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intro to biomedical sciences IBMS > blood borne viruses > Flashcards

blood borne viruses Flashcards

hepatitis CJD and HIV modes of transmission risks prevention relevance to dentistry

1
Q

what is a blood borne disease

A

a disease that can be spread from contamination of blood and other bodily fluids

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2
Q

give examples of blood borne diseases

A

hep B
hiv
viral haemorrhage fever

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3
Q

how do we classify viruses

A 
by the baltimore classification which involves 
I dsDNA virus 
II ssDNA virus 
III dsRNA 
IV + strand or sense ssRNA 
virus 
V- ssRNA
VI ssRNA-RT viruses
VIII dsDNA-RT
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4
Q

deacribe viral hepatitis

A

liver inflammation due to a viral infection
can be acute or chronic
five hepatotophic viruses-ABCDE

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5
Q

which other viruses can cause hepatitis

A

cytomegalovirus
epstein barr virus
flavivirus- yellow fever

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6
Q

what is another name glandular fever

A

epstein barr virus

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7
Q

what do we need to consider when taking the medical history

A

what type of hepatitis they had and whether they currently have it

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8
Q

describe hepatitis A

A

passed via food and drink with infected faeces- not usually blood borne viruses

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9
Q

how many cases of hep A are there a year

A

1.4 million cases every year

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10
Q

how can we prevent hepatitis A spreading

A

good hand hygiene and water filtration and vaccines

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11
Q

how many people in the developing world have hep A in the developing world

A

90% of children infected by the age of 10

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12
Q

how do we diagnose hepatitis A

A

IgM antibodies in blood

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13
Q

how many people are affected by symptomatic hep A a year

A

1.4 million

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14
Q

how many deaths per year does symptomatic hep A result in

A

102000 deaths per year

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15
Q

what is the treatment of hep a

A

rest and fluids

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16
Q

describe hep B

A

super infectious- risk of 6-30% from infected needle stick injury depending on hep B status
vaccine- successful in 95%

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17
Q

what is a notifiable disease

A

the doH will need to know about this

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18
Q

what does hep b cause

A

acute and chronic inflammation

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19
Q

where is hep b present

A

blood
semen
vaginal fluid
eg toothbrush sharing, razors

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20
Q

how can hep b be transmitted

A

vertical- mother to child

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21
Q

where does hep b replicate

A

in the liver cells and then cause damage to hepatocytes- this causes them to look slightly “blobby”

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22
Q

how does hep b REPLICATE

A

PARARETROVITAL

  1. enters via endocytosis into the hepatocyte
  2. viral capsid is shed- and transferred to the cell nucleus
  3. viral polymerase transforms the DNA into the circular loop
  4. the mRNAS make new DNA and capsids which form new virons which can be released from the cell- and the hepatocyte dies when lysis occurs
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23
Q

why does the viral polymerase make the DNA circular

A

to make it more stable

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24
Q

what does circular DNA contain

A

transcripts for 4 viral mRNAS

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25
Q

what does a hep b capsid look like

A

outer membrane- contains HBsAg and HBeAG ( hepatitis B e antigen) and means people can spread the virus
the inner membrane has HBcAg
and DNA polymerase and the RNA on the inside

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26
Q

what do we test for in a positive test for Hep B

A

postive in hepatitis B surface antigen and HBeAg

HBcAb- in previously exposed or currently exposed hep B

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27
Q

what does it mean if your blood test comes out negative for HBSAg and AntiHBC negative

A

not currently infected

never infected

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28
Q

what does it mean if your blood test comes outwit HBSAG +

A

currently infected

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29
Q

what does it mean if your blood test comes outwit HBsAG -

AND AntiHBc +

A

not currently infected but has been before

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30
Q

what does it mean if your blood test comes outwit HBeAg + and anti Hbe -

A

active viral replication

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31
Q

what does it mean if your blood test comes outwit HBSAG -

and anti HBE+

A

virus replication under immune control

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32
Q

what does it mean if your Anti HB less than 10ml/ml

A

not vaccinated/ineffective

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33
Q

what does it mean if your Anti HB 10-100ml/ml

A

partial vaccine response

consider repeating

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34
Q

what does it mean if your Anti HB greater than 100ml/ml

A

full vaccine response

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35
Q

what happens during hep b exposure

A

acute infection

acute hepatitis

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36
Q

how many people suffer from symptoms:

A

30% symptoms

70% subclinical

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37
Q

out of the 100% that have Hep B how many are healthy carries

A

30%

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38
Q

out of the 100% that have Hep B how many are recovered and healthy

A

less than 2%

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39
Q

out of the 100% that have Hep B how many suffer from cirrhosis

A

12-20% which can lead to hepatocellular carcinoma

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40
Q

what are the symptoms of hep B

A 
loss of appetite 
cause 
vomiting 
body aches 
mild fever
dark urine 
pruritus- itching 
liver failure may result in health
41
Q

what can chronic hep B lead to

A

hepatocellular carcinoma

42
Q

what is the treatment for hep B

A

most people spontaneously recover

immunocompromised might need antiviral or immune system modulators

43
Q

what do we test for during pregnancy

A

antenatal testing

80-90% mother to baby transmission

44
Q

what do we deliver to the baby if the mother is +

A

antibodies
then 1st dose of vaccine in 12 hours post birth
vaccines at 1,2 and 12 months

