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Exam 3 - Hepatitis Viruses Flashcards

1
Q

what does hepatitis cause?

A
  • inflammation of the liver
  • jaundice
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2
Q

what causes hepatitis?

A
  • viruses
  • trauma or disease
  • alcohol abuse
  • drug-induced toxicity
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3
Q

what were the two causes of the hepatitis epidemics in history?

A
  • war - crowding, unsanitary camps
  • serum hepatitis - yellow fever vaccine campaign
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4
Q

primary hepatitis

A
  • hepatits viruses
  • immediately after initial infection
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5
Q

secondary hepatitis

A
  • yellow fever, herpesviruses (HSV-1, HSV-2, CMV, EBV)
  • inflammation of liver after another type of disease or infection
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6
Q

Which hepatitis viruses can lead to chronic hepatitis

A

HepB, C, D, E, G

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7
Q

why is chronic hepatitis difficult to diagnose?

A

symptoms do not show until liver damage is advanced

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8
Q

chronic liver disease

A

liver inflammation persists for more than 6 months

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9
Q

liver cirrhosis

A

formation of fibrous tissues, nodules, scarring
- interferes with live cell function and blood circulation

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10
Q

chronic hepatitis causes an increased risk for _________

A

HCC (hepatocellular carcinoma cancer)

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11
Q

Hepatocellular Carcinoma (HCC)

A

primary liver cancer

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12
Q

in Hepatocellular carcinoma, HBV DNA causes ______________

A

HBV DNA causes breaks in hepatocyte chromosomal DNA

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13
Q

what are the 8 hepatitis viruses

A
  • HAV
  • HBV
  • HCV
  • HDV
  • HEV
  • HGV
  • torque teno virus (TTV)
  • sentinel (SEN)
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14
Q

90% of acute viral hepatitis cases are from ___________

A

HAV, HBV, HCV

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15
Q

all Hep viruses are spread through ____________, except HAV and HEV are spread through _____________

A

the blood; fecal-oral

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16
Q

H_V and H_V can be spread through sexual transmission

A

HBV; HCV

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17
Q

hepatitis virus infects and damages ___________, causing _______________

A

hepatocytes; inflammation

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18
Q

HAV signs and symptoms

A
  • fatigue, abdominal pain, loss of appetite, nausea, dark urine
  • adults experience more symptoms than children
  • jaundice if over 14 years old
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19
Q

HAV characteristics and structure

A

+ssRNA genome
- picocornaviridae family
- icosohedral, naked capsid
- acid and bile resistant
- infectious on surfaces for a month

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20
Q

HAV replication (steps and proteins involved)

A
  1. Attachment - HAVCR1/TIM-1 receptor
  2. Entry - endocytosis
  3. Uncoating
  4. Protein synthesis - IRES, 3C protease
  5. Genome synthesis
  6. Assembly in cytoplasmic vesicles
  7. Exocytosis
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21
Q

HAV is shed _______________

A

early on in stool

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22
Q

HAV vaccine

A
  • traditional whole pathogen
  • formalin-inactivated, cell culture produced
  • 2 doses, 6 months apart
23
Q

HAV treatment

A

supportive care

24
Q

HEV signs and symptoms

A
  • same as HAV
  • shorter duration
  • increased mortality rate in pregnant women
25
H_V may be a zoonotic pathogen
HEV
26
HEV characteristics and structure
+ssRNA - hepeviridae family - icosahedral, naked capsid
27
HBV signs and symptoms
- similar to HAV + joint pain - 30% show no symptoms
28
HBV characteristics and structure
- partially dsDNA - hepadnavirus family - enveloped - reverse transcriptase to replicate
29
HBV virion types
- spherical - most abundant - filamentous particles - Dane particle - infectious, enveloped
30
__________ and ___________ HBV virions have no genome and are not infectious
spherical; filamentous
31
spherical and filamentous HBV particles only have the ___ gene and only produce _____________
S; surface proteins
32
HBV replication (steps and proteins involved)
1. Attachment of Dane particle - NTCP receptor 2. Entry- endocytosis,viral core released into cytoplasm 3. Uncoating - partial dsDNA genome enters nucleus 4. DNA synthesis - formation of closed circular DNA molecule (ccDNA) - ccDNA supercoils to form episome 5. Protein synthesis - cellular RNAP2, S gene, C gene, P gene, X gene 6. Pregenomic +ssRNAs associate with polymerase, PKC, HSPs (chaperones) 7. Assembly - ER --> golgi 8. Exocytosis
33
S gene produces __________
surface (enveloped) antigens
34
C gene produces __________
capsid antigen
35
P gene produces __________
viral polymerase
36
X gene produces __________
protein kinase
37
HBV diagnosis
antigen detection - blood test
38
HBV vaccine
- recombinant subunit - antigens self assemble into spherical particles - 3 doses
39
HDV signs and symptoms
- similar to HBV - more sever hepatitis (superinfection)
40
HDV requires __________
HBV proteins to replicate, acts as helper virus
41
HCV signs and symptoms
- few/no symptoms for years - symptoms in advanced liver disease - similar to HBV + clay colored stool
42
H_V causes chronic infection in 55% to 85% of cases
HCV
43
HCV classification and structure
+ssRNA - flaviviridae family - icosahedral, enveloped capsid - IRES
44
HCV replication (steps and proteins involved)
1. Attachment - more than 1 receptor 2. Entry - endocytosis 3. Fusion of viral membrane 4. Protein synthesis - transl., IRES, +ssRNA 5. Polyprotein processed - NS2, NS3 proteases 6. Genome synthesis - NS5b 7. Assembly in cytoplasmic vesicles 8. Exocytosis
45
HCV diagnosis
ALT levels - symptoms present Antibody levels - chronic infections
46
HCV treatment - pegylated interferon a-2a or a-2b and/or ribavirin
- 48 weeks - close monitoring - adverse reactions - varying cure rate (80% for genotypes 2 or 3)
47
HCV has __ genotypes based on __________ and __________
6; duration and efficacy
48
HCV treatment - Victrelis and Incivek
- targets NS3 protease - more effective - increased side effects - genotype 1 cure rate = 80%
49
HCV treatment - pills
- 8-12 weeks - cure is >95% - minimal side effects
50
challenges with HCV prevention
- genetic variability - HCV immune evasion
51
_________ immunity is not effective against HCV
passive
52
Hepatitis G (HGV)
- blood to blood transmission - distant relative of HCV
53
Transfusion transmission or Torque teno virus (TTV)
- dont know if it causes disease
54
Sentinel Virus (SEN-V)
- little known about clinical significance - may be associated with post-transfusion hepatitis

Virology (10 decks)

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