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Bio 3021 Infectious Disease & Society > Hepatitis > Flashcards

Hepatitis Flashcards

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0
Q

What is the most notable sign of general hepatitis?

A

Jaundice

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1
Q

What is a general term reserved for infections of the liver?

A

Viral hepatitis

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2
Q

What is jaundice?

A

A yellow discoloration of the skin and conjunctiva of the eyes caused by concentration of bile pigments in the blood

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3
Q

Why do bile pigments accumulate in the blood?

A

Because the liver is damaged and fails to remove them from the blood

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4
Q

Liver disease and jaundice are well known to….

A

Babylonians and other ancient civilizations

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5
Q

When were there reports of scattered outbreaks of jaundice affecting populations?

A

17th,18th, 19th centuries

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6
Q

Campaign jaundice is

A

Common among military men

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7
Q

When was the first form of blood transmitted hepatitis reported?

A

1885

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8
Q

When was the transmission of blood serum hepatitis firmly established?

A

Late 1930s

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9
Q

What are two classifications for the hepatitis virus?

A

Acute self limited hepatitis & Persistent chronic hepatitis

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10
Q

What type of hepatitis is hep A classified as?

A

Acute self limited hepatitis

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11
Q

What type of hepatitis is hep B classified as?

A

Persistent chronic hepatitis

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12
Q

Describe the discovery of hep B

A

Blumberg took a serum sample from an Australian aborigine and reacted it with a serum antibody of an American hemophiliac. The protein antigen from AA correlated with the serum hepatitis.

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13
Q

Hep B virion is known as…

A

The Dane particle, researcher who discovered complete virion 1970

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14
Q

Describe key components of hepadnavirus (virion & genome)

A

Virion: abundant smaller spherical/filamentous forms that lack nucleocapsid and are not infectious

Genome: circular double stranded DNA with single stranded gap on one strand

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15
Q

What’s the name of the virus that causes hepatitis? Can it be cultivated in vitro?

A

Hepadnavirus; No

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17
Q

Distinctive characteristics of hepadnavirus (3)

A

Partly double stranded and partly single stranded circular DNA genome
Reverser transcriptase generates genome DNA from pregenome RNA with capsid during virus assembly
Makes large amounts of noninfectious spherical and filamentous particles

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18
Q

What antigens are hepatitis composed of? function?

A

HBsAg (surface antigen)- most important
HBcAg (core antigen)
HBeAg (endogenous DNA polymerase; correlates with virus replication)

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19
Q

How many of the hepadnavindae family cause hepatitis? asymptomatic carrier state? hepatocellular carcinoma?

A

4: HBV, WHV, GSHV, DHBV
4: HBV, WHV, GSHV, DHBV
3: HBV, WHV, GSHV

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20
Q

Worldwide; estimated infected with Hep B?

A

2 billion persons

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21
Q

Worldwide; have chronic Hep B infection (carriers)?

A

400 million persons

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22
Q

Worldwide; die every year due to Hep B? every min?

A

1 million persons; 2 people

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23
Q

Worldwide 76% of all cases of Hep B occur where?

A

Asia, Africa, and South America

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24
Q

United States; in 2011 infected with Hep B?

A

~12 million Americans

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25
Q

United States; new cases of Hep B in 2011?

A

~18,800 cases

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26
Q

United States; highest rates of Hep B among?

A

adult males 25-44 years of age

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27
Q

United States; have chronic Hep B (carriers)?

A

Up to 1.4 million persons

28
Q

How can Hep B transmitted?

A

Blood
Sexual
Mother to newborn
Casual contact

29
Q

Where is Hep B present in high quantities and detected frequently?

A

High in the blood serum; detected in high frequencies of the saliva, semen, & cervical secretions

30
Q

Clinical Disease: inapparent subclinical

A

asymptomatic

31
Q

Clinical Disease: anicteric hepatitis

A

symptoms w/o jaundice

32
Q

Clinical Disease: icteric hepatitis

A

symptoms + jaundice

33
Q

Clinical Disease: chronic hepatitis

A

carrier state

34
Q

Clinical Disease: Fulminant hepatitis

A

leads to death

35
Q

(4) Characteristics of Hep B clinical disease?

