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GI 14 Flashcards

1
Q

Hepatitis A Family

A

Picornaviridae

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2
Q

Hepatitis B Family

A

Hepadnaviridae

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3
Q

Hepatitis C Family

A

Flaviviridae

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4
Q

Hepatitis A Genome

A

ssRNA

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5
Q

Hepatitis B Genome

A

clsDNA

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6
Q

Hepatitis C Genome

A

ssRNA

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7
Q

Hepatitis A Mode of transimission

A

Faecal-Oral

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8
Q

Hepatitis B Mode of transimission

A

Blood Sexual Mother to child

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9
Q

Hepatitis C Mode of transimission

A

Blood Sexual Mother to child

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10
Q

Incubation period for Hepatitis A is

A

2-6 weeks

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11
Q

Incubation period for Hepatitis B is

A

1-6 months

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12
Q

Incubation period for Hepatitis C is

A

4- 26 weeks

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13
Q

Acute mortality rate by Hepatitis A,B and C is same

A

0.2%

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14
Q

Infection period for Hepatitis A

A

2 weeks before onset to 1 week after symptoms subside

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15
Q

Infection period for Hepatitis B

A

Many weeks before onset to life in carriers

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16
Q

Infection period for Hepatitis C

A

1 or more weeks before onset to life if carriers

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17
Q

Percentage of Chronicity of Hepatitis A

A

None

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18
Q

Percentage of Chronicity of Hepatitis B

A

5-10 %

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19
Q

Percentage of Chronicity of Hepatitis C

A

50-80%

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20
Q

Is there any vaccine discovered of Hepatitis A ?

A

Yes

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21
Q

Is there any vaccine discovered of Hepatitis B?

A

Yes

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22
Q

Is there any vaccine discovered of Hepatitis C ?

A

No

Under pipeline.

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23
Q

WHo goals 2016 for global hepatitis elimination by 2030

The 5 core strategies are-

A
  • HBV vaccination
  • Prevention of mother to child transmission fo HBV
  • Injecton and blood safety
  • Harm reduction
  • Test and treatment of HBV and HCV.
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24
Q

A virus has

A

Spikes
Envelope but not for all virus
Capsomere
Nucleic acid

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25
Q

What is a Virus?

A

Is not cells they are DNA and RNA or may be few are proteins but they need cellular components help to replicate. It means they are taking over our cells and using to replication.

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26
Q

What virus need to replicate ?

A

Human cell

27
Q

What is budding for a virus?

A

Virus moves to the edges of the cell and normal cell membrane normally sort of form around then and bud off from the cell which is budding.

28
Q

What is Viral Envelope ?

A

Is a combination of host and viral protein. And this viral envelope is very important to attach another host healthy cell.

29
Q

How to kill virus ?

A

Virus with envelope can kill by breaking the envelope with detergent or other types chemicals that no longer able to attach or survive.

30
Q

What is a Capsid of a virus?

A

Capsid is a regular arrangements of proteins and the whole idea of having a capsid is it protects the nucleic acid inside of the virus.

31
Q

What is Genomic material of a virus

A

Small can be either DNA or RNA single or Double stranded. Linear or circular.

32
Q

How to treat viral infection ?

A

i) Target the virus= DAA(Direct acting antivirals)

ii) Target the host= IAA (Indirect acting antivirals) this way the virus target the host rather than the virus.

33
Q

Selective drug targets of DAA

A

i) The first thing we can do its the specific interaction of the virus with the host cell with its viral protein with the specific Receptor of the host cells.
ii) We can target by DAA during fusion to release the sub virion and release the genome into the host
iii) We can target viral during translation of the protein.
iv) During Genome Multiplication
Or during assembly packaging and release.

34
Q

How virus resistance occur ?

A
  • Virus alter enzyme or receptor so that drug no longer able to bind.
    • Stop producing enzyme which activate the drug.
    • Immune system activator- interferons
    • Passive immunisation- Monoclonal antibodies.
35
Q

HAV (Hepatitis A) virus is single or doubel stranded ?

A

Single stranded RNA virus acid stable and heat resistant.

36
Q

How HAV replicate ?

A

As this is a single stranded and RNA virus so it directly translate enzyme and produce structural protein.

Virus does not need to enter the nucleolus so replicate into the cytoplasm from +stranded RNA to - Stranded RNA to +stranded RNA than virus is formed as new virion and released by lysis.

37
Q

MOA for HAV (A does not cause chronic condition only acute)

A

2-7 week incubation

Acid resistant during initial replication in intestine=> TO liver and replicate into the liver cells => Blood.

