Chapter 25: Hepatitis

Question 1

What are the different types of hepatitis?

Answer 1

A, B, C, D, E, G

Question 2

What sets HBV apart from the other hepatitis viruses?

Answer 2

HVB is the only DNA virus

Question 3

What sets HAV and HEV apart from the other hepatitis viruses?

Answer 3

They are transmitted in a fecal-oral mode. They are seen most often in areas with unclean drinking waters.

Question 4

What sets HDV apart from the other hepatitis viruses?

Answer 4

This virus can only be present when HBV infection is already present.

Question 5

Which hepatitis viruses are most transmitted by needle sticks?

Answer 5

HVB and HCV

Question 6

Which hepatitis viruses can act in an acute manner?

Answer 6

All of them!

Question 7

What are the attributable symptoms of acute viral hepatitis?

Answer 7

The patient will present with flu like symptoms of fever, fatigue, joint pain, cough and runny nose.
What sets hepatitis apart is the affect it has on the liver causing jaundice as bilirubin increases and leads to hepatocyte necrosis.
The inflammation and damage leads to hepatomegaly as well as increased liver enzymes.
Specifically AST and ALT. There will also be a marginal increase in GGT and alkaline phosphatase.

Question 8

What produces the AST and ALT?

Answer 8

hepatocytes

Question 9

What produces the GTT and alkaline phosphatase?

Answer 9

The cells lining the canaliculi

Question 10

How do you get HAV and what effects does it have at different ages?

Answer 10

HAV is one of the fecal-oral viruses. It is easily passed with poor handling of food paired with lack of handwashing (especially after using the bathroom).
It causes different problems by age.
Children are the most infected w/ milder symptoms including slight jaundice and other food-borne symptoms.
Adults are less common and lead to severe hepatitis but death is rare.

Question 11

What immune response would you expect to have with a current HAV infection?

Answer 11

Current infection = anti-HAV IgM

past = anti-HAV IgG

Question 12

What is the composition of a Dane particle and what viruses is it associated with?

Answer 12

Dane particle = envelop, capsid proteins, capsid and DNA of the HBV.

Question 13

What are the four types of infections that occur with HBV?

Answer 13

an acute infection
a fulminant infection
a chronic infection
a coinfection with HDV

Question 14

What is the different between acute and fulminant HBV infections?

Answer 14

An acute HBV infection will look like normal viral hepatitis with flu like symptoms and jaundice due to hepatocyte necrosis.
fulminant is like a full acute attack on the liver causing rapid destruction of the hepatocytes.

Question 15

What are the different types of chronic based HBV infections?

Answer 15

Asymptomatic = no damage but can still spread
Persistent = low-grade smoldering hepatitis
chronic active = acute state with normal recovery
coinfection = includes HDV

Question 16

What is the immune response to HBV?

Answer 16

The immune system uses cell mediated responses to kill HBV leading to damage to the hepatocytes it infects and cells around that site leading to necrosis of jaundice.

Question 17

Long lasting or damaging hepatitis can lead to what liver complications?

Answer 17

Primary hepatocellular carcinoma and possible scarring known as cirrhosis

Question 18

Describe the HBV antigens and what they tell us about the stages and infectivity of a patient.

Answer 18

HBV have three major antigens.
HBsAg, HBcAg, and HBeAg
HBsAG = surface antibody and resistance = immunity
HBsAg = current infection
Anti-HBsAg = past infection/immunity
Anti-HBcAg IgM = currrent
Anti-HBcAg IgG = past
HBeAg = high infectivity
Anti HBeAg = low infectivity

Question 19

What is the problem with HDV infections?

Answer 19

They have to have HBV present and when both are implemented = superinfection
There is a much higher risk for fulminant hepatitis and cirrhosis.
There is an increased mortality rate but it can be stopped by anti-HBsAg.

Question 20

What are HEV most associated with?

Answer 20

This virus is common in all areas other than north and south america.
It does affect central america interestingly enough.
It is most easily spread during monsoon or flooding seasons due to increasing waste and water mixing.
it causes the same symptoms as HAV.