Hepatitis Flashcards
Hepatitis leads to cancer. Is this because of oncogenic genes?
No. It’s because of continual cylces of destruction and regeneration (due to regenerative type of liver cells)
What six viruses can sporadically lead to hepatitis?
Yellow fever virus (flavivirus) Rubella (togavirus) Enteroviruses (Picornaviruses) Cytomegalovirus (Herpesvirus) Herpes simplex virus (Herpesvirus) EBV (herpesvirus)
When liver is damaged, what symptoms do you see? Why is the pathology happening?
fever, jaundice, liver enzyme release (up ALT and up AST)
pathology is because of immune response
Of hepatitis A through E, what are their sources? routes of transmission? and chonic?
A and E: source from feces -> fecal-oral –> not chronic
B-D: source from blood/blood derived body fluids-> percutaneous
permucosal –> chronic
What are the two types of hepatitis? Most common of each?
by far the most common acute: A (contaminated food)
common chronic: B C, lesser degree D
What is the type of virus Hepatitis A? When does viremia occur?
picorna virus (ssRNA, naked)
after crossing intestines
Order these in HAV:
virus in feces:
HAV specific IgG
HAV specific IgM
virus in feces from first week
then HAV-specific IgM
then HAV specific IgG
What can you give to exposed people around HAV to reduce incidence? What type of vaccine is there?
Immunoglobulin
Inactivated
Hepatitis B structures? What makes it unique among DNA viruses?
DNA genome (circular ds) has an infectious particle, but also in non-infectious forms
It’s a pseudo retrovirus. Upon entering in nucleus, completion of dsDNA closed circle (ccDNA–you can’t get rid of it!)
then u have RNA made
BUT the RNA can be reverse transcribed to form DNA for virions.
After HBV hits the infection, it goes to liver. Is there still a chance for immune system to win? is there a vaccine?
yes antibodies during viremia, or antibodies after liver
yes
What percent of HBV goes chronic?
10%
HBV: the surface antigen describes
whether the patient is diseased or immune:
HBsAg: infection
Anti-HbS: immune (clearance or vaccine)
HBV: the core antigen describes
the core antigen tells us how long the infection has been present
HBcAg: active infection (window period)
IgM anti-HBcAg: new infection is present, most specific marker for diagnosis of acute HBV infection because it persists during the window period
IgG anti-HBcAg
old infection is present
HBV:the soluble component of the core antigen tells us how infective the patient is
HBeAg
a soluble component of the viral core
presence connotes high infectivity
↑ “e” = ↑ “enfectivity”
Anti-HBeAg
presence connotes low infectivity
Which two hepatitis viruses are naked?
A and E
the vowels hit your bowels
(aren’t destroyed in gut)
Treatment for HBV? When and how?
not prescribed for acute, just for chronic when liver damage is associated with infection
usually a RT inhibitors (nucleoside analogs) +/- interferons
For HBV: Resistance to ____ can predispose resistance to other RT inhibitors
Lamidivine
Hepatitis D virus requires the presence of __
HBV infection
needs HBV surface antigen to infect liver cells
What is the difference between superfinfection adn coinfection?
Superinfection is on a person already infected with HBV–> more severe progression than coinfection (they get it together)
What type of virus is HCV? is there a vaccine
+ ss RNA flavivirus, one polyprotein (like the others)
no vaccine to prevent it
Unlike HBV, HCV is mostly transmitted by
blood (as opposed to sex)
histological features of chronic hcv?
accumulation of intracellular liquid within hepatocytes
fibrosis
2014: interferon free Direct actign antivirals is
treatment for HCV replaced old (interferons/ribivarin)
interferons free direct acting antivirals
Who is especially likely to die with hepatitis E
pregnant women