38
Q

Symptoms of HAV (Hepatitis A virus)

A

It cause harm int the liver and show Symptoms like nausea, dark urine, Jaundice, hepatomegaly.

39
Q

Treatment of HAV (Hepatitis A virus)

A

Self limiting

Need to avoid alcohol

40
Q

Prevention of HAV

A

Passive immunisation OR active immunisation.
HAV & HBV only funded for risk groups like i) children ii) transplant patients or iii) close contacts of hepatitis A cases.

41
Q

Difference of HAV vs HBV

A

HAV can not cause acute whereas HBV hepatitis B cause acute and chronic both conditions

42
Q

HBV is double or single stranded ?

A

Enveloped viruses and Odd genome like partially double stranded partially single stranded not

43
Q

What are the HBV has 4 genes ?

A

i) Pre S/S Envelope proteins
ii) C-Core proteins
iii) P-viral polymerase
iv) X-Regulatory proteins

44
Q

How Hepatitis B virus and its replication cycle happen?

A

Binding and entry via endocytosis=>Uncoating=>Nuclear entry=>DNA repair=>From RNA to DNA by reverse transcription=>dsDNA=> Envelopment with HBsAg=>Exocytosis or new virus.

45
Q

HBV Transmission ?

A

Blood blood or sexual contacts

Insects like bed bugs

46
Q

Risk factors for HBV virus

A

Traveling during incubation period.
Household contact with confirmed cases.
Sexual contact with confirmed cases.

47
Q

Pathophysiology of HBV :

A

In the first phase in week 1, it take to show sympthoms which we called (Immune tolerant phase)elevated HBV DNA but normal ALT(Alanine aminotransferase). In 2nd phase called (Immune active phase) where ALT & HBV DNA levels increase and liver injury. In 3rd phase Called Inactive or Chronic phase-where HBV DNA and ALT comes to normal and liver recovery, In final phase called HBeAg -negative immune re-activation phase-elevated ALT and HBV levels, liver injury but it take over years to get back.

However risk of chronicity level decreased with age but Immunocompromised hosts increased chronicity.

48
Q

Complications of HBV?

A
  • Long term chronic HBV can cause cirrhosis if untreated.

- Cancer

49
Q

How to Test of Hepatitis B virus (HBV) ?

A
  • Serology for antigen and antibody.

- Provides information on phase of infaction.

50
Q

Treatment for HBV is

A

Suppresses viral replication and stop progression.
Liver damage need to be control by the suppression of HBV.
Only possible functional or partial cure but not possible total cure. The reason why most of the person stay in long term therapy

HBV is not fully cure possible because of? CCC virus.

51
Q

Why HBV is not fully cure possible because of

A

CCC virus.

52
Q

What are the Prevention measures for HBV?

A

Safe sex
Not to share niddles within patients
Screening required during blood transferase.

53
Q

Hepatitis C virus or (HCV)

A
  • Acute and Chronic hepatic function.
  • Huge sequence diversity(high replication rate)
  • Envelope +stranded RNA virus.

Genus is Hepacivirus

54
Q

Risk factor for HCV

A

Traveling
Sexual contact
Body piercing or tattooing
Household contact

55
Q

How many HCV has genotypes ?

A

7 (Seven)

56
Q

What is Genotype depends of ?

A

Type and duration of the treatment.

57
Q

Among 7 genotypes of HCV which are more in prevalence ?

A

Type 1 around 46% and

Type 3 is around 30 %

58
Q

Pathophysiology of HCV:

A

80% of the patient Might not know about the primary symptoms of HCV months or years.

50-75% will get a chronic infection like fatigue and weight loss.

59
Q

Complications of HCV ?

A

Liver failure which leading to transplant.

Cancer (Hepatic cell carcinoma)

60
Q

Treatment options for HCV

A

Following are the HCV treatment options but the best option is Miviret-Glecaprevir (NS3/4A protease inhibitor)+ pibrentasvir.(NS5A inhibitor) & it takes 12 weeks

61
Q

How to screen HCV?

A

As this HCV is asymptomatic
So we need to screen them

Serology of Anti-HCV antibodies. If Positive then HCV RNA assay=> Positive=> HCV genotype assay is appropriate.

62
Q

Whom we should screen for HCV without symptoms ?

A
  • Recently moved from high HCV prevalence areas.
  • Spent time in prison.
  • History of acute hepatitis
  • Newly born baby with HCV infected mothers.
63
Q

How to Prevent HCV ?

A

Blood product screening
No needle sharing
Safe sex
NO vaccine yet for HCV but still trying.

64
Q

What are the challenges of making HCV vaccine ?

A

Highly variable
We don’t know how to measure it.
Difficult to assey
We cant make the antigen yet.

GI (16 decks)

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