28. Hepatitis virus Infections Flashcards
Clinical symptoms of hep
- jaundice
- dark urine
- abdominal pain
- itching
laboratory tests for hep
- levels of liver enzymes (AST, LDH) in blood are elevated
- hep markers
is hep cytolytic?
Hep is not cytolytic, doesnt kill liver cells
what causes symptoms in acute stage of hepatitis infection?
cytotoxic effects of host immune system.
Chronic hepatitis is caused by hep ______, damage to liver is caused by ____.
B, C, D
ineffective host immune system still causes inflammation and low level cytotoxicity.
Which hep virus causes the largest % acute disease?
Hep B > Hep A > Hep C
Which hepatitis virus do we have a vaccine for?
Hep A and B
NOT for C.
Which is more transmissible, hep B or C?
Hep B is more transmissible.
Which hepatitis virus can lead to Hepatocellular carcinoma (HCC)?
Hepatitis B and C.
% of HBV infections that lead to chronic infec, HCV?
HBV = 10% HCV = 50%
Difference in serology of chronic vs. acute HBV infection.
- difference is that surface protein (HBsAg) continues to be detected bc the virus persists, but no antibodies to the surface protein is developed (no anti-HBs). There are Ab to HBc (core protein) but remember these are not protective.
If the infection lasts > 6 months, it is considered to be a chronic infection
IgM antiHBc (+) and HBsAg (+)
acute HBV infection
If a pt shows symptoms of acute hep infection, and tests + for acute HBV infection:
- monitor & re-test after 6 months to determine if chronic, even though most HBV infections DO NOT become chronic.
- Suggest HAV vaccine, male homosexual activity increases risk of HAV infection, which could be more serious if added to HBV infection.
- advise safe sex practices = risk of transmission.
- Close contacts should get HBV vaccine (since he has it)
male homosexual activity increases the risk of ____ (hep) infection, which could be more serious with the underlying ___ infection.
HAV (may be more serious with underlying HBV)
Decreases in ACUTE hep infections are due to:
- vaccination programs (HAV & HBV)
- screening of blood supply (HBV & HCV)
- increased safe sex practices to prevent HIV infection
4 Risk factors for hep A transmission:
- Travel to a region with endemic HAV (Mexico, India, Africa)
- Close personal contact with infected (household contact, child day-care centers)
- male homosexuality
- Outbreaks due to contaminated food, water (infected food handlers)
3 events that occur with recovery from HBV infection:
Loss of symptoms
Loss of HBsAg
Appearance of anti-HBs **
key events that differentiate acute/chronic HBV infection:
weaker acute symptoms
anti-HBsAg antibodies never develop (but will show anti-HBc)
virus persists for more than 6 month (life long)
HBsAg indicates ___
presence of virus (acute or chronic)
IgG-HBc indicates ____
current or past infection
IgM anti-HBc indicates ____
current acute infection
Anti-HBs indicates ____
was vaccinated (not generally used)
What is the key antibody that distinguishes acute from chronic HBV?
IgM anti-HBc (-) = chronic.
progression to chronic infection is correlated with ___
age – yonger ppl are more likely to develop.
