Viral Hepatitis B/C and Tuberculosis Jeopardy

HBV Screening & Vaccination

100

For what 2 groups does the CDC recommended universal HBV screening?

All adults aged 18 years and older and all pregnant persons, regardless of age and during each pregnancy

200

Which hepatitis B screening serology reflects whether someone has been infected with hepatitis B in their lifetime?

Hepatitis B core antibody, TOTAL or IgG

300

Name 4 groups of people who are recommended post-vaccination serologic testing (BONUS 100 points for any additional group after first 4)

1. Health care personnel and public safety workers

2. Sexual and household contacts of HBsAg(+) persons

3. Hemodialysis patients

4. Persons with HIV and other immunocompromising conditions

5. Infants born to HBsAg(+) mothers or mothers whose HBsAg status remains unknown

400

What are the two most common clinical scenarios to explain the following screening result? HBsAg(-), anti-HBc(+), anti-HBs(-)?

1. Prior HBV infection

2. Occult HBV infection

Chronic HBV Management

100

For patients who are uninsured or with high deductible plans, name at least one source for prescribing affordable HBV antiviral medications.

GoodRx or Mark Cuban Cost Plus Drugs

200

Name the 2 first line HBV antiviral medications that are available as generic medications.

Entecavir and tenofovir disoproxil fumurate

300

Name an example of an immunosuppressive medication (or drug class) that poses a high risk of hepatitis B virus reactivation in persons who are either HBsAg-positive or HBsAg-negative and anti-HBc positive?

B-cell depleting agents, e.g. anti-CD20 monoclonal antibodies such as rituximab

400

What is the goal/treatment endpoint of nucleotide therapy and new functional cure therapies?

HBsAg loss (HBsAg conversion from positive to negative)

Hepatitis C

100

With what test(s) do we screen for HCV at NEMS?

HCV Ab with reflex HCV RNA

200

Sustained viral response/SVR (Cure) should be checked how many weeks after treatment ends and with what test?

12 weeks after last dose of treatment and with HCV RNA

300

What are 3 possible scenarios leading to a HCV Ab positive and HCV RNA negative result?

Prior HCV infection, self-resolved

Prior HCV infection s/p curative treatment

False negative HCV Ab

400

What are the 2 first-line pan-genotypic direct acting antiviral medications used for treatment-naive HCV and duration of treatment? (generic or brand name of medication acceptable)

Glecaprevir (300 mg)/pibrentasvir (120 mg) (Mavyret) x 8 wks

Sofosbuvir (400 mg)/velpatasvir (100 mg) (Epclusa) x 12 wks

Tuberculosis

100

Which TB screening test is recommended for persons who have received BCG vaccine?

IGRA (e.g. TB-Quantiferon or T-SPOT)

200

Name 3 symptoms of active TB disease

Unexplained weight loss

Hemoptysis

> 2 weeks cough

Night sweats

300

Name 3 short course LTBI regimens

4 months rifampin

12 weeks INH + rifapentine

3 months INH + rifampin

4 months rifabutin

400

Taking direct oral anticoagulants is an absolute contraindication to prescribing this regimen

4  months of rifampin