Viral Hepatitis
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| test of choice in viral hepatitis | serum test (look for antibodies and antigen markers)
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| use of liver biopsy | staging chronic hep c
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| Water/food borne viral hepatitis | A (2-6 weeks), E (2-9) weeks
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| Blood borne viral hep | B (2-6months), C (15-150 days), D (unlimited)
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| Chronic types of hepatitis | B, C, D
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| Hep vaccines available | A and B
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| Chronic hep | persistence >3-6 months
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| Primary cause of chronic hepatitis in outpatient setting | Viral
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| To check for acute hep A infection | IgM anti-HAV
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| Presence of IgG anti-HAV indicates | previous exposure to HAV, noninfectivity and immunity.
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| Childhood vaccination for Hep A | began in 2006
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| Hep B in childhood | more likely to become chronic. This is why vaccination was started in infants. High rate of transmission of mother to fetus. want to protect infant by providing immunoglobulin at delivery which reduces chance of child infection
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| Outer surface coat antigen in Hep B | S
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| Core antigens in Hep B | C and E
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| First evidence of Hep B infection, persists throughout clinical illnessDetection establishes infection with HBV & implies infectivity | HBsAG (also indicates chronic infection if IgM anti-HBc has already resolved)
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| Appears after clearance of HBsAg & after successful vaccination against Hep BDetection signals recovery from HBV infection, non-infectivity & immunity | anti-HBs
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| negative IgM anti-HBc plue positive HBsAg | chronic hep B infection
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| Symptoms plus Anti-HBc IgM | acute hep b infection.
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| HBeAg | means someone is definitely in the infectious stage
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| Anti-HBe | presence indicates less viral replication and infectivity
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| high rate of chronic hep C is | 85%
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| Diagnostic criteria for Hep C | presence of anti-HCV by ELISA. May need confirmation with HCV RNA and anti-HCV RIBA. Antibody levels rise slowly
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| Hep D infection requires present coinfection with | Hep B (specifically, presence of HBsAg)
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| 95% of people with hepatitis B | are acute. Don't develop chronic
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| Diagnosis for Hep D | anti-HDV or HDV RNA in serum
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| Pregnant women mortality is higher in | Hepatitis E (10-20%).
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| Hep E | generally benighn and self-limited. Does not have a chronic form. Rare in US, consider diagnosis if acute hepatitis after travel to endemic area . Diagnosis by presence of anti-HEV
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| Acute Hep B | Postive Anti-HBc IgM
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| Past or resolved hep B | anti-HBs positive
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| Hep B vaccination | anti-HBc negative, anti-HBs positive
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| Lab result consistent with acute viral hepatitis | ALT>AST (remember, L is not Lower! but it is more Liver specific)
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| Which type of viral hep has an especially high mortality rate in pregnant women | Hep E
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Created by:
ltm12