Chapter 3.25 Hepatitis Viridae Flashcards
What infection is caused by viral hepatitis?
infection of liver hepatocytes by viruses
What are the 5 known RNA viruses that infect the liver?
Hep A Hep C Hep D Hep E Hep G
What is the 1 DNA virus that infects the liver?
Hep B
Which hepatitis infections are transmitted by fecal-oral route?
Hep A and E
*A and E are at both ends of ABCDE so they are transmitted by both ends of the GI tract: A=anal E=enteric
How are most hepatitis infections transmitted?
via blood-to-blood (parenteral) contact
*BCD= BlooD
What viruses can cause acute viral hepatitis?
all- ABCEG
What viruses can cause chronic viral hepatitis?
HBV, HCV, HDV
What is the clinical manifestation timeline of a patient with acute viral hepatitis?
1- systemic symptoms- fatigue, low grade fever, muscle/joint aches, cough, runny nose
2- (1-2 weeks)- jaundice (bilirubin buildup), liver cell necrosis
3- painful enlarges liver, high liver-enzyme count
What enzymes are produced when hepatocytes necrose?
AST- aspartate aminotransferase
ALT- alanine aminotransferase
GGT- gamma-glutamyl transpeptidase
alkaline phosphatase
What elevated levels in the blood signal acute viral hepatitis?
AST, ALT, GGT, alkaline phosphatase
Why is chronic viral hepatitis difficult to diagnose?
patient is asymptomatic with only enlarged tender liver and mildly elevated liver enzymes
What is the difference in enzyme levels between acute viral hepatitis and stone blocking bile duct?
acute viral hepatitis- AST and ALT are high and moderaly GGT and alkaline phosphatase (initially) then they all rise higher (later)
stone- GGT and alkaline phosphatase high only
What is the shape of Hep A virus?
naked icosahedral capsid with + single stranded RNA
*in Pico family
Examples of Hep A transmission?
infected food handler contaminating food after poor hand washing
persons ingesting fecal contaminated water
close person-to-person contact in fay care
Who are most frequently infected with Hep A?
young children
What serology can be done to distinguish Hep A?
detect anti-HAV IgM and anti-IgG in serum
*HAV is antigenic capsule resulting in host anti-HAV IgM and anti-HAV IgG
Where does Hep B virus colonize in the body?
body fluids- semen, urine, saliva, blood, breast milk
What is the shape of HBV
Big virus with enveloped icosahedral capsid and double stranded circular DNA
*HBV= Big and Bad
What is the intact HBV virus called?
Dane particle (Big like a great DANE)
What does the Hep B surface antigen look like?
filamentous structures that have and envelope and capsid proteins
Why is Hep B surface antigen important?
having anti-HBsAg means a patient is immune
What is the marker for active Hep B disease and highly infectious state?
HBeAg
What is the relationship between pregnant mothers and Hep B?
pregnant mothers with HBeAg will almost always transmit HBV to offspring
How is HepB transmitted?
from blood-to-blood
non-oral transmission called parenteral transmission
ex. needle sharing, accidental medical exposure, sexual contact, blood transfusions
What kinds of hepatitis can Hep B cause?
acute hepatitis, fulminant hepatitis, chronic hepatitis, and co-infection with hepatitis delta virus
What are the 3 kinds of Chronic hepatitis?
- asymptomatic carrier- never develops antibodies and harbors virus without injury
- chronic-persistent hepatitis- patient with low-grade hepatitis
- chronic active hepatitis- has acute hepatitis state that continues without normal recovery for 6-12 months
How does liver injury occur from HBV?
cell-mediated immune system attack on HBV
*immune complexes of antibody and HBsAg deposit in tissues and activate immune system
What cancer can be a complication of HBV?
primary hepatocellular carcinoma
What permanent damage to the liver can occur from HBV?
cirrhosis
What form of hepatitis is occurring if serology testing has HBsAg present?
LIVE virus and infection (chronic or acute)
What form of hepatitis is occurring if serology testing has anti-HBsAg present?
immune, cure, no active disease
What form of hepatitis is occurring if serology testing has HBcAg present?
use to understand how long the infection has been ongoing
What form of hepatitis is occurring if serology testing has IgM anti-HBcAg or IgG anti-HBcAg present?
IgM - acute
IgG - chronic
What form of hepatitis is occurring if serology testing has HBeAg present?
High infectivity
What are the characteristics of HDV?
RNA helical shaped virus transmitted parenterally and can only replicate with the help of HBV
How does HDV use HBV for help?
HDV uses HBV’s envelope, HBsAg
*HBV + HDV = Big Bad Dude
What is the activity of HDV without HBV?
defective
What is the superinfection that HDV can cause?
HDV infects people with chronic HBV
*causes acute hepatitis in a patient who already is chronically infected with HBV
What hepatitis is the leading cause of chronic hepatitis in the US?
Hep C
What is the shape of Hep C?
enveloped icosahedral RNA virus in flavivirus family
How is HCV transmitted?
parenterally primarily through injection of drugs
What is the incubation period for Hep C?
6-12 weeks
What is the clinical presentation of patient with HPV
acute infection- asymptomatic
chronic infection - chronic hepatitis
How to diagnose HCV?
test for anti-HCV antibodies that is detectable in 6-8 weeks
Which hepatitis is known as the non-A hepatitis?
Hep E
How is Hep E transmitted?
fecal-oral route- usually through water contamination
What are the characteristics of Hep G?
RNA virus in the flavivirus family
- transmitted by transfusion and parenteral routes
- not conclusively known to cause liver disease
