Viral hepatitis: Difference between revisions
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==Causes== | ==Causes== | ||
===Hep B=== | |||
Hep B | |||
HBsAg: first +; if + long time may be chronic; implies infection -infectivity. | HBsAg: first +; if + long time may be chronic; implies infection -infectivity. | ||
| Line 14: | Line 11: | ||
HBV dna: like HBe-Ag but more sensitive & precise. | HBV dna: like HBe-Ag but more sensitive & precise. | ||
===Hepatitis C=== | |||
Risk: Drugs (IVDA/intranasal cocaine), hemodialysis, transplant-92, needle stick, maternal-fetal transmission (5%), sex. | |||
Hepatitis C | |||
Blood products: cyro> 1987, PRBC>94, 1/10000-100000. | Blood products: cyro> 1987, PRBC>94, 1/10000-100000. | ||
| Line 26: | Line 20: | ||
No vaccine. | No vaccine. | ||
#acutely>asymptomatic: 60% | |||
#syx>constitutional | |||
#chronic: HCC 1- 4% | |||
#extrahepatic: PAN, cryoglobulinemia, porphyria cutanatardica. | |||
LFTs q3-6 months if all normal then q1year. | LFTs q3-6 months if all normal then q1year. | ||
| Line 46: | Line 37: | ||
ribavirin- anemi | ribavirin- anemi | ||
==Disposition== | |||
===Admit Criteria=== | |||
# INR >2 | |||
# Unable tol POs | |||
# Pain control | |||
# Bilirubin >30 | |||
# Hypoglycemia | |||
# Significant comorbid illness/immunocomp | |||
# >50 years | |||
==See Also== | ==See Also== | ||
GI: Jaundice | GI: Jaundice | ||
==Source == | ==Source == | ||
Adapted from Stevens, Donaldson, Pani | Adapted from Stevens, Donaldson, Pani | ||
[[Category:GI]] | [[Category:GI]] | ||
[[Category:ID]] | |||
Revision as of 12:24, 14 March 2011
Causes
Hep B
HBsAg: first +; if + long time may be chronic; implies infection -infectivity.
Anti-HBs: + p clearance of Ag or vaccination; appears p windon period; if Ag neg then implies recovery, noninfectious
Anti-HBc: +in window; appears early; IgM = acute & in flares; IgG always present.
HBe-Ag: implies viral replication & infectivity; if + > 3 months may be chronic.
HBV dna: like HBe-Ag but more sensitive & precise.
Hepatitis C
Risk: Drugs (IVDA/intranasal cocaine), hemodialysis, transplant-92, needle stick, maternal-fetal transmission (5%), sex.
Blood products: cyro> 1987, PRBC>94, 1/10000-100000.
of 100 pt infected>85 chronic, 70 chronic active, 15 cirrohsis, hcc, 5 die.
No vaccine.
- acutely>asymptomatic: 60%
- syx>constitutional
- chronic: HCC 1- 4%
- extrahepatic: PAN, cryoglobulinemia, porphyria cutanatardica.
LFTs q3-6 months if all normal then q1year.
LFTs: do NOT indicate infectivity or chronicty.
Infectious: based on PCR
Tx: alpha interferon 50% respond in 1 year. May try ribavarin in conjuction if failed.
SE: fatigue, worsened hepatitis.
ribavirin- anemi
Disposition
Admit Criteria
- INR >2
- Unable tol POs
- Pain control
- Bilirubin >30
- Hypoglycemia
- Significant comorbid illness/immunocomp
- >50 years
See Also
GI: Jaundice
Source
Adapted from Stevens, Donaldson, Pani