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Boards.CP.Micro > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

Hepatitis A virus:

  • DNA/RNA
  • Family
  • Transmission
A
  • RNA
  • Picornavavirus
  • Fecal-Oral
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2
Q

Who does HAV primarily effect?

A

Children, often before 11 y/o

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3
Q

Diagnosis of Acute infection depends on demonstrating what?

A

IgM anti-HAV

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4
Q

IgG anti-HAV indicates.

A

Acute or past infection

-persists for life

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5
Q

Hepatitis B virus:

  • DNA/RNA
  • Family
  • Name of intact virion
A
  • DNA
  • Hepdnavirus
  • Dane particle
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6
Q

HBV viral markers:

-HbsAg (surface antigen)

A

Indicates Active disease

-either acute infection or chronic carrier state

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7
Q

HBV viral markers:

-HBeAg (when is it produced?)

A

-Indicates chronic carriage with active viral replication

only produced when the virus in in replicating form

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8
Q

HBV viral markers:

  • Anti-HBc (antibody to B core antigen)
  • IgM
  • Total antibodies (IgG/IgM)
A
  • Present throughout lifetime of someone who has been INFECTED
  • Acute infection
  • Acute and Past infection
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9
Q

HBV viral markers:

-Anti-HBe (3)

A
  • Found when HBe becomes negative
  • Does NOT imply resolved infection or immunity
  • Indicates chronic carrier without active viral replication
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10
Q

HBV viral markers:

-HBsAb (antibody vs surface antigen)

A
  • Indicates resistance from infection

- Found in IMMUNIZED persons and those who have successfully cleared HBV infection

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11
Q

When do serologic markers for HBV emerge?

A

2-10 weeks following infection

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12
Q

What marker appears 1st following HBV infection; followed by which ones?

A
  • HBsAg
  • HBeAg
  • IgM anti-HBc
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13
Q

T/F: HBV DNA is detectable in serum before HBsAg.

A

True

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14
Q

What serologic markers coincide with emergence of symptoms?

A

-Anti-HBc

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15
Q

What antibodies emerge when there is complete resolution of acute HBV infection?

A
  • Anti-HBe

- Anti-HBs

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16
Q

What remains positive in patients who develop chronic HBV infection? (what is criteria for diagnosis)

A

HBsAg remains positive

-persistence for >6months

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17
Q

Persistent HBsAg without clinical hepatitis is called what

A

-Chronic Carrier State

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18
Q

Chronicity develops in % of:

  • Healthy
  • Immunocompromised adults
  • Neonates infected transplacentally
A
  • 5%
  • 10%
  • 90%
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19
Q

What is chronic HBs antigenemia associated with?

A

Polyarteritis Nodosum (PAD)

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20
Q

Which Hepatitis virus can only infect hepatocytes with HBV DNA?

A

HepD (HDV)

21
Q

HBeAg - Chronic Hepatitis B is characterized by what? *3)

A
  • Circulating HBV DNA
  • Fluctuating aminotransferases
  • Tendency towards fulminant hepatitis with liver failure
22
Q

HBeAg - Chronic Hepatitis B results from what?

A

Mutations in the C or pre C region of the HBV genome in which a premature stop codon impairs synthesis of HBeAg

23
Q

What are the 3 major applications for molecular assays in HBV?

A
  • Making initial diagnosis of HBV
  • Replicative vs. Nonreplicative Chronic HBV
  • Response to therapy (undetectable HBV DNA is consiered a virologic response)
24
Q

Those with ____ copies of HBV DNA/mL are considered replicative chronic HBV.

A

> 10^5 copies of HBV DNA

25
HBV Serology - No prior infection nor immunization: - HBsAg - Anti-HBc - Anti-HBs
HBV Serology - No prior infection nor immunization: - HBsAg - Neg. - Anti-HBc - Neg. - Anti-HBs - Neg.
26
HBV Serology - Prior immunization: - HBsAg - Anti-HBc - Anti-HBs
HBV Serology - Prior immunization: - HBsAg - Neg. - Anti-HBc - Neg. - Anti-HBs - Positive
27
HBV Serology - Acute HBV: - HBsAg - Anti-HBc - Anti-HBs
HBV Serology - Acute HBV: - HBsAg - Positive - Anti-HBc - Positive (IgM) - Anti-HBs - Neg.
28
HBV Serology - Chronic HBV: - HBsAg - Anti-HBc - Anti-HBs
HBV Serology - Chronic HBV: - HBsAg - Positive - Anti-HBc - Positive - Anti-HBs - Negative
29
HBV Serology - Resolved HBV: - HBsAg - Anti-HBc - Anti-HBs
HBV Serology - Resolved HBV: - HBsAg - Neg. - Anti-HBc - Positive (IgM&IgG) - Anti-HBs - Positive
30
Hepatitis C virus family.
Flavivirus
31
What is the most common cause of transfusion associated viral hepatitis?
HepC
32
What percentage of those infected develop chronic HCV?
60%
33
What percentage of those with chronic HCV develop cirrhosis?
15%
34
What percentage of those with cirrhosis develop HCC?
5%
35
What are the extrahepatic manifestations of HCV? (3)
- Mixed cryoglobulinemia - Glomerulonephritis - Aplastic anemia
36
Diagnosis of HCV is based on which 3 assays?
- EIA based assays for anti-HCV antibodies - HCV RNA - Recombinant Immunoblot Assay (RIBA)
37
HCV Assay results - Early HCV infection (<3 months): - Anti-HCV (EIA) - RIBA - HCV RNA
HCV Assay results - Early HCV infection (<3 months): - Anti-HCV (EIA) - Neg. - RIBA - Neg. - HCV RNA - Positive
38
HCV Assay results - Current HCV infection (acute or chronic): - Anti-HCV (EIA) - RIBA - HCV RNA
HCV Assay results - Current HCV infection (acute or chronic): - Anti-HCV (EIA) - Positive - RIBA - