1 / 13

Viral Hepatitis

Viral Hepatitis. Australian Family Physician Vol. 30 No.5, May 2001 Presented by 郭詠怡 Date presented:25/8/2003. Causes of hepatitis. incubation (days): HAV: Enteric 15-60 HBV: Blood borne 45-160 HCV: Blood borne 14-120

owen-ross
Download Presentation

Viral Hepatitis

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Viral Hepatitis Australian Family Physician Vol. 30 No.5, May 2001 Presented by 郭詠怡 Date presented:25/8/2003

  2. Causes of hepatitis • incubation (days): • HAV: Enteric 15-60 • HBV: Blood borne 45-160 • HCV: Blood borne 14-120 • HDV: Blood borne 42-180 • HEV: Enteric 15-64 • HGV: Blood borne unknown

  3. HAV and HEV: with water/ food outbreaks ( travelling to developing world). No chronic carriers • HBV and HCV: STD, injecting drug use, occupational exposure in health care worker, causing acute and chronic hepatitis, carriers,, hepatocellular carcinoma • HDV: super infection or coinfection with HBV • HGV: possibly causes transfusion hepatitis

  4. Other causes of hepatitis • Other viruses: Herpes viruses -CMV -EBV Yellow fever virus Other causes: nonviral infections, drugs, alcohol, anoxic liver injury

  5. Needlestick exposure • Collection nurse (recipient) • Skin unbroken? • Gloves worn? • Had blood been drawn or was sterile needle involved? • Did injury result in blood being drawn? • Patient (source) • Injection drug use • Sexual preference • Blood ransfusions • Overseas travel • Migration history

  6. Tests to order after needlestick exposure • On the patient (source) • HIV Ab, HBsAg, HCV Ab • On the nurse (recipient) • HBsAb, storage of serum

  7. Main clinical presentations in viral hepatitis • HAV: --acute hepatitis in adults—(75% symptomatic, but self limiting); children usually asymptomatic --fulminant hepatitis (rare) HBV: --acute hepatitis (mostly self limiting,50% asymptomatic) --fulminant hepatitis (specially if coinfected with HDVor concurrent HCV --chronic hepatitis leading to carrier state 5-10%

  8. Main clinical presentations in viral hepatitis • HCV: --chronic hepatitis leading to carrier state 50-70% --acute hepatitis (75% asymptomatic) --fulminant hepatitis (uncommon, seen with concurrent HBV HDV: --acute exacerbation in chronic hepatitis B (HDV superinfection) --fulminant hepatitis ( if coinfected with HBV) --chronic hepatitis leading to carrier state (variable 5-70%) HEV: --acutehepatitis (usually self limiting) -- fulminant hepatitis (rare, but seen in pregnant women)

  9. Hepatitis serology clinical situationtests to order HAV acute hepatitis HAV IgM HBV see next slide HCV acute hepatitis HCV Ab, HCV PCR chronic carrier HCV Ab HDV(only coinfection or HBsAG, HBcIgM, if HbsAg+) superinfection HDV Ab HEV acute hepatitis HEV Ab HGV HGV PCR

  10. HBV serology • Late incubation period: HBsAg • Acute hepatitis: HBsAg, HBcIgM, HBcAb Total, HBeAb, HBV DNA • Window period: HBcIgM, HBcAb Total, HBV DNA • Healthy carrier: HBsAg, HBcAb Total, HBeAb • Chronic carrier/ replicative: HBsAg, HBcAb total, HBeAg, HBV DNA • Recovery/immunity: HBcAb Total • Recent vaccination: HBsAb

  11. Treatment for viral hepatitis • Virus Antiviral • A,E,G not available • B,D interferon+lamivudine • C interferon+ribavirin

  12. Prevention of viral hepatitis VirusVaccineSchedule A Havrix or 2 doses at 0 VAQTA and 6 months B,D Engerix B 3 doses at 0,1,6 or HBVax II months

  13. Summary of important points • Most cases of viral hepatitis are self limiting or asymptomatic • Epidermiological hisory is helpful to determine which tests to order • There are a number of markers for HBV, used for different stages of the disease. • Vaccination can prevent infection with certain hepatitis viruses, eg. HAV and HBV • The role of some new viruses thought to cause hepatitis is controversial

More Related