Hepatitis

Question 1

Hepatitis C proteins

Answer 1

ssRNA

C=capsid

E1 and E2=envelope

NS3=protease –> new target (telaprevir, boceprevir)

NS5A=protease (ledipasvir)

NS5=RNA-dependent RNA polymerase –> new target (sofosbuvir)

Question 2

HEP C
______________; rarely leads to fulminant hepatitis immediately)

Often asymptomatic in acute infection

Insidious onset; severity can be predicted by alcohol intake

6-8 wks incubation period

Answer 2

Most commonly (85%) acute to chronic liver disease (15% may clear

Question 3

Hep C Diagnosis

Answer 3

Anti-HCV antibodies (EIA)  this Ab is NOT protective and does not distinguish between acute or chronic

Question 4

NS3=protease –> new target (telaprevir, boceprevir)

NS5A=protease (ledipasvir)

NS5=RNA-dependent RNA polymerase –> new target (_____)

Answer 4

hep c

sofosbuvir

Question 5

• Most commonly (85%) acute to chronic liver disease (15% may clear; rarely leads to fulminant hepatitis immediately)
• Often asymptomatic in acute infection
• Insidious onset; severity can be predicted by alcohol intake

______ incubation period

Answer 5

6-8 wks

Hep c

Question 6

Major cause of chronic liver dz worldwide

Replication occurs via virus encoded RTase (P)

Transmission via blood/ fluids

Answer 6

Hepatitis B

Question 7

Acute and chronic hepatitis

Most adults recover (only 5% progress to chronic)

more children progress to chronic

Answer 7

HEP B

Question 8

Liver damage is NOT due to virus killing cell

Answer 8

HEP B

Question 9

Picornavirus
Oral/fecal transmission (can also get from contaminated strawberries)
Severe drop in 2000 with vaccine
0.5% mortality

Answer 9

Hep A

Question 10

Hepviridae
Oral/fecal transmission (reservoirs in pigs/swine)
Not common in US (clean water)

Answer 10

Hep D

Higher mortality in pregnant women

Question 11

“Ground-glass” hepatocytes

“Sanded-nucleus”

Answer 11

Hep B

Question 12

Delta virus

Parenteral transmission

Answer 12

Hep D

Replication incompetent, completely dependent on Hep B coinfection

Question 13

IgM antibodies in serum (IgG indicates previous infection/immunization)

HAVAg in stool early in disease

Elevated ALT/AST

Jaundice (+other sx) more likely to occur in older vs younger patients

Answer 13

Hep A diagnoisis

Question 14

Hep A diagnoisis

Answer 14

IgM antibodies in serum (IgG indicates previous infection/immunization)

HAVAg in stool early in disease

Elevated ALT/AST

Jaundice (+other sx) more likely to occur in older vs younger patients

Question 15

ACUTE and spread by fecal-oral route

Answer 15

Hep A

Question 16

CHRONIC and blood/body fluid transmission

Answer 16

Hep B, C, D

Question 17

Can progress to hepatocellular carcinoma

Answer 17

Hep B and C

Question 18

Heps with vaccine

Answer 18

Hep A, B,