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CSIM 1: Virology Strand > CSIM 1.55: Viral Hepatitis > Flashcards

CSIM 1.55: Viral Hepatitis Flashcards

1
Q

How is Hepatitis A to E usually spread?

A 
A: Enteric (faecal-oral)
E: Enteric (faecal-oral)
C: Parenteral (blood-bourne)
D: Parenteral (blood-bourne)
B: Parenteral (blood-bourne)
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2
Q

Describe the hepatitis A virus:

1) Genus
2) Family
3) Genetic material
4) Incubation period

A

Hepatitis A:

1) Hepatovirus
2) Picornaviridae
3) Positive sense ssRNA
4) 2 to 4 weeks

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3
Q

Describe the resolution of hepatitis A

A

Usually self-resolving after 8 weeks

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4
Q

Which populations are icteric and symptomatic with Hepatitis A?

A

Over 2 years: 80% are anicteric and asymptomatic

Below 2 years: 80% are icteric and symptomatic

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5
Q

What are the symptoms of viral hepatitis?

A
  • Fatigue
    • Anorexia
    • Jaundice
    • Nausea
    • Low fever
    • Headache and myalgia
    • Abdominal pain
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6
Q

How is hepatitis A diagnosed using lab tests?

A
  • Raised liver enzymes
    • IgM (IgG for previous infection)
    • PCR
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7
Q

How is hepatitis A prevented and controlled?

A
  • Good hygiene
    • Immunoglobulin for prophylaxis in high risk contacts
    • Vaccine
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8
Q

How many genotypes of Hep E are there, and which genotype is most prevalent in industrialised nations and why? How is it often acquired?

A

Four genotypes, genotype 3 is the most common in industrialised nations as it is closely related with undercooked pork products

  • Waterborne
  • Faecal-oral
  • Zoonosis
  • Pork food products
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9
Q

Describe the resolution of hepatitis E

A
  • 20% mortality in pregnant women, low mortality otherwise in immunocompetent
    • Self-limiting
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10
Q

Describe the prevention of hepatitis E

A
  • No vaccine available

* In immunocompromised, antivirals used

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11
Q

How many genotypes of hepatitis B are there?

A

8 genotypes

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12
Q

What is tested for when searching for hepatitis B?

A
  • Hepatitis B surface antigen (HBsAg)
    • Antibodies against Hepatitis B core antigen (HBcAg)
    • Viral DNA measurements
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13
Q

What antigen is associated with increased hepatitis B replication?

A

HBeAg

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14
Q

How can hepatitis B be transmitted?

A
  • Transfusion
    • Fluids
    • Transplantation
    • Close contact (horizontal)
    • Mother to baby (vertical)
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15
Q

In what proportions of individuals is jaundice seen with Hepatitis B?

A

10% young children

50% adults

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16
Q

What is fulminant hepatitis?

Which hepatitis virus is this seen with?

A

Severe liver damage in which a liver transplant is required

HBV

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17
Q

What are the complications of ‘complicated’ HBV?

A
  • Chronic active hepatitis
    • This leads to cirrhosis
    • Hepatocellular carcinoma
18
Q

How can one differentiate between a chronic or an acute infection of hepatitis B

A
  • IgM present in acute infections
    • Hepatitis B becomes defined as chronic when HBsAg is found to be present for over 6 months (happens in 25% of people)
19
Q

Which hepatitis becomes latent? Where? What causes reactivation?

