(1) Hepatitis Virus (HAV and HBV) Flashcards
1
Q
viruses that cause the same conditions, the same disease which is hepatitis
A
Hepatitis Virus
2
Q
why does hepatitis virus, regardless of the pathogen are able to cause hepatitis?
A
because these viruses have a high affinity to liver in which they attack and where they reside
the fucking bold wont work, i hate life
3
Q
Greek word “hepar”
A
liver
4
Q
Latin word “itis”
A
inflammation
5
Q
Greek word “hepar” + Latin word “itis” =?
A
Hepatitis
6
Q
Hepatitis may be caused by?
A
viruses, or by non-infectious
agents
not microorganism
7
Q
what are the two main groups of Hepatitis?
A
- Primary hepatitis viruses
- Secondary hepatitis viruses
8
Q
what group mainly affects the HEPATOCYTES
A
Primary hepatitis viruses
9
Q
what hepatitis virus are found in the primary hepatitis virus
A
types A, B, C, D, E, and G
hepatitis
no F
10
Q
main cause of viral hepatitis amounting to 95% of hepatitis cases
A
Primary hepatitis viruses
11
Q
also produce liver inflammation, but is secondary to other disease processes.
A
Secondary hepatitis viruses
12
Q
Liver is not the host cell, and the disease itself serves as a complication from another primary infection
A
Secondary hepatitis viruses
13
Q
what are the main causes for secondary hepatitis viruses?
A
- EBV
- CMV
- Herpes virus
14
Q
what are the starting symproms for hepatitis?
A
flu-like symptoms
fatigue, fever, myalgia, loss of appetite, nausea, vomiting, diarrhea or constipation, and mild to moderate pain in the right upper quadrant of the abdomen
15
Q
Progression of the hepatitis can cause specific complication such as?
A
- hepatomegaly
- jaundice
- dark urine
- light feces
16
Q
what are the 2 acute stages of viral hepatitis
A
- Acute Stage
- Fulminant Acute Stage
17
Q
Stages of Viral Hepatitis
sudden onset of signs and symptoms which may slowly progress to other stages or forms
A
Acute Stage
18
Q
Stages of Viral Hepatitis
Causes sudden onset of signs and symptoms with an immediate progression to lethal stages, and the stage wherein an individual may be prone to complications
A
Fulminant Acute Stage
19
Q
Stages of Viral Hepatitis
Also known to be the latent, or asymptomatic stage, wherein there are no signs and symptoms, but there is an active condition
A
Subclinical without Jaundice Stage
20
Q
Stages of Viral Hepatitis
Occurs months to years after the acute stage
A
Chronic Stage
21
Q
INITIAL LABORATORY FINDINGS
What elevation of certain analyte are seen?
A
bilirubin and other liver enzymes, especially, ALT
22
Q
INITIAL LABORATORY FINDINGS
TOF
Specific indicators of liver inflammation and must be followed by specific serological or molecular tests to identify the cause of hepatitis more definitively
A
F (non specific)
23
Q
what hepavirus
- Nonenveloped, single-stranded ribonucleic acid virus (ssRNA).
- Hepatovirus genus of the picornaviridae
- *Measures 27 nanometers.
A
HEPATITIS A VIRUS (HAV)
24
Q
The first strain of Hepatovirus to be discovered—MS-1
A
HEPATITIS A VIRUS (HAV)
25
* Localizes in the cytoplasm of infected hepatocytes.
* Formerly known as **infectious hepatitis or shortincubation hepatis**
HEPATITIS A VIRUS (HAV)
26
MOT of Hepatitis A Virus
- Fecal-oral route
- person-to-person contact.
- Ingestion of contaminated food or water
- Ingestion of raw shellfish from contaminated water beds
- Rarely, contaminated blood
27
# What Hepavirus
* Also known as the infectious hepatitis, or MS-1
* It has a short incubation period with an abrupt onset of signs and symptoms.
