Hep B

• How can hep B be transmitted?

  Vertical transmission

  Sex

  Needle use
• How may a patient present with acute hep B?

  Asymptomatic (70%)

  Jaundice

  Abdo pain

  Nausea and/or vomiting
• How may a patient present with chronic hep B?

  Asymptomatic (until complications develop)

  Non-specific symptoms

  Symptoms of chronic liver disease

  Symptoms of cirrhosis and portal hypertension
• What do ALT and AST levels look like in acute vs chronic hep B?

  Acute: Raised >10x the upper limit of normal

  Chronic: Mildly raised
• Fill in this table regarding hep B serology

  A) -ve

  B) -ve

  C) -ve

  D) -ve

  E) -ve

  F) +ve

  G) -ve

  H) +ve

  I) +ve

  J) +ve

  K) IgM +ve

  L) -ve

  M) +ve

  N) IgG +ve

  O) -ve

  
• When is HBsAg positive in hep B?

  Current infection
• When is hepatitis B surface antibody (anti-HBs) positive in hep B?

  Previous infection or vaccinated
• When is hepatitis B core antibody (anti-HBc) positive?

  If a patient has been infected with hep B (NOT seen post-vaccine) - can be previous infection or current
• Which antibody is more predominant in acute HBV?

  IgM
• Which antibody is more predominant in chronic HBV?

  IgG
• How is acute HBV managed?

  Supportively

  Drugs - entecavir or tenofovir

  Transplant (only done in patients with liver failure)
• How is chronic HBV managed?

  Antiviral therapy (not used in all patients)
• What are some complications associated with HBV infections?

  Fulminant hepatic failure

  Cirrhosis

  Hepatocellular carcinoma