Hepatitis

[Kluver_Bucy]

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I'm having problems with B and C. Which one is more likely to be transferred from blood? How about sexual intercourse?

Also, which has the worst prognosis? Thanks everyone for helping out with my questions. 😍

 

[idq1i]

1 - both are quite hardy. Both are transmitted parenterally

2 - 85% of B is cleared completely
only 15% of C is cleared. The other 85% goes to cirrhosis + HCC

If you look at the %, the flavivirus (HCV) has the worst prognosis

 

[omarsaleh66]

Some associations:

Needle stick, Poly arteritis nodosa, Reiters, Hep D --> think Hep B

blood transfusion, cryoglobinuria --> think Hep C

I know buzzwords are really used that much anymore but who knows? it show up.

EDIT: I think Hep B is more common in sex, Hep C is more on transfusions, but these can be flipped around too.

 

[smgilles]

I'm having problems with B and C. Which one is more likely to be transferred from blood? How about sexual intercourse?

Also, which has the worst prognosis? Thanks everyone for helping out with my questions. 😍

The most efficient way to acquire HBV is through injection of the virus into the blood stream. Common but less efficient routes of infection are sexual contact and birth.

HCV is transmitted primarily in infected blood and sexually. IV drug users, transfusion and organ recipients, and hemophiliacs receiving factors VIII or IX are at highest risk for infection.

HCV is transmitted similarly to HBV but has a greater potential for establishing persistent, chronic hepatitis, which leads to cirrhosis and PCH. The initial disease is asymptomatic, but 80-85% of HCV patients establishes chronic disease.

 

[crys20]

hep c is lowly transmitted via sex and is mostly via blood. hep b can be sexually transmitted or blood sticks.

 

[p53]

hep c is lowly transmitted via sex and is mostly via blood. hep b can be sexually transmitted or blood sticks.

Tommy must have been really ROUGH on Pam.

 

[crys20]

Pam had hep c long before tommy. it has a high correlation with tatoos which she had gotten decades before. Most people who have it in that frame got it from needle sticks via tatoo needles.

 

[idq1i]

cryoglobinuria --> think Hep C

it's cryoglubulinemia, not -uria

 

[Idiopathic]

Hep C is NOT usually transmitted via sex, just so you know. Something like 6% of monogamous partners with infected sexual partners get infected themselves.

1) Most common hepatitis likely to be acquired by needle stick - hep B
2) Most common hepatitis likely to be acquired via sex - hep B
3) Most common hepatitis likely to be acquired via transfusion - hep C

per goljan

 

[omarsaleh66]

it's cryoglubulinemia, not -uria

my bad.

 

[souljah1]

Depends on what patient population you are working with.

AT SFGH, if you get a needle stick you are worrying about HepC much more than B.

Someone mentioned above that 15 or so % of Hep C is cleared and the rest go on to get cirrhosis or HCC. That is not true according to my Hepatology attending last week (editor of Hepatology.) Yes about 15-20% (depending upon the literature you cite) gets cleared, but the other 80-85% are not absolutely destined to develop cirrhosis. A good portion of those with chronic hep c never develop cirrhosis, and many who do have liver fibrosis have stage 1 fibrosis which really has no impact on mortality given that their synthetic function is absolutely normal and they have no evidence of portal HTN. Now, if someone is co-infected with HIV, all of these data are out the window.

Also Hep C is very much unlikely to spread through sexual intercourse in monogamous people compared to Hep B. Most Hep C is contracted through IVDU and then transfusions. Some even suggest that sharing straws and doing coke can lead to transmission via blood subsequent to mucosal injury. Hep B, you should think transfusions, vertical transmission, sex, sticks.

 

[Mumpu]

Also chronicity is reversed in neonates -- B tends to become chronic while (whilst?) C is usually cleared.