Floating topic
Case 3
Symptoms
Abdominal pain, fever, dark urine, jaundice
Children may not have any
1-6 months post-infection
Stigma
Have FAQ-type pamphlet
e.g. will vaccine cause MS?
CDC says no!
Confidentiality
Who has access to test results?
Patient wishes vs. risk of family/friends
Feelings of guilt
Don't judge
Impairs communication
State of body
Liver transplant?
Need prophylactic treatment
To avoid infection of new liver
Only in chronic Hep B
Last stages of liver cirrhosis
Acute liver failure
Testing
Virological
More accurate for chronic Hep
Tests for viral DNA/RNA
Serological
Cheaper b/c can be analyzed outside lab
Screens for virus exposure via plasma
anti-HBs = Hepatitis B Surface Antibody
indicates recovery/immunity/vaccination
anti-HBe = Hepatitis B e Antibody
indicates Hep B clearance in pts with antiviral therapy
IgM anti-HBc = IgM Antibody to Hepatitis B core antigen
indicates acute Hep B or reactivation
anti-HBc = Total Hepatitis B Core Antibody
indicates previous/ongoing Hep B infection
appear symptom onset --> persist for life
HBeAg = Hepititis B Surface Antigen E
indicates active Hep B replication
risk of tranmission
HBsAg = Hepititis B Surface Antigen A
first marker to appear
if persists > 6 months indicates chronic Hep B
Treatment
Avoid alcohol + liver-intense
medication over 1 year
Antiviral
Stops viral replication
Interferons
Strenghtens body's own immune system against the virus
Insurance?
Risk factors for contracting Hep B
Sexual habits
Difficult to talk about
Daily habits
Dangerous to child
Alcohol-use
Risk behaviours for Hep B
Vaccination for child
Side-effects
"nothing" life-threatening
Usually mild lasting >24h
Dramatically reduces chances of infection
24-hours post vaccination
Free vaccinations for children in Romania
If child contracts Hep B, increased risk of developing chronic Hep B later
Check antibody level in blood
Consent
Mandated by the state?
Mom or grandparents?
Connection b/w drug intake + Hepititis B
Damaging nasal passages + oral cavity
More susceptible to other infections
Concurrent damage of liver
Spread via infected cooker, prep water, drug, needles
