Flashcards in Hepatitis B Deck (52)
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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
