when can an individual receive Serum HAV Ig for pre/post exposure
prophylaxis?
(Ans- pre:
- <2 weeks before a trip
- under 2 years old
post:
- up to 2 weeks post-exposure
transmission of HBV
(Ans- mucosal contact with infected blood or body fluid (saliva, semen)
pathophysiology of HBV
(Ans-
exposure to HBV --> cell-medicated immune response in cell nucleus -->
Cytotoxic T cells and NKC are sent to the virus to release inflammatory
cytokines --> initiation of inflammatory response --> HBV infiltrates
hepatocytes and replicates quickly
incubation period for HBV
(Ans- 60-150 days (average 90)
s/s acute HBV
(Ans- general illness (loss of appetite, fever, n/v)
s/s chronic HBV
(Ans- JAPSH
- jaundice
- ascites
- peripheral edema
- spider telangiectasias
,- hepatosplenomegaly
- positive serum test for 6 months
risk factors for HBV
(Ans-
- close contact
- hemodialysis
- IVDU
- tattoos (dye)
abnormal liver enzymes and serological markers for HBV (5)
(Ans-
1. HBsAg (marker of active disease)
2. IgM anti-HBc (recent infection <6months)
3. HBcAb Total (golden ticket for immunity)
4. HBsAb (surface antibody determines immunity from vaccination)
5. HBV DNA PCR Quantitative (viral load - how much viral is in the blood)
treatment of HBV
(Ans-
- medication (Tenofovir, Entacivir)
- PegIFN
- oral meds (only effective in chronic disease, stops viral repetition)
when to treat HBV
(Ans-
- viremia >2000
- fam hx of HCC
, - >40 years old
- ALT elevated more than 2x the upper limit
- liver biopsy
prevention of HBV
(Ans- vaccine, especially in hemodialysis patients
transmission of HCV
(Ans- infected blood
what are 80% of the new cases of HCV due to?
(Ans- PWID (people who inject drugs)
pathophysiology of HCV
(Ans- classified into 7 genotypes and several subtypes (1a and 1b cause
60% of cases)
can be acute or chronic
incubation period of HCV
(Ans- 2-22 weeks
s/s of HCV
(Ans- mostly asymptomatic until irreversible liver damage occurs
abnormal liver enzymes and serologic markers (5)
(Ans-
1. HCV Ab (only determines if you have been exposed)
2. HCV Ab w/ reflex PCR (best lab to order)
3. HCV RNA PCR Quantitative (tests for viral load)
4. HCV Genotype (used to characterize virus after diagnosis)