Questions and Answers
What is the major cause of liver cirrhosis and liver carcinoma?
Which of the following groups is at risk for occupational exposure to HBV?
How is Hepatitis A diagnosed?
How long can HCV survive on surfaces at room temperature?
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What is the mode of transmission of Hepatitis A?
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What is the duration of Hepatitis A virus infection?
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What is the consequence of Hepatitis A virus infection?
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What is the average incubation period of HCV?
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How can a dentist/health care provider prevent the transmission of hepatitis?
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What is the primary way to prevent HCV transmission in the dental setting?
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How long can Hepatitis A virus remain infectious on environmental surfaces?
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What is a challenge to HCV vaccine development?
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What is the common characteristic of symptoms of all types of viral hepatitis?
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What is the most effective disinfectant against HCV?
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What is the mode of transmission of Hepatitis E?
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What is the classification of Hepatitis D?
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What is the duration of time it may take for the HCV Ab to be detectable after initial infection?
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What is the primary mode of transmission of Hepatitis B?
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What test can be ordered to support clinical suspicion of acute Hepatitis B infection?
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What is the average incubation period of Hepatitis B?
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Who are at risk of HBV infection?
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What is the window period for HCV RNA detection after initial infection?
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What is the interpretation of a test result with HBsAg negative, anti-HBc positive, and anti-HBs negative?
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What is the average incubation period of Hepatitis A?
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How is Hepatitis A primarily transmitted?
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How many times more infectious is Hepatitis B than HIV?
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What is the interpretation of a test result with HBsAg negative, anti-HBc negative, and anti-HBs negative?
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What is the main reservoir for HBV transmission?
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What should patients be advised not to share to prevent the spread of infection?
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What is the primary method of testing for Hepatitis C infection?
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What is the significance of IgG anti-HAV in Hepatitis A diagnosis?
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Why is it important to order all 3 tests when testing for Hepatitis B?
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When can IgM anti-HBc be elevated?
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What is the interpretation of a test result with HBsAg positive, anti-HBc positive, and anti-HBs negative?
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What is the interpretation of a test result with HBsAg negative, anti-HBc negative, and anti-HBs positive?
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Who should perform the testing for Hepatitis C infection?
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Study Notes
Viral Hepatitis Overview
- Viral hepatitis is a silent epidemic worldwide, causing liver cirrhosis and liver carcinoma.
- Hepatitis refers to an inflammatory condition of the liver, commonly caused by viral infections, but also by autoimmune hepatitis, medications, toxins, and alcohol.
Types of Viral Hepatitis
- Hepatitis A, B, C, D, and E are classified as viral infections of the liver.
- Hepatitis A: fecal-oral transmission.
- Hepatitis B: sexual fluids and blood-to-blood transmission.
- Hepatitis C: blood-to-blood transmission.
- Hepatitis D: travels with Hepatitis B.
- Hepatitis E: fecal-oral transmission.
Symptoms of Viral Hepatitis
- Fever.
- Fatigue.
- Loss of appetite.
- Nausea and vomiting.
- Abdominal pain.
- Gray-colored bowel movements.
- Joint pain.
- Jaundice.
Hepatitis A
- HAV is an RNA picornavirus, endemic in many developing countries.
- Typically causes a self-limited infection of less than two months' duration, conferring immunity when resolved.
- HAV remains infectious on environmental surfaces for more than a month.
- Incubation period: 15 to 50 days (average: 28 days).
- Needs supportive treatment.
- Transmission: ingestion of fecal matter from close contact with an infected person, sexual contact, or contaminated food and drinks.
- Prevention: vaccination, hand hygiene, proper food handling, and disinfection of contaminated surfaces.
Hepatitis B
- HBV is an encapsulated DNA virus that replicates within the hepatocyte.
- Transmitted by percutaneous or mucosal exposure to the body fluids of an infected person.
- HBV is 50-100 times more infectious than HIV outside the body.
- Incubation period: 45 to 160 days (average: 120 days).
- Chronic infection serves as the main reservoir for HBV transmission.
- Transmission: percutaneous, mucosal, or non-intact skin exposure to infectious blood or body fluids.
- Adults at risk for HBV infection: injection-drug use, sexual exposure, household contacts, developmentally disabled persons, correctional facilities, occupational exposure, hemodialysis patients, and persons with HCV infection or chronic liver disease.
- Prevention: vaccination, avoiding unprotected sex, percutaneous or mucosal contact with infected blood, body fluids, and contaminated items.
Hepatitis C
- HCV is an RNA virus with great molecular heterogeneity, making vaccine development challenging.
- Chronic HCV infection is the leading cause of liver-related death and hepatocellular carcinoma in the Western world.
- Incubation period: 14 to 180 days (average: 45 days).
- No vaccine available.
- HCV survival: up to 6 weeks on surfaces at room temperature, and up to 5 months in water at low temperatures.
- Prevention: no vaccine for primary prevention, standard precautions remain the foundation of protection against transmission.
Laboratory Findings
- Hepatitis A diagnosis: presence of elevated IgM anti-HAV for 2-4 weeks during the acute phase of the infection, and later by rise in IgG anti-HAV in the convalescent phase.
- Hepatitis B diagnosis: presence of HBsAg, anti-HBc, and anti-HBs.
- Hepatitis C diagnosis: detecting antibodies to the virus (HCV Ab) or viral RNA in the blood.
Prevention and Advice
- Advice to healthcare providers: not to share sanitary and household items that may carry traces of blood, and to avoid percutaneous exposure to infected blood.
- Advice to patients: not to share injecting or snorting equipment, and to avoid percutaneous exposure to infected blood.
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Description
Learn about the causes and effects of Viral Hepatitis, a leading cause of liver cirrhosis and liver carcinoma. Understand the inflammatory condition of the liver and its various causes.