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GIR Test 2 > B5.027 - Hepatitis Viruses > Flashcards

B5.027 - Hepatitis Viruses Flashcards

1
Q

describe HAV

A

picornoviridae HAV aka enterovirus 72 small (27nm) non enveloped ssRNA (+) replication exclusively in cytoplasm

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2
Q

HAV typical serologic course

A

1-2 months after exposure - fecal HAV, ALT rises total anti HAV develops after 2-4 months, stays for life IgM starts after 1 month, drops around 4

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3
Q

is there a vaccine for HAV?

A

yes, greatly reduced incidence after 1995

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4
Q

incubation period, jaundice by age group, complications/clinical sequelae of HAV

A

avg 30 days 6-14 yo - 40-50% >14 yo - 70-80% fulminant hepatitis cholestatic hepatitis relapsing hepatitis no clinical sequelae

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5
Q

HAV vaccine

A

inactivated vaccine adsorbed onto aluminum hydroxide 94-100% effective

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6
Q

what types of enveloped proteins does HBV have

A

small, medium and large

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7
Q

what role does the large protein have

A

has receptor binding site

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8
Q

what proteins does HBV need to make it infectious

A

small and large proteins

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9
Q

why does HBV need small particles

A

to ensure release of proteins from cell

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10
Q

possible mechanisms of HBV induced liver carcinogenesis

A
  1. integration of HBV DNA into host DNA leading to genome instability and mutations 2. DNA damage from chronic infection 3. X protein acts as transcription activator 4. persistent liver damage resulting in hepatocyte proliferation
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11
Q

treatment of HBV in order of use

A
  1. tenofovir 2. entecavir 3. telbivudine 4. adefovir 5. lamivudine 6. Pegylated IFN 7. IFN alpha
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12
Q

first line treatment of HBV

A

tenofovir entecavir

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13
Q

describe labs for HBV

A

HBsAg - surface angigen, marker of infectivity when found in serum anti-HBsAg - antibody to HBsAg, marker of immunity anti-HBcAg - marker of past or current infection

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14
Q

what is IgM anti-HBc

A

antibody indicating recent infection with HBV

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15
Q

IgG anti HBc

A

IgG is a subclass of anti HBc indicates older infection with HBV

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16
Q

what is HBeAg

A

Hepatitis B e antigen can only be present if HBsAg is positive. Indicates active infection

17
Q

what is anti HBe

A

antibody to e antigen may be present in infected or immune person

18
Q
A

susceptible to HBV infection

19
Q

HBsAg neg

Anti HBc pos

Anti HBs pos

A

immune to natural infection

20
Q

HBsAg neg

Anti HBc neg

AntiHBs pos

A

immune due to vaccine

21
Q

HBsAg pos

AntiHBc pos

IgM antiHBc pos

anti HBs neg

A

acutely infected

22
Q

HBsAg pos

anti HBc pos

IgM antiHBc neg

anti HBs neg

A

chronically infected

23
Q

HBsAg neg

IgM anti HBc pos

anti HBs neg

A
  1. resolved HBV infection
  2. may be susceptible with a false positive anti HBc
  3. may have low level chronic infection
  4. may be resolving an acute infection
24
Q

describe the two types of HDV infection

A

coinfection with HBV

Superinfection (ad different times)

25
Q

outcomes of coinfection

A

3-4% fulminate hepatitis –> death

90% - acute severe disease –> recovery

5% - crhonic –> cirrhosis

26
Q

superinfection outcomes

A

5% - fulminate hepatitis –> death

10-15% acute severe disease –> recovery

80% - chronic hepatitis –> cirrhosis

27
Q

HCV

incubation period, acute illness, case fatality rate from acute infx

A

6-7 wks

mild <20%

low

28
Q

current treatment of HCV

A

ledipasvir and sofosbuvir

29
Q

describe the developement of HCV associated HCC

A

viral entry and replication

inflammation, cellular growth signals, resistance to apoptosis, oxidative stress, metabolic disorders

fibrogenesis, hypoxia, genetic instability, LPS translocation from intestinal microbiota

30
Q

incidence of HCC in different hepatitis

A

HBV - 60%

HCV - 25%

neither - 12%

both - 3%

31
Q

host of the four types of HEV

A

1 - humans and pigs

2 - humans

3 - humans and animals

32
Q

route of admin of 4 types of HEV

A

1, 2 - fecal oral, vertical

3, 4 - zootonic usually swine, environmental and blood transfusion

33
Q

geographical distribution of the 4 types of HEV

A

1 - mainly asia

2 - MX and west africa

3 - worldwide

4 - china, east asia, central europe, america

34
Q

seasonality of types of HEV

A

1,2, - flooding/monsoon season

3,4 - no

35
Q

clinical presentation of HEV types

A

1,2 - acute self limited hepatitis

3,4 - may lead to chronocity in immunosuppressed (3)

36
Q

prognosis/chronic infection of HEV types

A

1 - high mortality in pregnancy

2 - fulminant hepatitis not noted, no chronic

3, 4 - higher overall mortality relative to 1, and in older adutls, yes chronic

GIR Test 2 (17 decks)

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