45
Q

how can we prevent Hep B

A

safe sex
immunisation
PPE

46
Q

describe the hep B vaccine

A

derived in 1981
currently in recombinant from
boosters might be needed

47
Q

describe Hepatitis C

A

single stranded RNA virus replicated in hepatocytes

48
Q

how does hep C replicate

A
  1. attaches to the hepatocyte by protein E and gets endocytose
  2. incorporated into the DNA cell, shuts down normal cell function
  3. capsid production and assembly
  4. hepatocyte cell lysis leading to spread of hep c virus
49
Q

what are the risks to get hep c

A

blood transfusion prior to 1987
unprotected sec
vertical transmission from other to baby

50
Q

how much % of the world pop have hep c

A

3%

51
Q

what is the main symptom of hep c

A

fatigue

52
Q

what is cirrhosis

A

liver cells start to die off and scarring starts to occur

53
Q

how long can it take for hep c progression

A

20-30 years

54
Q

why is there no virus for hep c

A

mutation occurs and highly variable structure

55
Q

describe hep D

A

it is a sub viral satellite- only replicates in the presence of hep b

56
Q

when does hep D replicate

A

only in the presence of hep B

57
Q

what is hep d & E associated with

A

IV drug use

58
Q

how does hep D enter the hepatocyte

A

due to the help of the Hep B surface antigen

59
Q

what is the mortality rate when someone has hep B and Hep D

A

20% highest mortality rate

60
Q

how is hep e transmitted

A

not a BBV
faecal oral route
domestic animals act like a reservoir

61
Q

what can hep E lead to in immunocompromised patients

A

fibrosis and cirrhosis

62
Q

describe hIV

A

it is a retrovirus

uses reverse transcriptase to make cDNA which can be integrated into the host cell

63
Q

how does HIV replicate

A
  1. binds to the host cell eg a T cell lymphocyte by the CD4 receptor
  2. HIV releases reverse transcriptase to produce cDNA
  3. viral dna enters the cell nucleus and enters the host dan
  4. viral proteins are produced and are immature HIV
  5. the virus buds from the host cell and viral proteases break down the proteins making a mature HIV
64
Q

how is HIV transmitted

A

blood
semen
sexual transmission
vertical transmission

65
Q

how do we prevent the spread of HIV

A 
safe sex 
safe injections 
antenatal treatment 
PEP
conception 
no sharing razors
66
Q

what is AIDS

A

if enough CD4 cells are depleted

67
Q

how many CD4 do uninfected adults have

A

500-1600 cells per mm3

68
Q

how can cd4 count vary

A

by exercise

sleep

69
Q

what is a dangerous count of CD4 which can lead to progression of AIDS

A

less than 200

70
Q

when is the viral load undetectable

A

40-75 copies within 1ml of blood

71
Q

why are low loads good

A

reduce the transmission but does not eradicate

72
Q

what are the symptoms of acute HIV

A 
fatigue 
headache
rash 
sore throat 
lymohadenopathy 
fatigue
73
Q

what are chronic symptoms of HIV

A 
fever 
WEIGHT LOSS 
lymphadenopathy 
same as acute besides 
fungal infections- candida 
bacterial-TB
74
Q

describe prion disease

A

infectious agent made from proteins

affects the brain and neural tissue

75
Q

what does prion disease affect

A

the brain and neural tissue

76
Q

how does prion cause disease

A

it causes properly folded proteins to convert into the misfolded prion form

77
Q

what is the the ultimate end of prions disease

A

tissue damage and death

78
Q

what are prions resistant to

A

denaturation by chemical and physical agents making disposal and decontamination difficult
cannot be autoclaved

79
Q

describe prion affected tissued

A

microscopic holes giving a sponge appearance

80
Q

describe CJD

A

Creutzfeldt- Jakob disease

leads to dementia, personality changes, hallucinations

81
Q

what rate does CJD occur at

A

1 case/million per year

82
Q

how many people in the UK are carries of CJD

A

1/2000

83
Q

what are the types of CJD

A

sporadic
familial
varient
iatrogenic

84
Q

describe sporadic CJD

A

no cause identified

accounts for 85%

85
Q

describe familial CJD

A

15% of cases

86
Q

what is variant CJD

A

caused by the consumption of food contaminated with prions which also cause bovine spongiform encephalopathy

87
Q

describe iatrogenic CJD

A

contamination from an infected person- result of medical procedure

88
Q

when was mad cow disease first discovered

A

1986

89
Q

when was the first case of vCJD found in humans

A

1996

90
Q

what is HTLV

A

human T lymphocytic virus

91
Q

how many types of HTLV

A

4 types- type one is the most important

92
Q

what is HTLV1 linked to

A

myelopathy

leukaemia

93
Q

what is HTLV2 linked to

A

milder neurological conditions and infections

94
Q

what are oncoviruses

A

can lead to cancer

blood borne and transmitted by body fluids

95
Q

which virus can lead to cancer

A 
HBV 
BCV 
BTLV 
HPV 
karposis sarcoma associated with herpesvirus 
MCV- merkel cell polyomavirus 
glandular fever
96
Q

what is post exposure prophylaxes

A

available from a&e
genitourinary
ID unit
provided with drug treatment to prevent infection

97
Q

what should we help with IV drug users

A

need to help injectors switch
oral substitution
by smoking, snorting,swallowing

98
Q

what advice should we give to Iv DRUG USE

A 
use of sterile eq 
where to get supplies 
where to inject 
how to 
dealing with injection issues

intro to biomedical sciences IBMS (35 decks)

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