1. Blood Borne Viruses

Question 1

Definition of hepatitis

Answer 1

Inflammation of the liver

Question 2

Types of hepatitis viruses (6)

Answer 2

Hep A
Hep B
Hep C
Hep D
Hep E
GBV-C (formerly Hep G)

Question 3

Transmission of Hep A

Answer 3

Faecal-oral route

Question 4

Transmission of Hep B (3)

Answer 4

Parenteral
Sexual
Perinatal

Question 5

Transmission of Hep C (3)

Answer 5

IV drug use
Blood and blood products
Sexual

Question 6

Transmission of Hep D

Answer 6

Blood-to-blood contact if Help B present

Question 7

Transmission of Hep E

Answer 7

Faecal-oral route

Question 8

Hep B particles (3)

Answer 8

Dane particle
Spherical
Filamentous

Question 9

What is the Dane particle comprised of

Answer 9

Complete virion

Question 10

Clinical course of acute Hep B (3)

Answer 10

Infection
Incubation period
Clearance of antigens and creation of anti-HBs after 6mths

Question 11

Length of incubation period of Hep B

Answer 11

2-3 months

Question 12

Definition of incubation period

Answer 12

Period between exposure to an infection and the appearance of the first symptoms

Question 13

Hep B symptoms (3)

Answer 13

Usually none
Flu-like illness
Jaundice

Question 14

Clinical course of chronic Hep B (3)

Answer 14

Infection
Incubation period
Persistence of HBsAg, no anti-HB development

Question 15

When is HBV considered chronic

Answer 15

When an antibody to the core Ag is present, but there is no antibody to HBsAg (surface antigen)

Question 16

Testing method for acute Hep B (2)

Answer 16

IgM anti-core - positive

HBsAg - positive/negative (still developing)

Question 17

Testing method for chronic Hep B (3)

Answer 17

IgM anti-core - negative
HBsAg - positive
IgG anti-core - positive/negative

Question 18

Test results if Hep B, previous infection (3)

Answer 18

IgG anticore - positive
HBsAb - positive/negative
Negative for other markers

Question 19

Test results if Hep B vaccinated (2)

Answer 19

HBsAb - positive

Negative for other markers

Question 20

Reasons for HBV vaccine (3)

Answer 20

Some countries as part of childhood vaccination
HCWs who perform exposure prone procedures
Highly immunogenic

Question 21

When is post-exposure prophylaxis (PEP) not required for HBV

Answer 21

For those who had a successful response to the vaccine

Question 22

Definition of prophylaxis

Answer 22

Treatment given or action taken to prevent disease

Question 23

Treatment for unvaccinated HBV exposure (2)

Answer 23

HBIG x1 (initiated Hep B vaccine series)

Question 24

Treatment for vaccinated non-responder for HBV exposure (2)

Answer 24

HBIG x1

Vaccine booster

Question 25

HBV treatment

Answer 25

Antiviral drugs Immunomodulatory agents Oral nucleoside analogues Nucleotide analogues

Question 26

What is a marker of a highly infectious disease/individual

Answer 26

HBeAg | Creation of antibodies against HBsAg leads to immunity when anti-HBeAg is present

Question 27

Clinical course of HCV infection (2)

Answer 27

Infection | Incubation period

Question 28

HCV incubation period

Answer 28

Up to 26wks (mean is 6-12wks)

Question 29

HCV symptoms (2)

Answer 29

Symptomless Non-specific symptoms Jaundice

Question 30

HCV testing methods (4)

Answer 30

Anti-HCV test (detects antibodies presence) HCV-RNA test (identifies virus in blood) Viral load/quantitative HCV test (measures viral particles in peripheral blood) Vital genotyping (type of HCV present)

Question 31

HCV recovery (3)

Answer 31

Less likely than from HBV Chronic infection more likely No vaccine currently available

Question 32

HCV treatment (2)

Answer 32

Direct acting antiviral agents | Protease inhibitors

Question 33

Composition of HIV (2)

Answer 33

Single-stranded RNA | Envelope composed of lipid and viral proteins

Question 34

Survival of HIV (3)

Answer 34

Does not survive long outside human (host) Cannot reproduce outside human host Easily killed by heat

Question 35

HIV transmission (7)

Answer 35

``` Blood/blood products transfusion IV drug user needle sharing Needle stick injuries Male homo/heterosexual contact Intrauterine Childbirth Breast milk ```

Question 36

Clinical course of HIV disease (3)

Answer 36

HIV destroys CD4 cells (central to immune response initiation) Acute seroconversion illness has an incubation period of 1mth and resembles mild glandular fever End point is AIDS

Question 37

Common pattern of HIV disease progression (3)

Answer 37

Primary infection Prolonged (mean 10yrs) period of clinical latency Appearance of clinically apparent disease

Question 38

Definition of AIDS

Answer 38

The presence of one or more indicator conditions in association with HIV

Question 39

Examples of AIDS indicator diseases (4)

Answer 39

Lymphoma TB Pneumonia Kaposi sarcoma

Question 40

HIV testing (2)

Answer 40

``` ELISA test (antibody detection) Blood test ```

Question 41

HIV treatment (3)

Answer 41

Anti-retroviral drugs/therapy NRTIs/NNRTIs (non/nucleoside reverse transcriptase inhibitors) Combination - HAART (highly active ART)

Question 42

HBV structure

Answer 42

Partially double stranded DNA virus

Question 43

HCV structure

Answer 43

Single stranded RNA virus

Question 44

HIV structure

Answer 44

Single stranded RNA virus

Question 45

HBV/HCV/HIV vaccination (3)

Answer 45

HBV - yes HCV - no HIV - no

Question 46

HBV/HCV/HIV primary method of spread (3)

Answer 46

HBV - unprotected sex HCV - IV drug use HIV - unprotected sex

Question 47

HBV/HCV/HIV sharps injury transmission (3)

Answer 47

HBV - 1/3 HCV - 1/30 HIV - 1/300

Question 48

HBV/HCV/HIV PEP (3)

Answer 48

HBV - yes HCV - no HIV - yes

Question 49

HBV/HCV/HIV most infective

Answer 49

HIV