HEPATITIS A
28
What is the Hepatits A genus and specie
Genus hepatovirus, species **enterovirus 72**
| Family: Picornaviridae
29
most common type of hepatitis and the most frequently encountered in the laboratory
Hepatitis A Virus
30
Where does the antigen and Antibody for HAV can be seen
ANTIBODY - Serum
ANTIGEN - Stool
31
what is the target analyte for HAV?
antibody - in serum
32
# REGARDLESS OF TYPE, what antibodies can be seen
IgG or IgM
- Acute infection
- chronic infection, a convalescent infection (almost in recovery), a past infection, or the presence of immunity against the virus
- IgM
- IgG
33
main antibody for HAV
anti-HAV
34
# Hepatitis A Virus
TOF
has acute stage and chronic hepatitis?
F (acute only - self limiting)
35
# Hepa A Markers
Early shedding of the virus are found in?
Stool - ANTIGEN
36
# Hepa A Markers
Appearance of IgM anti-HAV with the onset of the symptoms is considered to be
reactive with an acute infection
| Other markers: Icterus and Inc. liver enzyme levels
37
# Hepa A Markers
Report the finding
Serum is positive for IgM anti-HAV
Reactive
if negative = non-reactive
| simple symbols of (+) and (-) can be used
38
# Hepa A markers
anti-HAV igG indicates what when seen in serum?
Immunity or recovery
| hepatitis A does not have a chronic stage
## Footnote
use RIA or ELISA okie
39
# Hepa A virus - Course of Infection
The onset of the disease starts with the presence of the virus in the?
Stool
40
# Hepa A virus - Course of Infection
presence of virus in the stool -> ?
followed by a **peak in IgM anti-HAV** along with the continuous increase to a plateau of IgG anti-HAV
41
Lab diagnosis for HAV
- Indirect ELISA
o IgM Anti-HAV
o IgG Anti-HAV
- Indirect RIA
- Reverse Transcriptase PCR (RT-PCR)
- Stool Electron Microscopy
- Clinical Findings
| if DIRECT ELISA = Antigen hinahanap
42
# Hepa A Virus - Clinical Manifestation
give the cause
- Fever
- Nausea and Vomiting
- Abdominal pain in the right upper quadrant
- Malaise, myalgia, and weight loss
- Jaundice
- Yellow to tea-color
urine
- Infectiion
- Liver to deaminsae proteins
- NONE
- Liver is not converting glucos to glycogen
- Infelmmation of the liver and inability to process bilirubin properly
43
what is the most common prevention of Hepa A Virus?
HAV vaccine
44
HAV Vaccine are developed when? and what is the other name
* Developed in 1995.
* Formalin-killed HAV
45
# HAV Vaccine
TOF
Recommended for routine immunization of children
aged 25 yrs old
F (12-23 months)
| tangina may children bang 25 yrs old???????
46
Enumerate the HAV preventions for NON-IMMUNIZED
- **Intramuscular injection of immune globulin** (pooled human plasma containing anti-HAV)
- **Prophylactic** administration of the hepatitis A vaccine
47
One of the major worldwide One of the major worldwide health problems, especially in the **hospital setting**
HEPATITIS B VIRUS (HBV)
- Infects 2 billion people worldwide
- 360 million chronic infections
- 500,000 to 1.2 million deaths each year
48
Highly endemic virus in the Far East, parts of the Middle East, subSaharan Africa and Amazon areas
HEPATITIS B VIRUS (HBV)
49
what family is the Hepa B virus and what characteristic of the virus
Family: Hepadnaviridae
- Circular DNA
- PARTIALLY double-stranded
50
# Hepa B Virus
considered as partially double stranded due to the presence of two regions
- complete region with double strands
- gap region with a single strand
51
# Hepa B Virus - Regions
contains all genetic -nformation to produce both the **hepatitis B surface antigen (HBsAg)** and **hepatitis B core antigen (HBcAg)**
complete region with double strands
| Hb**s**Ag = SURFACE antigen
Hb**c**Ag = CORE antigen
52
# Hepa B Virus - Regions
accounts for
10% to 15% of the molecules total length
gap region with a single strand
53
what is the retroviral replication of Hepa B virus?
