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Blood Borne Viruses Flashcards

1
Q

What are the long term consequences of hepB and C?

A

Liver cirrhosis

Hepatocellular carcinoma

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2
Q

Is HIV more prevalent in men or women in the UK?

A

Men

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3
Q

Globally, are men or women more at risk of getting HIV?

A

Women

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4
Q

Globally, which group of people is most likely to get HIV?

A

MSM

Men who have sex with men

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5
Q

Describe HIV

A

Human immunodeficiency virus
Retrovirus RNA
Infects and replicates in CD4 cells

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6
Q

Describe how HIV replicates

A 
Free virus binds to CD4 receptor - fuses with cell via fusion pore
Empties contents into cell
Reverse transcription (form ds DNA)
Integration of viral DNA into cell's DNA
Transcription to make the proteins
Virus pushed out of the cell
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7
Q

If HIV becomes latent, how long is it usually latent for?

A

2-10 years on average

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8
Q

What is the CD4 cell count in severe HIV infection/AIDS?

A

< 200

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9
Q

What are the symptoms/signs of an acute HIV infection?

A 
Fever
Weight loss
Pharyngitis
Sores
Thrush 
Myalgia 
Hepatosplenomegaly
Malaise
Headache
Neuropathy 
Lymphadenopathy 
Rash 
Nausea/vomiting
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10
Q

Why does HIV often go unnoticed?

A

Symptoms are very general

Must think if the pt has any risk factors for HIV

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11
Q

Name some HIV associated infections that can affect the brain

A

Cryptococcal meningitis
Toxoplasmosis
AIDS dementia complex

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12
Q

Which HIV associated infection can affect the eyes?

A

Cytomegalovirus (CMV)

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13
Q

What HIV associated problems affect the mouth?

A

Cold sores
Ulcers
Candida

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14
Q

What HIV associated problems can occur in the blood?

A

Hyperglycaemia

Dyslipidaemia

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15
Q

Which HIV associated infections can affect the lungs?

A

Histoplasmosis
Pneumocystis pneumonia
TB

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16
Q

What bone problem is associated with HIV?

A

Osteoporosis

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17
Q

What CVS problems can be HIV related?

A

Heart disease

Stroke

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18
Q

What infection of the liver is HIV associated?

A

Hep C

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19
Q

Which HIV associated infections can affect the GI tract?

A

Cytomegalovirus
Cryptosporidiosis
Mycobacterium avium complex

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20
Q

What reproductive system problems can occur that are HIV associated?

A 
Genital ulcers
HPV 
Cervical cancer
Menstrual problems
Pelvic inflammatory disease
Vaginal yeast infections (candida)
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21
Q

Describe HIV wasting syndrome

A

Lost at least 10% body weight
At least 30 days of diarrhoea/weakness and fever
Leads to organ failure

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22
Q

How is HIV transmitted?

A

Sexually (vaginal/oral/anal)
Sharing needles
Vertical (utero/childbirth/breast feeding)
Medical procedures (blood/skin graft/organ)

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23
Q

What is the risk of contracting HIV from sharing a needle?

24
Q

What carries the highest risk for contracting HIV?

25
When do we start antiretroviral therapy?
As early as possible Usually when CD4 count < 350 Some people need time to get used to being on a lifelong treatment first
26
What can we do for partners of patients who are HIV positive?
Give antiretroviral prophylaxis | Education on safest sex
27
What are the aims of HIV treatment?
``` Reduce viral load Reconstitute immune system Improve quality of life Increase lifespan Decrease risk of transmission ```
28
What is the treatment for HIV?
Antiretroviral therapy 3 drugs in combination 2 reverse transcriptase inhibitors (+ protease/integrase/entry inhibitor)
29
What are the 5 main groups of hepatitis?
A-E
30
How is hepatitis B spread?
Blood Sex Vertical
31
How long is the incubation period for HepB?
6 weeks to 6 months
32
What is the treatment for HepA and E?
Supportive | Generally self-limiting
33
How is HepC mainly transmitted?
Blood | Sex
34
What is the incubation period of HepC?
6 - 12 weeks
35
What is the risk of catching Hep B through a needlestick injury?
1 in 3
36
Give some symptoms of acute HepB infection
``` Jaundice Abdominal pain Nausea/vomiting Fatigue Anorexia Arthralgia (joint pain) ```
37
What are the outcomes for people with acute HepB infection?
Most clear the infection within 6 months - after this they will have life long immunity 6-10% people become chronically infected
38
What marker is seen first in an acute HepB infection?
HBsAg | Surface antigen
39
Just after we are able to identify the surface antigen, what else will enter the blood?
HBeAg | E-antigen
40
After the antigens for HepB are detected in the blood, what would we expect to find on doing bloods again?
IgM | The core antibody fighting it (quick response)
41
What appears sequentially after the core antibody?
E-antibody | HBeAb
42
Which marker in the blood determines that we have life long protection against HepB?
Surface antibody | HBsAb
43
Which marker persists for life in people who've had HepB infections and cleared them?
IgG - core antibody | HBcAb
44
How do we define a chronic HepB infection?
Persistence of HBsAg (surface antigen of the virus) for more than 6 months
45
What percentage of people with chronic HepB will develop cirrhosis and hepatocellular carcinoma?
``` Cirrhosis = 25% Carcinoma = 5% ```
46
What is the treatment for HepB?
No cure Life long antivirals to suppress the viral replication (However some people will control the virus with just their immune system)
47
Describe the vaccine given for HepB
Genetically engineered surface antigen 3 doses plus a booster if required Effective in most people Produces surface antibody response (life long protection)
48
Describe the serology present on an acute HepB infection
``` Surface antigen (HBsAg) = positive Core antibody (IgM) = positive Surface antibody (HBsAb) = +ve/-ve depending on the time since infection ```
49
What would the serology look like for a past/cleared infection?
Negative surface antigen Positive core antibody (IgG) Positive surface antibody - immunity
50
What would the serology for a chronic infection look like?
Positive surface antigen Positive core antibody (IgG) Negative surface antibody (not immune)
51
What would the serology look like for someone who was never infected but vaccinated?
Negative surface antigen Negative core antibody Positive surface antibody (immunity)
52
What percentage of people who get HepC become chronically infected?
80%
53
What percentage of people with HepC infection are asymptomatic?
80%
54
What are the symptoms of HepC infection?
Fatigue Dark urine Nausea Abdominal pain
55
What treatment is available for HepC?
Can be cured Directly acting antiviral drug combination (for 8-12 weeks) Very expensive drugs so cannot get these globally No vaccine yet

Infection And Immunity (9 decks)

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