Hepatitis Flashcards
Name the viral infection. Diagnostic Test: -IgM anti-HAV, positive -IgG anti-HBsAg, positive -IgG anti-HBcAg, positive
Acute Hepatitis A; previous exposure to Hep B (vaccine)
Name the viral infection.
Diagnostic Test:
-IgM anti-HBsAg, positive
-IgM anti-HBcAg, positive
Acute Hepatitis B
Name the viral infection.
Diagnostic Test:
-IgM/IgG anti-HBsAg, positive
-IgM/IgG anti-HBcAg, positive
Chronic Hepatitis B
Name the viral infection. Diagnostic Test: -RT-PCR anti-HCV, positive -IgG anti-HBsAg, positive -IgG anti-HBcAg, positive
Chronic Hepatitis C; previous exposure to Hep B (vaccine)
Name the viral infection.
Diagnostic Test:
-RT-PCR anti-HCV, positive
-ALT serum levels very high
Acute Hepatitis C
Symptoms of hepatitis (6). Which age group tends to be the most jaundiced?
- fatigue
- abdominal pain
- loss of appetite
- nausea/vomiting
- dark urine
- jaundice
- Older age group (over 14)
Which two types of hepatitis do not persist in the liver (there is NO CHRONIC DISEASE)? Which causes the most chronic disease?
Hep A and Hep E; Hep C
You are a IV drug user; which type of hepatitis would you most likely get?
Hep C
You have lots of sex; which type of hepatitis would you most likely get? How long was your incubation period? What are your symptoms due to, primarily?
- Hep B
- about 2 months
- cell mediated immune response (not virus!!)
You ate contaminated shellfish and are now having hepatitis symptoms; which type do you have and what kind of virus class is it?
Hep A; RNA Picornavirus (single serotype; +ssRNA, icosahedral, nonenveloped; transmitted fecal-oral)
Which hepatitis types have vaccines? Describe the vaccine for each and who can receive it.
- Hep A: inactivated vaccine (via formalin); people at risk for Hep A (infants, CKD, high endemic HAV)
- Hep B: VLPs; everyone at birth
You went swimming in the water in Mexico and swallowed some water and are now having hepatitis symptoms. Which kind of virus do you probably have? Is there a vaccine for this virus?
- Hep E [Mexico = travel! and non person-to-person contact = drinking fecally-contaminated water]
- No
What’s the incubation period of:
- Hep A
- Hep C
- Hep B
- Hep A = 3.5 weeks (virus shedding when asymptomatic)
- Hep C = about a month
- Hep B = 2 months
Name the virus Family for:
- Hep A
- Hep B
- Hep C
- Hep D
- Hep E
- Picornavirus
- Hepadnavirus (enveloped, cDNA–partially ds)
- Flavivirus (enveloped, +ssRNA, associated with VLDL)
- none; needs HBV to replicate
- Calicivirus (+ssRNA, icosohedral)
Why does Hep B have a variety of morphologies? Why is this good therapeutically?
- Big round = virus
- Rod-like = non-infectious HBsAg
- Small round = non-infectious Dane particles
- -Purpose is to act as decoys for the immune system to mount responses against other antigens other than the Hep B viurs
- -HBsAg and Dane particles (VLPs) are the basis of Hep B vaccines
The ______ you are when you get Hep B, the more likely you are to get a chronic infection. Therefore the best treatment is _____.
- younger
- prevention (vaccines!)
Hep B: In the cytoplasm, how are new partially dsDNA strands made for packaging?
mRNA is reverse transcribed to ssDNA, which is then made into partially dsDNA
Can Hep B DNA integrate into the cellular DNA?
Yes!
The presence of _____ during a Hep B infection can increase the probability that you will get primary hepatocellular carcinoma [superinfection]. Describe this particle.
- Hep D
- Viriod and ribozyme that processes itself (with exception of host RNA poly); small RNA, encoding 1 antigen; packaged in Hep B sAg
Why does HBV have a high correlation with hepatocellular carcinoma (HCC)? (4 reasons)
- Due to damage, liver undergoes sustained cell proliferation, which enables increased genetic errors
- Integration of viral DNA into host chromosome can cause genomic instability
- Virally-encoded “X” protein linked to oncogenic properties, like inhibiting p53
- HCC correlated with HBV surface antigen expression/X expression
Error-prone viral RNA polymerases, like in Hep ___, lead to many ______. This makes it difficult to develop vaccines.
- C
- quasi-species
High incidence of both ____ (85%) and _____ infection allow Hep C to spread throughout the population. Hep C is also associated with increased onset of ______, primarily due to increased immune response.
- Chronic
- Asymptomatic
- HCC (Hepatocellular carcinoma)
What is the incubation time of Hep C? How do you know the difference between an acute and chronic infection? When do anti-HCV Abs appear? How do you treat Hep C genotype 1 (most prevalent in US)?
- Less than a month
- ALT levels!! ALT very very high with acute infection (1.5 months); ALT levels fluctuate with chronic infection
- after about 4 months
- Ribavirin + IFN
Why does HCV have a high correlation with hepatocellular carcinoma (HCC)? (5 reasons)
IMMUNOREGULATION!!!
- HCV core protein inhibits p53/Rb)
- HCV core induces steatosis, leading to oxidative-stress-induced cell proliferation
- HCV envelope protein (E2) inhibits NK cells
- NS3 inhibits p53 to increase cell proliferation
- NS5A inhibits p53 to prevent apoptosis