Reverse transcription from RNA to DNA
54
# Hepa B Virus - Eradication
it is Stable, and long-enduring due to the virion having a?
covalently closed circular DNA (cccDNA) within the **hepatocyte nuclei**
| inner talaga
55
# Hepa B Virus - Eradication
TOF
HBBV DNA integrated into the host genome
F (HBV lang)
56
Considered to be the most severe type of hepatitis as it may lead to severe complications, especially if not treated
HEPATITIS B
57
serum hepatitis, or MS-2
HEPATITIS B
58
why Hepa B is termed as SERUM HEPATITIS or MS-2
transmitted through contact with infected **serum**, or infected **blood**
59
which has longer incubation period, HAV or HBV
HAV (2-6)
HBV (4-26)
60
# Hepa B
circular DNA and are considered to be the
infectious form of the virus
Dane particles
61
Hepa B MOT
- Parenteral (contaminated
needle)
- Vertical
- Sexual (wow)
62
what stages are found in Hepatitis B
Acute and Chronic Stage
63
wow IgM and IgG antibodies is found in HBV patient, what does this mean?
ACUTE stage - IgM
CHRONIC - IgG
| presence of IgG may indicate all
possible indications
64
# Hepa B - TOF
May lead to liver cirrhosis and cancer, and has a avatar state
F (carrier state lang)
| no signs and symptoms, but infective to other
65
Treatment of Hepa B
interferons or liver transplant
66
# Hepa B - Serologic Markers
where does Antigen and Antibody found and detected?
Serum
67
# Hepa B - Serologic Markers
use of different
biomarkers specific to the disease
Hepatitis B Profile
68
# Hepa B - Serologic Markers
* Known as the Australian Ag
* It is considered as the best indicator of early acute infection.
HEPATITIS B SURFACE ANTIGEN (HBsAg)
69
# Hepa B - Serologic Markers
Indicates active HBV infection, whether acute of chronic
- A reactive or (+) result in HBsAg is indicative of an active HBV infection
HEPATITIS B SURFACE ANTIGEN (HBsAg)
70
# Hepa B - Serologic Markers
HBsAg disappears during the
convalescent stage
| yield a (-) result for HBsAg
71
# Hepa B - Serologic Markers
* Found within the core of the intact virus.
* It is not detected in the serum since it is mainly recovered from the center of an infected hepatocyte
HEPATITIS B CORE ANTIGEN (HBcAg)
## Footnote
Due to its absence in the blood, it is not considered to be part of the hepatitis B profile which uses serum as a sample
72
# Hepa B - Serologic Markers
* It is produced during infection wherein an individual is
considered to be highly-infectious.
* Serves as a good indicator of **chronic hepatitis**.
HBe Ag/ E Ag/ E Protein
73
# Hepa B - Serologic Markers
* Indicates a high level of virus, and a high degree of infectivity.
* It also indicates an active viral replicatio
HBe Ag/ E Ag/ E Protein
74
# Hepa B - Serologic Markers
* A lifetime marker of HBV infection since it persists for life and is not subjected to any change moving forward.
* It is the first antibody (Ab) to appear at the same time ALT elevates.
ANTI-HBc
| Read as the “antibody for the HB core antigen”
75
# Hepa B - Serologic Markers
* It is the only marker that can be found in asymptomatic carriers and during the window period.
* A marker for previous infection as well, and considered to be a **non-protective antibody.**
ANTI-HBc
76
# Hepa B - Serologic Markers
what are the 2 ways of preparation of ANTI-HBc
- **IgM anti-HBc** which contains IgM only
- **Total anti-HBc** which contains both IgM and IgG.
77
# Hepa B - Serologic Markers
Report the test for ANTI-HBc
IgM anti-HBc: +
total anti-HBc: +
presence of **IgM**
78
# Hepa B - Serologic Markers
Report the test for ANTI-HBc
IgM anti-HBc: -
total anti-HBc: +
presence of **IgG**
79
# Hepa B - Serologic Markers
The first serologic evidence of convalescent phase, or the onset of recovery
ANTI-HBe
80
# Hepa B - Serologic Markers
However, it is not a protective antibody and is only used as a marker
ANTI-HBe
81
# Hepa B - Serologic Markers
* The antibody found in cases of immunity to further HBV infection. Therefore, it is a protective antibody.
ANTI-HBs
| “antibody for the HB surface antigen”
82
# Hepa B - Serologic Markers
The antibody found in cases of immunity to further HBV infection. Therefore, it is a protective antibody
| May persist throughout life
ANTI-HBs
83
# Hepa B - Serologic Markers
Indicates viral clearance, resolving infection, recovery, or
lifelong immunity
ANTI-HBs
| PROTECTIVE ANTIBODY TO
84
if u see this card
study course of infection
85
# FOUR STAGES OF HBV INFECTION
Identify what Test
Acute: +
WIndow: -
Complete Recovery: -
Chronic Carrier: +
HBsAg
86
# FOUR STAGES OF HBV INFECTION
Identify what Test
Acute: -
WIndow: -
Complete Recovery: +
Chronic Carrier: -
ANTI-HBs
87
# FOUR STAGES OF HBV INFECTION
Identify what Test
Acute: +
WIndow: +
Complete Recovery: -
Chronic Carrier: +
ANTI-HBc
88
# FOUR STAGES OF HBV INFECTION
what is the positive antibody for the acute stage and Chronic Carrier stage for ANTI-HBc
Acute stage = IgM
Chronic Carrier Stage = IgG
89
# INTERPRETATION PATTERN OF HBV MARKERS
steps, familliarize mo nalang
first markers to look at are the antigens.
1. **HBsAg**as it is specific for HBV
2. **HBe Ag** to determine the stage since it is a marker for the most infectious stage of hepatitis
3. **HBcAg** in order to determine whether it is a chronic or an acute infection.
4. These will be followed by**Anti-HBe, and Anti-HBs**
90
Interpret the pattern of HBV Markers
Anti-HBc IgM: Negative (-)
Total Anti-HBc: Negative (-)
HBsAg: Positive (+)
ANTI-HBs: Negative (-)
HBeAg: Negative (-)
ANTI-HBe: Negative (-)
HBV Incubation Period
91
Interpret the pattern of HBV Markers
Anti-HBc IgM: Positive (+)
Total Anti-HBc: Positive (+)
HBsAg: Positive (+)
ANTI-HBs: Negative (-)
HBeAg: Positive (+)
ANTI-HBe: Negative (-)
Acute HBV with High Infectivity
92
Interpret the pattern of HBV Markers
Anti-HBc IgM: Positive (+)
Total Anti-HBc: Positive (+)
HBsAg: Negative (-)
ANTI-HBs: Positive (+)
HBeAg: Negative (-)
ANTI-HBe: Positive (+)
Recent Resolving HBV
93
Interpret the pattern of HBV Markers
Anti-HBc IgM: Positive (+)
Total Anti-HBc: Positive (+)
HBsAg: Negative (-)
ANTI-HBs: Negative (-)
HBeAg: Negative (-)
ANTI-HBe: Negative (-)
Acute HBV "Window" Period
94
Interpret the pattern of HBV Markers
Anti-HBc IgM: Negative (-)
Total Anti-HBc: Positive (+)
HBsAg: Positive (+)
ANTI-HBs: Negative (-)
HBeAg: Positive (+)
ANTI-HBe: Negative (-)
Active Chronic HBV
95
Interpret the pattern of HBV Markers
Anti-HBc IgM: Negative (-)
Total Anti-HBc: Positive (+)
HBsAg: Positive (+)
ANTI-HBs: Negative (-)
HBeAg: Negative (-)
ANTI-HBe: Positive (+)
Chronic HBV, Carrier State
96
Interpret the pattern of HBV Markers
Anti-HBc IgM: Negative (-)
Total Anti-HBc: Positive (+)
HBsAg: Negative (-)
ANTI-HBs: Positive (+)
HBeAg: Negative (-)
ANTI-HBe: Positive (+)
Resolved HBV
97
Interpret the pattern of HBV Markers
Anti-HBc IgM: Negative (-)
Total Anti-HBc: Negative (-)
HBsAg: Negative (-)
ANTI-HBs: Positive (+)
HBeAg: Negative (-)
ANTI-HBe: Negative (-)
HBV Immunity
98
# TEST FOR HBV: FIRST GENERATION TESTS
* Principle: precipitation of antigen and antibodies.
