Hepatitis D & E

by Carlo Raj, MD

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    00:01 A few words about hepatitis D, now.

    00:03 The major ones are A, B, and C.

    00:05 Just a few words about D & E.

    00:08 Just to make sure we're complete and you don't miss any questions.

    00:11 Hepatitis D, right off the bat- the most important identification of this will be.

    00:16 It's a partial RNA.

    00:18 And, With that said, it will never cause fulminant hepatitis by itself.

    00:24 It can't - partial. It requires the help. Almost always with the partner, it's partner is b.

    00:31 concomitant infection Can co-infect or super infect with HPV and that becomes ridiculously dangerous.

    00:38 It accelerates the liver damage like you would not believe.

    00:41 Frequent, especially among, remember, Hepatitis B, how would you pass this on? Sexually or parentally, IV drug abusers are key candidates that you are paying attention to.

    00:55 Diagnosis: Anti-HDV Ab.

    00:59 Empiric therapy with, once again, IFN stands for interferon; recommended due to increased risk of liver disease.

    01:06 Fulminant liver disease remember.

    01:08 Remember, often times, d & b will be coming together as a package.

    01:12 Keep that in mind partial, DNA.

    01:15 Few words about hepatitis E here.

    01:18 This is an RNA virus.

    01:20 This is through the feco-oral route.

    01:22 What is the other type of virus that is also commonly feco oral? Good. Hepatitis A.

    01:29 Endemic areas you definitely want to know.

    01:31 This include the Indian sub-continent and Mexico, and Southeast Asia.

    01:39 Clinically resembles very much feco-oral.

    01:43 HAV infection.

    01:44 High mortality in pregnancy is big time for you.

    01:48 High mortality in pregnancy from Fulminant liver failure up to 20%.

    01:52 That is unfortunate.

    01:53 That is not a small percentage.

    01:55 So, if you think about hepatitis e, reflexively, you should be thinking about, The Far East Area, South East Asia, maybe Indian sub continent or the Mexican peninsula.

    02:08 And then you should be thinking about high mortality in pregnancy.

    02:12 Diagnosis: suspect with history to travel to such endemic areas.

    02:17 And HEV-IgM Available through your CDC.

    About the Lecture

    The lecture Hepatitis D & E by Carlo Raj, MD is from the course Cirrhosis – Liver Diseases.

    Included Quiz Questions

    1. Partial RNA virus
    2. ssDNA virus
    3. Partial DNA virus
    4. RT cDNA virus
    5. DNA virus
    1. Persons who practice poor sanitation
    2. IV drug abusers
    3. Homosexual men
    4. Pregnant women
    5. Persons with hemophilia
    1. Both viruses affect 1 cell and cause worsening of the infection.
    2. Both viruses affect the cell, with the net effect being impairment of the cell function similar to that of a cell affected by 1 virus.
    3. Both viruses affect 1 cell, with the net effect being attenuation of cell function.
    4. First, the hepatitis B virus affects the cell, and then hepatitis D decreases the destruction caused by hepatitis B on the cell.
    5. The hepatitis D virus functions independently of the hepatitis B virus.
    1. Northern South America
    2. Southeast Asia
    3. Mexico
    4. Indian subcontinent
    5. African subcontinent

    Author of lecture Hepatitis D & E

     Carlo Raj, MD

    Carlo Raj, MD

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