Term
| the time they get infected with the virus to the time they start to show symptoms |
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Definition
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Term
| the symptoms you can get PRIOR to liver problems |
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Definition
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Term
| a term that means "jaundice" |
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Definition
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Term
| clearance or something "cure" of the disease |
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Definition
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Term
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Definition
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Term
| when liver is shutting down (could be end stage liver disease) |
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Definition
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Term
| describes duration of the disease |
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Definition
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Term
| deposits of fat causes liver enlargement |
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Definition
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Term
|
Definition
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Term
| growth of connective tissue destroys liver cells |
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Definition
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Term
| acute, but does not commonly occur in the US; SE Asia, N Africa (more severe in pregnant women) |
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Definition
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Term
| most commonly tested for in the US |
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Definition
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Term
|
Definition
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|
Term
| one of the more common forms of chronic hepatitis |
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Definition
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Term
| most common form, but not many pts will progress to chronic as compared to hepatitis C |
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Definition
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Term
| cannot survive without Hepatitis sB so if a patient tests positive for this then you also have to test for Hepatitis B |
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Definition
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Term
|
Definition
| oral-fecal (primary mode); contaminated water, ice food; blood borne transmission (uncommon) |
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Term
| If it occurs in the US it is usually through an outbreak |
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Definition
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|
Term
| liver inflammation in hepatitis A |
|
Definition
| nausea and abdominal discomfort |
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|
Term
| children with Hepatitis A |
|
Definition
| frequently asymptomatic/unrecognized |
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Term
| incubation period for hepatitis A |
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Definition
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Term
| can be given to someone who is traveling but it is really recommended they get the HepA vaccine instead |
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Definition
| IgG (pooled human plasma) |
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Term
| Immune Globulin HAV dose: 0.02 mL/kg IM |
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Definition
| pre-exposure short term coverage (1-2 months) |
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Term
| Immune Globulin HAV dose: 0.06 mL/kg IM (repeat every 5 months) |
|
Definition
| pre-exposure long term coverage (3-5 months) |
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|
Term
| Immune Globulin HAV dose: 0.02 mL/kg IM |
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Definition
| Post-exposure within 2 weeks 80-90% efficacy |
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Term
|
Definition
| inactivated HAV antigen; REFRIGERATE |
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Term
| 2 dose series vaccines JUST for HepA (separated by 6 months) |
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Definition
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|
Term
| HepA and HepB vaccine-- you can do a 3 or 4 dose series that protects against both |
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Definition
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Term
|
Definition
| time, supportive care, avoid alcohol and Tylenol; wash hands; no antiviral agents for txt |
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Term
| acquired/transmitted in similar ways; co-infection leads to higher progression of chronic liver disease |
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Definition
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Term
| 100 times MORE infectious than HIV |
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Definition
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|
Term
| Hepatitis B is more infectious |
|
Definition
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|
Term
| incubation period of 90 days to jaundice; 60 days to ALT abnormalities |
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Definition
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|
Term
| has a longer incubation period than Hep A (3 months as compared to 1 month); carriers = people who have chronic HepB |
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Definition
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|
Term
| necroinflammatory disease; HBeAg + or - |
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Definition
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|
Term
| intermittent increased ALT/AST > 10x ULN and >2x baseline |
|
Definition
| acute exacerbation/flare HBV |
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|
Term
| reappearance of necroinflammatory disease in inactive HBsAg carrier state or resolved HB (increased ALT/AST, increased VL) |
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Definition
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|
Term
|
Definition
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Term
|
Definition
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|
Term
| classified as active because you can detect the virus in them |
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Definition
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|
Term
| still have the surface antigen present for greater than 6 months; low viral load compared to active carriers |
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Definition
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|
Term
| prevention of Hepatitis B |
|
Definition
| alcohol consumption, watch hepatically cleared meds; education; pre-exposure vs. post-exposure; vaccination for everyone |
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|
Term
| inactivated, HBsAG (surface antigen), recombinant; REFRIGERATE; IM |
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Definition
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|
Term
|
Definition
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|
Term
| recombinant HBsAg, diphtheria and tetanus toxoids and acellular pertussis and inactivated poliovirus |
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Definition