* A (+) is indicated by a line of identity—a smooth, curved
line within the medium.
OUCHTERLONY
99
# TEST FOR HBV: SECOND GENERATION TESTS
Determine what test
Precipitation with current
Counter Immunoelectrophoresis
(CIE)
100
Determine what principle
Rheophoresis
Precipitation by evaporation
101
# TEST FOR HBV: SECOND GENERATION TESTS
Determine what Principle
Complement
Fixation
Fixation complement by antigenantibody reaction
102
The latest generation of tests and are considered to be the
most sensitive.
TEST FOR HBV: THIRD GENERATION TESTS
103
# TEST FOR HBV: THIRD GENERATION TESTS
* Principle: agglutination
* Anti-HBs is passively attached to
latex particles
Reverse Passive
Latex Agglutination
104
# TEST FOR HBV: THIRD GENERATION TESTS
* Principle: hemagglutination
* Anti-HBs passively attached to red cells
Reverse Passive
Hemagglutination
105
# TEST FOR HBV: THIRD GENERATION TESTS
* Hepatitis B profile tests
* Serves as a screening test
- most common
ELISA
106
# TEST FOR HBV: THIRD GENERATION TESTS
* Most sensitive for HBsAg
determination
RIA
107
# TEST FOR HBV: THIRD GENERATION TESTS
* Incorporates HBV DNA
* Serves as a confirmatory test,
and is considered as a definitive
test
PCR
108
# LABORATORY DIAGNOSIS, PREVENTION, AND CONTROL
what tests utilized Liver enzyme test
SGPT/ALT, and bilirubin
109
# LABORATORY DIAGNOSIS, PREVENTION, AND CONTROL
Serological tests
- HBs, HBc, and HBe Ag to test for acute and carrier stages
- ANTI-HBc and ANTI-HBe
- ANTI-HBs to test for immunity.
110
# LABORATORY DIAGNOSIS, PREVENTION, AND CONTROL
TOF
Treatment is asymptomatic
| diko gets
T
111
# LABORATORY DIAGNOSIS, PREVENTION, AND CONTROL
Prevention is done through
- Avoidance of mode of transmission or high-risk behaviors.
- Vaccine acquisition—HB vaccine acquired in three doses.
- Proper and thorough screening of donors and blood products.
- Recombinant vaccine
- Hepatitis B Immune Globulin (HBIG)
112
# LABORATORY DIAGNOSIS, PREVENTION, AND CONTROL
Administered within 24 hours of exposure and again 25-30 days later for cases of (among nonimmunized patients) accidental needlestick exposure, exposure of mucous membranes or open cuts to HBsAg positive blood.
Hepatitis B Immune Globulin (HBIG)
113
# LABORATORY DIAGNOSIS, PREVENTION, AND CONTROL
Immediately (no later than 24 hours after birth) to infants born to mothers with acute hepatitis B in 3rd trimester, or with HBsAg at delivery
Hepatitis B Immune Globulin (HBIG)
