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