HTHSCI 1DT3 Lecture Notes - Lecture 9: Polyneuropathy, Hla-Dq2, Zoonosis
23 Jun 2018
School
Department
Course
Professor
DISEASE COURSE
- Transmission by blood products (haemophiliacs pre-1985), IVDU (60-90%) and sexual contact
(but mainly only in MSM (4-8%), small amount of vertical transmission
- 4-6 week incubation period
- Acute (<6 months) in 20-40% can be asymptomatic
- Chronic (>6 months) in 60% of women and 80% of men
- Has effects on brain as well as liver (tiredness etc.)
DIAGNOSIS
Antibodies take ages:
thus HCV RNA required for diagnosis
TREATMENT
- Acute infection treated with IFN monotherpay with excellent outcomes (SVR = 98% - Jaeckel et
al 2002) i.e. treatment in acute stage much more successful
- Immunosuppression is a major indication for treatment as antibody responses are impaired
Chronic treatment:
- Genotypes 1 & 4: alpha-interferon (3miu tiw) for 12 months, ribavirin (600-1200mg/day)
protease inhibitors for type 1
- Genotypes 2&3: alpha-interferon (3miu tiw) for 6 months, ribavirin (600-1200mg/day)
- Protease inhibitors target NS3; polymerase inhibitors target NS5b
Hepatitis D
- Few parts of S.America, Africa, E.Europe have high prevalence
- Super-infection causes much faster cirrhotic progression = 2-3 years
you can see persistence of anti-HAV, HbsAg, HDV RNA, more highly elevated ALT which
remains high and fluctuates and jaundice occurring more quickly:
Hepatitis E
- Hepeviridae
EPIDEMIOLOGY
- Mainly in Africa and S.Asia
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Transmission by blood products (haemophiliacs pre-1985), ivdu (60-90%) and sexual contact (but mainly only in msm (4-8%), small amount of vertical transmission. Acute (<6 months) in 20-40% can be asymptomatic. Chronic (>6 months) in 60% of women and 80% of men. Has effects on brain as well as liver (tiredness etc. ) Antibodies take ages: thus hcv rna required for diagnosis. Acute infection treated with ifn monotherpay with excellent outcomes (svr = 98% - jaeckel et al 2002) i. e. treatment in acute stage much more successful. Immunosuppression is a major indication for treatment as antibody responses are impaired. Genotypes 1 & 4: alpha-interferon (3miu tiw) for 12 months, ribavirin (600-1200mg/day) Genotypes 2&3: alpha-interferon (3miu tiw) for 6 months, ribavirin (600-1200mg/day) Protease inhibitors target ns3; polymerase inhibitors target ns5b. Few parts of s. america, africa, e. europe have high prevalence. Super-infection causes much faster cirrhotic progression = 2-3 years.
