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B - Gynaecology > Hepatitis B > Flashcards

Flashcards in Hepatitis B Deck (52)
1

What is hepatitis B?

An infection of the liver caused by the hepatitis B virus (HBV)

2

What type of virus is HBV?

A double-stranded DNA virus which replicates by reverse transcriptase

3

How many people worldwide have hepatitis B?

Over 350 million

4

What proportion of the UK is thought to have hepatitis B?

1 in 350

5

How is hepatitis B transmitted?

Parenterally via infected blood or body fluids

6

What are the routes of transmission of HBV?

- Vaginal or anal intercourse
- Sharing needles
- Sharps injuries
- Vertical transmission
- Blood transfusion

7

What is the effect of the HBV?

Interferes with the functions of the liver by replicating in hepatocytes

8

What causes damage to the liver in hepatitis B?

Hosts immune response causing hepatocellular damage

9

What are the risk factors for hepatitis B?

- IV drug use
- Multiple sexual partners
- MSM
- Born in highly endemic region
- Household contact with EBV
- Infected with HIV or Hep C
- Dialysis

10

What are the two forms of hepatitis B infection?

- Acute infection
- Chronic infection

11

How can acute hepatitis B infection present?

- Can be asymptomatic
- Can have acute viral hepatitis

12

What are the features of acute viral hepatitis?

- General ill-health
- Loss of appetite
- Body aches
- Mild fever
- Dark urine
- Progressive jaundice

13

How long do the symptoms of acute viral hepatitis last?

A few weeks and then gradually improves

14

What can acute hepatitis occasionally lead to?

Fulminant hepatitis

15

What is the danger of fulminant hepatitis?

It can be fatal

16

What is chronic hepatitis B?

A spectrum of disease characterised by the presence of detectable hepatitis B surface antigen (HbsAg) in the blood for longer than 6 months

17

How can chronic hepatitis progress?

- Inactive
- Liver fibrosis
- Cirrhosis
- Hepatocellular carcinoma

18

How can chronic hepatitis B be classified?

- e antigen positive
- e antigen negative

19

What is the presence of hepatitis B e antigen associated with?

- Higher rates of viral replication
- Increased infectivity

20

What are the potential symptoms of chronic hepatitis B?

- Fatigue
- Anorexia
- RUQ pain

21

What investigations are used for hepatitis B?

- Serological markers
- General liver investigations
- Tests for Hep C and HIV
- Screening for liver cancer
- Staging investigations

22

What are some general liver investigations?

- FBC
- Bilirubin
- Liver enzymes
- Clotting
- Ferritin
- Lipid profile
- Autoantibody screen
- Caeruloplasmin

23

What test can be used to screen for liver cancer?

- Ultrasonography
- Alpha-fetoprotein

24

What are some hepatitis B staging investigations?

- Transient elastography
- Liver biopsy

25

What can be used to determine a person's hepatitis B infection status?

Serological markers

26

What are the serological markers looked at in hepatitis B?

- Surface antigen (HbsAg)
- Core antibody (HbcAb)
- Surface antibody (HbsAb)

27

What are the serological markers of an acute infection?

- HbsAg +ve
- HbcAb (IgM) +ve
- HbsAb +ve/-ve

28

What are the serological markers of a cleared hepatitis B infection?

- HbsAg -ve
- HbcAb (IgG) +ve
- HbsAb +ve

29

What are the serological markers of a chronic hepatitis B infection?

- HbsAg +ve
- HbcAb (IgG) +ve
- HbsAb -ve

30

What are the serological markers of a person vaccinated for hepatitis B?

- HbsAg -ve
- HbcAb -ve
- HbsAb +ve

31

What general advise is given to patients with hepatitis B?

- Avoid unprotected sex until non-infectious
- Give explanation of the condition and long-term health implications
- Advise not to give blood
- Avoid alcohol until liver enzymes normal

32

Where can acute hepatitis B be treated?

In primary care unless seriously ill

33

What are the main treatment options for acute hepatitis B?

Supportive management with fluids, anti-emetics and rest

34

When is anti-viral treatment indicated in hepatitis B?

Fulminant hepatitis

35

How is chronic hepatitis B cured?

There is no cure

36

How is chronic hepatitis B managed?

Through life-long anti-virals to suppress replication

37

Who may not require life-long anti-virals in chronic hepatitis B?

Those who are inactive carriers

38

When do inactive carriers of hepatitis B not require antiviral treatment?

- Low viral load
- Normal LFTs
- Mild fibrosis

39

What drug can be used to treat hepatitis B?

Peginterferon alfa-2a

40

What is the action of peginterferon alpha-2a?

Stimulates the immune system to attack the virus

41

What are the common side-effects of peginterferon alpha-2a?

Flu-like symptoms

42

What is the main method of preventing hepatitis B?

Vaccination

43

What is the hepatitis B vaccination?

A genetically engineered surface antigen

44

How many doses of hepatitis B vaccine are provided to give coverage?

3 + boosters if required

45

Who is the hepatitis B vaccine most effective in?

Younger people

46

What is defined as a protective response to the hepatitis B vaccine?

≥10mlU/ml of anti-HB antibodies in the serum

47

When is the hepatitis B vaccine routinely given?

To all babies at 8, 12, and 16 weeks

48

Who is hepatitis B vaccine given to if not received as a baby?

Those at risk of hepatitis B or complications

49

What are the potential complications of hepatitis B?

- Fulminant hepatic failure
- Cirrhosis
- Hepatocellular carcinoma
- Cryoglobulinaemia
- Membranous nephropathy
- Polyarteritis nodosa

50

What is the important public health consideration with hepatitis B?

It is a notifiable disease

51

What is meant by hepatitis B being a notifiable disease?

All suspected cases should be reported to the local Health Protection Team via notification form

52

Should a patient be told that the local health protection team is being notified of their hepatitis B?

Yes