Case 3

Connection b/w drug intake + Hepititis B

Spread via infected cooker, prep water, drug, needles

Concurrent damage of liver

Damaging nasal passages + oral cavity

More susceptible to other infections

Vaccination for child

Consent

Mom or grandparents?

Mandated by the state?

Check antibody level in blood

If child contracts Hep B, increased risk of developing chronic Hep B later

Free vaccinations for children in Romania

Dramatically reduces chances of infection
24-hours post vaccination

Side-effects

Usually mild lasting >24h

"nothing" life-threatening

Risk factors for contracting Hep B

Alcohol-use

Risk behaviours for Hep B

Daily habits

Dangerous to child

Sexual habits

Difficult to talk about

Treatment

Insurance?

Interferons

Strenghtens body's own immune system against the virus

Antiviral

Stops viral replication

Avoid alcohol + liver-intense
medication over 1 year

Testing

Serological

Screens for virus exposure via plasma

HBsAg = Hepititis B Surface Antigen A
first marker to appear
if persists > 6 months indicates chronic Hep B

HBeAg = Hepititis B Surface Antigen E
indicates active Hep B replication
risk of tranmission

anti-HBc = Total Hepatitis B Core Antibody
indicates previous/ongoing Hep B infection
appear symptom onset --> persist for life

IgM anti-HBc = IgM Antibody to Hepatitis B core antigen
indicates acute Hep B or reactivation

anti-HBe = Hepatitis B e Antibody
indicates Hep B clearance in pts with antiviral therapy

anti-HBs = Hepatitis B Surface Antibody
indicates recovery/immunity/vaccination

Cheaper b/c can be analyzed outside lab

Virological

Tests for viral DNA/RNA

More accurate for chronic Hep

State of body

Liver transplant?

Only in chronic Hep B

Acute liver failure

Last stages of liver cirrhosis

Need prophylactic treatment
To avoid infection of new liver

Stigma

Impairs communication

Don't judge

Feelings of guilt

Confidentiality

Patient wishes vs. risk of family/friends

Who has access to test results?

Have FAQ-type pamphlet

e.g. will vaccine cause MS?

CDC says no!

Symptoms

1-6 months post-infection

Children may not have any

Abdominal pain, fever, dark urine, jaundice