A

Hepatitis B becomes latent in liver cells

Reactivation caused when patient becomes immunocompromised

20
Q 
Which of the following markers is present in acute hepatitis B infection?
  •  HBsAg
  •  Anti-HBs ab
  •  Anti-HBc IgM
  •  Anti-HBc IgG
  •  HBeAg
  •  Anti-HBe ab
  •  HBV DNA
21
Q 
Which of the following markers is present in chronic hepatitis B infection?
  •  HBsAg
  •  Anti-HBs ab
  •  Anti-HBc IgM
  •  Anti-HBc IgG
  •  HBeAg
  •  Anti-HBe ab
  •  HBV DNA
22
Q 
Which of the following markers is present in a past or remote hepatitis B infection?
  •  HBsAg
  •  Anti-HBs ab
  •  Anti-HBc IgM
  •  Anti-HBc IgG
  •  HBeAg
  •  Anti-HBe ab
  •  HBV DNA
23
Q 
Which of the following markers is present in a person vaccinated against hepatitis B?
  •  HBsAg
  •  Anti-HBs ab
  •  Anti-HBc IgM
  •  Anti-HBc IgG
  •  HBeAg
  •  Anti-HBe ab
  •  HBV DNA
24
Q

What does the hepatitis B vaccine produce antibodies against?

25
How is hepatitis B treated and prevented?
TREATMENT: Antivirals • (formulary:) Tenofovir • Interferon-based PREVENTION: • Vaccines (pre and post-exposure) • Hepatitis B immunoglobulin (passive immunity for babies born to HBV mothers) • Infection control
26
Describe the HBV vaccine
* Recombinant DNA (no live virus) | * Combined with HAV vaccine
27
Who is given a Hep B vaccine in the UK?
* HCPs * Injecting drug users * Promiscuous individuals * Close family of case or carrier * Chronic renal or liver disease
28
How is Hepatitis B vaccination administered? (time-wise
3 doses • 0 months • 1 month • 6 months Post exposure accelerated: • 0 months • 1 month • 2 months
29
Which hepatitis virus requires the 'machinery' of hepatitis B to replicate? How do both of these infections occur together?
Hepatitis D - delta virus Coinfection: • Both viral infections occur at the same time Superinfection: • Hepatitis B infection already present • Subsequent hepatitis D infection occurs
30
What antigens are seen in hepatitis D?
* Outer HBsAg (needs hep B to make the coat for it) | * Inner HDAg
31
How is hepatitis D detected?
* IgM and IgG | * PCR not possible as the genetic information is too small
32
How is HDV prevented?
By virtue of hepatitis B vaccination and prevention, hepatitis D is prevented
33
How can HDV be treated?
Interferon antivirals
34
What are the Hepatitis C genotypes?
``` 6 genotypes: • 1a • 1b • 1c • 1d • 1e • 1f ```
35
Describe the hepatitis B virus: 1) Genus 2) Family 3) Genetic material 4) Incubation period
Hepatitis B: 1) Orthohepadnavirus 2) Hepadnavirus 3) dsDNA 4) 40 to 100 days
36
Describe the hepatitis C virus: 1) Genus 2) Family 3) Genetic material 4) Incubation period
Hepatitis C: 1) Hepacivius 2) Flaviviridae 3) Positive sense ssRNA 4) 8 weeks
37
Describe the hepatitis D virus: 1) Genus 2) Family 3) Genetic material 4) Incubation period
Hepatitis D: 1) delta virus 2) ? 3) Negative sense ssRNA 4) 3 to 7 weeks
38
Describe the hepatitis E virus: 1) Genus 2) Family 3) Genetic material 4) Incubation period
Hepatitis E: 1) Hepevirus (not 'herp-') 2) Hepeviridae 3) Positive sense ssRNA 4) 6 to 9 weeks
39
Which hepatitis is asymptomatic acutely?
Hepatitis A when over 2 years of age (80%) Hepatitis C
40
What proportion of hepatitis C infections become chronic? What does this cause?
80% become chronic * Chronic liver disease * Cirrhosis * Hepatocellular carcinoma
41
How is HCV detected in the lab?
* HCV antibody or antigen test | * PCR for RNA
42
How is HCV prevented?
* No vaccine * Standard infection control * Targeted screening NB treated with antivirals - curable

CSIM 1: Virology Strand (12 decks)

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