Exam 3 Hepatitis B, D Flashcards
Hepatitis B virus is part of what family _____
Hepadnaviridae
Hepatitis B is a ____ virus
HepaDNAvirus
Hepatitis B targets what organ?
Liver
Hepatitis B causes _____ due to increase of liver enzymes
Icteric (jaundice)
350 million are chronically infected by HBV worldwide in what countries?
Africa and Southeast Asia
HBV incidence is declining due to:
Routine HBV immunization
What are the four HBV infection routes?
- Major source is blood
- Birth (prenatal)
- Sexual contact
- Environmental survival
What are the clinical outcomes of HBV?
- Acute infection
- Chronic infection
____ of HBV infections are resolved
90%
HBV carrier state is signified as:
HBsAg+ > 6 months
HBV structure
Enveloped and icosahedral
What is the genomic material found in HBV?
- Partial dsDNA
- covalently closed circular DNA (cccDNA)
- part of one strand missing
What enzyme does HBV use to replicate?
Reverse transcriptase (RT)
HBV replicates via ____ intermediate
RNA
HBV virion is termed _____
Dane particle
HBV Dane particle contains:
- Protein kinase
- Polymerase (RTase)
HBV contains what three antigens?
- HBcAg
- HBeAg
- HBsAg
What is HBsAg?
Surface antigen
HBsAg is a marker of ____
Infection
What is HBcAg?
Core antigen (not found in serum)
What is HBeAg?
- Extracted antigen
- Soluble and “extractable” part of HBcAg
HBeAg is secreted into serum and is a marker of:
Active HBV replication AND high infectivity
HBV presence in serum: “S” means _____
Infectious
HBV presence in serum: “S + E” means _____
Highly infectious
What are the steps of HBV replication?
- Completion of dsDNA
- Viral replication via RNA intermediate using RTase
- RTase makes second partial DNA strand to be dsDNA
Risk factors associated with HBV
- Medical employee (1%)
- Other/unknown is 47%
HBV in ____ is a moderate risk
Saliva
HBV is an occupational hazard in ____
Dentistry
Concentration of HBV in blood is ___
High
____ immunity is required to resolve acute HBV infection
Cell-mediated
Chronic HBV infection involves _____ response to ____ antigen
T cell; HbcAg
Chronic HBV infection is more likely in patients with _____
Weak immune response
HBV acute infection - incubation period
2-6 months
What are the four clinical periods of HBV acute disease?
- Incubation
- Pre-icteric
- Icteric
- Convalescence
Symptoms of acute viral hepatitis
- Dark urine
- Jaundice (skin, sclera)
In someone with acute viral hepatitis, liver functions tests will be ____
Elevated
Elevated ____ leads to jaundice
Bilirubin
Symptoms of chronic HBV
- Cirrhosis of liver
- Hepatocellular carcinoma
____ can build up inside the cell. What does that look like?
HBsAg; filamentous, “ground glass” hepatocytes
Serology for acute HBV infection
- illness typically resolves
- most antibodies to HBV decrease eventually
Serology for chronic HBV infection
- HBsAg remains high (carrier state = more than 6 months)
- continued presence of HBeAg
HBV-DNA and HBeAg indicate:
Active viral replication
Those immunized for HBV have:
Antibodies to HBsAg
HBV chronic outcomes are related to:
Age
_____ infections have the highest risk of HBV infection becoming chronic
Neonatal/perinatal
____% of neonatal infection may become chronic
90
What is the most important cause of neonatal hepatitis?
HBV through infected birth canal
What three interventions can be used to reduce transmission of HBV?
- HBV vaccine
- HBV immunoglobulin
- Antiviral drugs
Neonatal prevention of HBV involves:
- Vaccine for all neonates
- HBV immunoglobulin for HBV+ mothers
HBV prevention for healthcare workers
- Vaccination
- HBV immunoglobulin if exposed
Chronic HBV treatment methods
- Interferons/PEG-Interferon
- Antiretrovirals
What antiretrovirals are used for chronic HBV treatment?
- nucleoside analogues (NRTI’s)
- nucleotide analogues
Nucleoside analogues have ____ drug resistance, whereas nucleotide analogues have ____ rate of resistance
Rapid; low
Hepatitis D infects people who are infected with:
Hepatitis B virus (cannot infect cells by itself, steals HBV envelop protein)
What glycoproteins are needed by Hepatitis D?
M, S, L glycoproteins
HDV is transmitted like _____ and worsens ____ infections
HBV; HBV
HBV vaccine is protective against:
HDV