagnoses

    • Serum bilirubin: Increased
    • ALT/AST (liver enzymes): Marked elevations
    • Alkaline phosphatase: Mild elevations
    • Prothrombin time (PT): Usually normal, prolonged in severe hepatitis

    Oral manifestations of hepatitis C

    • Lichen planus
    • Sjögrens syndrome
    • Xerostomia
    • Sialadenitis
    • some forms of oral cancers

    Treatment of Acute Viral Hepatitis

    • Symptomatic treatment: bed rest, light palatable meals. Hospitalization is rare.

    Prevention

    • Improve hygiene is critical.
    • Passive immunity (immunoglobulin for exposure to HBV) and active immunity (vaccines) are important preventive steps.

    Post-exposure Procedures for accidental exposure to blood sources from HBV- or HCV-positive patients

    • Carefully wash the wound without rubbing using soap and water.
    • If necessary, use a disinfectant with established efficacy against the virus (e.g., iodine solution).
    • Collect complete medical and clinical information from the patient to assess possible health risks.

    Additional notes:

    • Multiple, very similar infections: symptoms/signs can't alone distinguish a specific type of viral hepatitis
    • Accurate diagnosis relies on lab results
    • Various types of oral manifestations exist due to hepatitis C.

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    Viral Hepatitis PDF

    Description

    This quiz covers the key aspects of viral hepatitis, focusing on its types, causes, and impacts on liver function. Learn about the differences between acute and chronic hepatitis, including potential outcomes and liver's role in metabolism and detoxification. Test your understanding of the virulent agents and drug-induced factors associated with hepatitis.

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