A

incubation 45-120 days (long incubation)
icteric phase begins within 10 days after onset
dark urine, stools pale, liver enlarged & tender
transition from feeling well to ill is slow (insidious)

36
Q 
Predicted Outcomes of
Subclinical ?
Anicteric hepatitis?
Icteric hepatitis?
Complete recovery?
Chronic disease?
A

65-80%
20-35%
90-98%
2-10%

37
Q

The likelihood of becoming a carrier of Hep B in comparison to age?

A

Varies inversely with age at which initial infection occurs

38
Q

Which antigens indicate past infection?

A

HBsAg & HBcAg

39
Q

What is the function of HBeAg?

A

correlates to virus replication & may indicate chronic/ carrier state

40
Q

Diagnostic Value for IgM Anti-HBc?

A

most sensitive for acute infection

41
Q

Diagnostic Value for IgG Anti-HBc?

A

indicate past infection

42
Q

Diagnostic Value for IgG Anti-HBs?

A

indicate past infection
indicate neutralizing antibody
indicates immune protection

43
Q

Diagnostic Value for IgG Anti-HBe?

A

indicates acute infection
indicates active virus replication
indicates chronic carrier state

44
Q

Hep B virus is _____ more infectious than HIV?

A

50x-100x

45
Q

Hep B vs. HIV (concentration in blood)?

A

HIV 10^6 to 10^8

Hep B 10^8 to 10^10

46
Q

Hep B vs. HIV (risk of infection)?

A

HIV <.5%

Hep B ~18%

47
Q

Treatment & Control of Hep B virus?

A 
prophylaxis (Hep B immune globulin)
acute infection (no antivirals)
chronic infection (interferon alpha; Epivir)
48
Q

An active homosexual was _____ more likely to contract Hep B than an active male heterosexual?

A

10-15x

49
Q

Development of Hep B Virus Vaccine?

A

Dr.Hillemann
65 weeks needed to make one batch of Dane particle
7 stages needed to extract Dane particles prior to animal tested

50
Q

How was the Dane particle extracted from volunteers who were carriers for Hep B?

A

plasmaphoresis

51
Q

Describe the process of plasmaphoresis?

A
  1. Serum containing Dane particle are centrifuged to purify
  2. Dane particle inactivated with formaldehyde
  3. Each batch tested for inactivation
52
Q

When was Phase 1 code broken?

A

June 1980

53
Q

Details for the plasma-derived vaccine?

A

prepared of inactivated Dane particles purified

no longer produced due to fears of HIV infection

54
Q

Details of recombinant vaccine?

A

produced in yeast that contains the HBsAg
killed vaccine
HBsAg purified from yeast
3 intramuscular doses induce antibody response

55
Q

Name who should receive the Hep B vaccine?

A

health care workers, prisoners, sexually active homosexual males, morticians, hemodialysis pts

56
Q

Along with Hep A, who is a member of the picornavirus?

A

pilovirus

57
Q

United States: new cases of Hep A in 2011?

A

~2,700

58
Q

Hep A is not….

A

a sexually transmitted disease & has no chronic infections (no carriers)

59
Q

Hep A transmission is associated with?

A 
poor hygiene
poor sanitation
contamination of water or milk
consumption of contaminated raw oysters
blood transfusion
60
Q

Hep A transmission is not associated with?

A 
sharing of utensils
sharing of cigarettes
kissing
sexual activities
transmission by insects
61
Q

(4) Characteristics of Hep A clinical disease?

A

incubation 12-50 days (short)
pts remain asymptomatic despite active replication in gut
transition from feeling well to ill occurs abruptly
icteric phase begins 10 days of initial clinical symptoms: dark urine, pale stools, jaundice

62
Q

Predicted Outcomes of Hep A?

A

children <5 years have milder cases than adults
complete recovery is usual
chronic disease has not been observed

63
Q

Clinical Diagnosis of Hep A?

A

not as complex as Hep B
Biochemical assessment of liver functions
detection of Hep A virus-specific antibodies: IgM anti-Hep A & IgG anti Hep A

64
Q

Treatment of Hep A virus?

A

no antiviral drug available

vaccination is mainstay for prevention of Hep A

65
Q

Hep A vaccine?

A

2 killed vaccines available (Vaqta & Havrix)

Bio 3021 Infectious Disease & Society (4 decks)

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