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|
Term
|
Definition
| we are not giving envelope or core, we are just giving surface antigen only |
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|
Term
| done for hepB vaccine 1-2 month after vaccine series to see if patients actually had a response |
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Definition
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|
Term
| for immediate protection-- unvaccinated person ($$$) |
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Definition
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|
Term
| prevent infection after acute exposure; prevent re-infection after liver transplant |
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Definition
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|
Term
| 2 main categories for antiviral therapy |
|
Definition
| interferon (injectable); nucleoside/tide analogs (oral) |
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|
Term
|
Definition
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|
Term
|
Definition
| lamivudine, emtricitabine, telbivudine, entecavir |
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|
Term
|
Definition
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|
Term
| HIV antiviral activity as well |
|
Definition
| lamivudine, emtricitabine, tenofovir |
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|
Term
| in non-HIV patients you usually see these antivirals used |
|
Definition
| telbivudine, entecavir, adefovir |
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|
Term
| poorly tolerated (flu like symptoms) also feel as though they have hepatitis; injection site reactions; short acting pt has to take every other day |
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Definition
|
|
Term
| preferred interferon because it is long acting--- can cause lab abnormalities |
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Definition
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|
Term
| this is a nucleoside/tide option because it is oral; do not see it used much anymore |
|
Definition
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|
Term
| not FDA approved for hep B; not first line for just hep B; well tolerated, would consider for co-infected patient (HIV and hepB) |
|
Definition
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|
Term
| can cause nephrotoxicity at higher doses |
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Definition
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|
Term
| nucleoside reverse transcriptase; well tolerated overall |
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Definition
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|
Term
| more potent than lamivudine; if patient was on lamivudine do not switch them to this because they are so similar (hep b may already be resistant to it) |
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Definition
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|
Term
| if HBV patient has a positive envelope antigen, we will look at this to determine length of treatment |
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Definition
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|
Term
| if ALT is less than 1 times the upper limit of normal in chronic HBV |
|
Definition
| monitor every 3-6 months and check for seroconversion |
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|
Term
|
Definition
| see every 3 months to monitor ALT; may do a biopsy |
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|
Term
|
Definition
| check the pt to see if the ALT is consistently elevated; check to make sure antigen still positive; treat if they are persistant in this category |
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|
Term
| if HBV envelop is negative (but antibody positive) |
|
Definition
| watch both ALT and the viral load; if ALT is consistently elevated and viral load is up then we will treat |
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|
Term
| preferred agents for chronic HBV |
|
Definition
| adefovir, entacavir, telbivudine, peginterferon (do not use peg if they are previous IV drug users) |
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|
Term
| end of treatment response |
|
Definition
| normal ALT, viral load < 2000 |
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|
Term
|
Definition
| will be on PEGYLATED for at least a year |
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|
Term
| number one indication for liver transplantation |
|
Definition
|
|
Term
| hepatitis C is the leading cause of: |
|
Definition
| chronic liver disease; cirrhosis; liver cancer; death due to liver disease; liver transplantation |
|
|
Term
| There are more people infected with this in the US; there are more people infected with HepB in the world |
|
Definition
|
|
Term
|
Definition
| most common chronic form of hepatitis |
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|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| patients with HepC are more susceptible |
|
Definition
| liver cancer as well as non-hodgkins lymphoma |
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|
Term
|
Definition
|
|
Term
| is the most commonly occurring genotype in the US |
|
Definition
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|
Term
|
Definition
| approximately 75% of the HCV infections (Was also the hardest to treat) |
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|
Term
| No Vaccine!! No pre-exposure prophylaxis!! |
|
Definition
| hepatitis C: antiviral therapy is recommended for pts with chronic hepatitis |
|
|
Term
|
Definition
| pegylated interferon and ribavirin |
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|
Term
| 2 new ones approved for genotype 1 in the Spring 2011 to be used in combo with pegylated interferon and ribavirin for HCV |
|
Definition
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|
Term
| binds to cell membrane; induction of intracellular enzymes; viral replication inhibition, suppression of cell proliferation, immunomodulating activities |
|
Definition
| Peginterferon-Alfa 2a (Pegasys) |
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|
Term
| is not a direct acting antiviral. it primes the liver, works a bit on the immune system, helps suppress HepC and usually works best in combo with ribavirin |
|
Definition
|
|
Term
| decreases cellular purine metabolism, increases RNA virus mutation, increases antiviral cytokines; pregnancy category X; once you have to change the dose for AEs you are compromising its efficacy! |
|
Definition
|
|
Term
| Peginterferon alfa-2a in hep C genotype 1,4 |
|
Definition
| <75 kg: 1000 mg/day PO in 2 divided doses; >75 k: 1200 mg/day PO in 2 divided doses |
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|
Term
| Peginterferon alfa-2a in hepatitis C genotype 2, 3 |
|
Definition
| 800 mg/day in 2 divided doses x 24 weeks |
|
|
Term
|
Definition
| cannot be taken by themselves; substrate and inhibitor of CYP3A4/5; wait for stabilization for those with decompensated liver disease |
|
|
Term
| Start PEG-INF and ribavirin before adding Boceprevir |
|
Definition
|
|
Term
| side effects include anemia, rash/itching, insomnia; food helps with absorption |
|
Definition
|
|
Term
| being with triple therapy for first 12 weeks then stop this |
|
Definition
|
|
Term
|
Definition
| anal/rectal itching can occur due to drug precipitating out as it is getting excreted (take with high fat content food) |
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|
Term
|
Definition
|
|
Term
| should always be monitored with hepatitis patients because of the extrahepatic manifestations |
|
Definition
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