Hepatitis 2 Flashcards
Which hepatitis has a 30-50% perinatal infection rate if untreated?
hepatitis B
hepatitis B and C are transmitted mainly how?
sexual and IV drug
what are you chances of getting hepatitis C if you are IV user?
50-60%
hepatitis is ___ times more prevalant than HIV in Australia
18 times
hepatitis is ___ times more prevalant than HIV in Victoria
16 times
hepatitis B has how many walls? nonenveloped?
double walled with outer envelope and inner capsid
What are HBsAG particles?
Hepatitis B Surface Antigen particles (incomplete viruses)
Hep B preGenome has own polymerase?
Yes, pregenomic RNA
describe the extracellular Hep B genome? ds? ss? RNA? DNA?
dsDNA
4 general different reading frames for Hep B coding
core (c)
surface(s)
polymerase(p)
X
Why do you get lots of mutant Hep B viruses?
reverse transcription from RNA to dsDNA has a high error rate
Hep B penetration is where?
mucosal epithelia
Hep B replication is where?
Liver
High concentration of Hep B in body fluids? 3 places
blood
serum
wound exudates
Moderate concentration of Hep B in body fluids? 3 places
semen
vaginal fluid
saliva
3 Hep B modes of transmission:
Sexual
Parenteral-needle stick
Perinatal
Which moms are more likely to transmit Hep B perinatally?
HBeAg positive ‘e antigen’
Hep B incubation period?
60-90 days
45-180 day range
Hep B jaundice by age? why?
5
dictated by immune response
which group has higher chronic infection of Hep B?
<5yr olds 30-90%
General trends for outcome of Hep B with age?
the younger you are, the more likely to have chronic Hep B infection but more asymptomatic. The older you are, the more symptomatic but the less chronic infection
Natural history of chronic Hep B infection? how long?
acute chronic hepatitis cirrhosis liver cancer death 30-50 years
Hep B recovery serology looks like how?
initial rise in IgM and HBsAg
Then as IgM goes down you have increased and sustained:
Anti-HBs (surface protein)
anti-HBc (core protein)
In chronic Hep B serology, what is missing?
Missing Anti-HBs
there is Anti-HBc
Why is a missing Anti-HBs bad for chronic Hep B?
the existing Anti-HBc is a poor anti-HBs so it persists
Chronic carrier of Hep B has what serology marker?
HBsAg positive
what is the most common cause of liver cancer?
Hep B sequelae
% of Hep B lifetime mortality?
~30%
How long from infection to cancer for Hep B?
10-30years
How much more likely are you to get hepatocellular carcinoma with Hep B carriers?
100x yo….
HBeAg indicates what?
active replication
HBsAg indicates?
general marker for infection
What is a marker of acute Hep B infection?
rising anti-HBc IgM
What is a marker of past or chronic Hep B infection?
anti-HBc IgG
when do you use HBV-DNA testing?
indicates active replication
used for escape mutants
3 current treatments for Hep B?
interferon alpha pegylated nucleoside/tide analogues new NCTP (sodium co-transporting polypeptide)
what kind of drugs are adefovir, tenofovir? for what? what do they target?
Hep B
nucleotide analogues
target polymerase function
What is 3TC/Lamivudine?
nucleoside analogue (no phasphate group)
Hep B vaccine is now cultured from?
yeast
Hep B vaccine protects from what? how many doses?
Hep B
Hep D
2-3 doses
how is Hep D like Hep B?
ssRNA with a delta antigen and encased in the Hep B surface antigen
How can you catch Hep D?
only infects in conjunction with Hep B
What happens when you get HBV and HDV coinfection?
severe acute disease
low risk of chronic infection
what happens in a HDV superinfection?
HDV after an already HBV+
get chronic HDV and liver infection
