Case 3

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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