hepatitis

Question 1

A

Answer 1

infectious hepatitis
picornavirus
- naked capsid + RNA virus
fecal oral route
does not cause chronic liver disease
incubation is 1month

1) diagnosis is IgM antiHAV antibody
- IgG anti-HAV ABs life long protection, so not used (passive immunity)
2) havrix and vaqtra
3) twinrix (A and B combination recombinant vaxx)

Question 2

B

Answer 2

serum hepatitis
hepadnavridae
blood, sexual contact, mother-child
- 90% of infants develop chronic infections
640,000 people estimated to be infected in US, about13,800 acute infections per year
incubation is 3 months
chronic hepatitis in 5-10%
primary hepatocellular carcinoma possible
subunit vaccine available

Question 3

C

Answer 3

non A non B
flaviridae
blood, sexual contact, mother-child
3 month incubation
chronic in 85%
cirrhosis in 5-25%
primary hepatocellular carcinoma

Question 4

D

Answer 4

strand linear RNA
only replicates in presence of HBV
incubation 15-64 days
acute, fulminant, and chronic hepatitis

Question 5

E

Answer 5

enteric non-A, non-B
hepeviridae
fecal-oral route
serious in pregnany women
chronic in pt with immunosuppressive therapy

Question 6

blood donations

Answer 6

1) screened for hepatitis B surface antigen
2) antibodies for hepatitis
3) transaminase assay
- indicates liver damage, marker of viral infection
4) nucleic acid amplification to detect HIV and HCV

Question 7

picornavirus structure

Answer 7

1) icosohedral capsid has four viral polypeptides

Question 8

viral genome RNA delivered into cytoplasm functions as mRNA

Answer 8

1) VIRAL RNA dependent RNA polymerase
- needs this to work

Question 9

spread of HAV within the body

Answer 9

1) rarely transmitted via the blood
2) level of viremia is low
3) chronic infection does not occur
4) virus in stool before symptoms and antibodies

Question 10

hepatitis B

Answer 10

1) DNA virus but replicates through RNA intermediate
-reverse transcriptase
- DNA -> RNA -> DNA
2) HBV polymerase
- does a lot of stuff

Question 11

dane particle of HBV

Answer 11

1) rcDNA relaxed circular DNA
2) dslRNA double stranded linear DNA
3) some virions just have RNA

Question 12

Cell mediated immunity

Answer 12

1) if sufficient, resolution of HBV
- 90%
2) if not, chronic disease, primary hepatocellular carcinoma or cirrhosis
-9% positive with HBag+ for > 6mo
- 1% fulminant

Question 13

detection of HBV

Answer 13

1) HBsAg
- MOST important
2) chronic carrier
- HBsAg + on two occasions at least 6 mo apart
3) HBeAg
- presence of the infectious virus (chronic infection)
4) antibody is complexed and not detectable

Question 14

HBV treatment

Answer 14

1) intron A
- interferon alpha-2b
- PEG effective only in 1/3 patients
- linking both of them enable longer blood circulation
2) epivir HBV
- inhibits viral DNA pol
3) hepsera
- activity against HBV DNA pol
-treats chronic HBV
4) others are baraclude, viread, vamlidy

Question 15

HBV vaccine

Answer 15

1) HBsAg genetically engineered, recombinant

Question 16

hepatitis C estimated acute infections

Answer 16

1) 85% chronic HPC
2) 70% chronic liver disease
3) 10-20% develope cirrhosis

Question 17

HCV replication

Answer 17

1) HCV binds to CD81 and scavenger receptor class B receptors expressed on hepatocytes
2) RNA dependent RNA polymerase with helicase activity
3) cell based replication system not available

Question 18

who gets HCV

Answer 18

1) before blood testing 80-90% of post transfusion hepatitis was caused by HCV

Question 19

HCV treatment

Answer 19

1) sofosbuvir
- inhibits nonstructural protein NS5B RNA dependent RNA polymerase
2) simeprevir, grazoprevir
- inhibits NS3/A4 protease
3) daclatasvir, elbasvir
- NS5A replication complex inhibitor

Question 20

impact of HIV on HCV disease

Answer 20

1) 8-10x greater rate of increase of HCV RNA
2) more rapid progression to cirrhosis and primary hepatocellular carcinoma
3) major cause of hospitalization and death
4) hepatotoxicity of antiviral HIV treatment with HCV