Liver: Hepatitis

Viral Hepatitis

Hepatitis A (HAV)

  • Timing: Acute Mn
  • Transmission: Fecal-Oral Mn

Hepatitis B (HBV)

  • Timing: Acute or Chronic (HCC Risk)
  • Transmission: Parenteral Blood or STD Mn
  • DNA Virus (All Others RNA)
  • Testing:
    • HBsAg: Active
    • HBeAg: Highly Infective
    • Anti-HBc Ab (Core): Hx of Infection
      • IgM: Acute < 6 mo
      • IgG: Chronic > 6 mo
    • Anti-HBs Ab (Surface): Immune
  • Vaccine
    • > 90% Effective in Children, Less in Elderly
    • Less Effective in ESRD with Hemodialysis – Give Double the Normal Dose

Hepatitis C (HCV)

  • Timing: Acute or Chronic (HCC Risk)
  • Transmission: Parenteral Blood Mn
  • Most Common Indication for Liver TXP

Hepatitis D (HDV)

  • Timing: Acute or Chronic (HCC Risk)
  • Transmission: Parenteral Blood or STD Mn
  • Cofactor with HBV Mn
    • Having Both Indicates Worse Prognosis

Hepatitis E (HEV)

  • Timing: Acute Mn
  • Transmission: Fecal-Oral Mn
  • Cause Fulminant Hepatic Failure in Pregnancy Mn

Mnemonics

Hepatitis Modes of Transmission

  • “A-B-C-D-E” Like a Human Body
    • Fecal-Oral: Out of the Ends (A & E)
    • Sexual: Just on the Inside of Ends (B & D)
    • Blood: All on the Inside (B, C & D)

Hepatitis Chronicity Timing

  • A/E: “AcutE” Are Only Acute
  • B/C/D: Acute or Chronic

Hepatitis D & E Considerations

  • D-D: D Depends on B
  • E-E: E in Expectant Mothers