Hepatitis

Question 1

How are the different Hepatitis viruses related?

Answer 1

They are not closely related but they all have similar sx and they all infect hepatocytes

Question 2

All hep viruses are treated with ?

Answer 2

supportive care, HBV and HCV have other tx options

Question 3

Which hep viruses are transmitted through the fecal-oral route?

Answer 3

A and E

Question 4

Which hep viruses are transmitted through blood?

Answer 4

B, C, D

blood, sex, birth

Question 5

Which hep viruses have vaccines for prevention?

Answer 5

A, E, B, D can be prevented via HBV vaccine as long as person is HBV neg.
*no HCV vaccine!

Question 6

what is hep D and how do you get it?

Answer 6

it is a viriod that cannot infect you without HBV so there are 2 modes of infection with HDV:
1- coinfection with HBV and HDV at same time (better prognosis, less common)
2- chronic HBV infected person later gets infected with HDV = SUPERINFECTION, (worse prognosis because liver is already in bad shape when HDV gets to it)

Question 7

If you suspect HAV and run labs what does it mean if you find HepA IgM vs. HepA IgG

Answer 7

IgM= acute infection
IgG = recovered or vaccinated

Question 8

Explain the following lab findings individually:
HepBsAg
HepBeAg
HepBcAb
HepBeAb
HepBsAb

Answer 8

They go in the order they show up
HepBsAg=acute/ incubation period
HepBeAg= time course
HepBcAb=early convalescence (recovery)
HepBeAb= timecourse
HepBsAb=late convalescence/ vaccinated

Question 9

If a person has a + HepC EIA test but a negative RIBA test, what does that mean for their dx?

Answer 9

the +EIA was false positive

RIBA is more accurate

Question 10

How do you test for HepD?

Answer 10

delta antigen, if present = HepD infection

Question 11

Which Hep viruses never cause chronic hepatitis?

Answer 11

A and E

Question 12

If a person develops chronic hepatitis, which virus are they likely to have? and what are they now at risk for?

Answer 12

B or C

risk for cirrhosis, and cancer

Question 13

How do you treat chronic viral hepatitis?

Answer 13

polymerase inhibitors and pegylated alpha interferon (lots of SE)

Question 14

Which HCV serotypes respond well to tx?

Answer 14

2 and 3 respond well,

1 and 4 do not but new drugs are in the pipeline for type 1

Question 15

Why is a liver transplant not guaranteed to cure chronic hepatitis?

Answer 15

the virus may have extrahepatic reservoirs which can infect the new liver
*this may be prevented with a short course of antivirals before LDLT

Question 16

Why isn’t there a vaccine for HCV?

Answer 16

Ab is not protective

Question 17

HAV virology

Answer 17

picornavirus
ssRNA
naked
icosahedral capsid
one serotype *no reinfection

Question 18

HBV virology

Answer 18

Hepadnavirus
small
ENVELOPED
DNA
partly double stranded

Question 19

HEV virology

Answer 19

small 
naked positive sense ssRNA 
icosahedral capsid
its the Hep A of China
only one serotype

Question 20

Why does HepB have the potential to produce immune complex disease?

Answer 20

replication produces incomplete “decoys” which soak up Ab so the true viral particles can avoid Ab

Question 21

HCV virology

Answer 21

FLAVIVIRUS
ENVELOPED
positive-sense RNA

Question 22

Which is more likely to cause chronic hepatitis HepB or C?

Answer 22

C (85%)

B (10%)

Question 23

If I say Egypt, you say Hep_?

Answer 23

Hep C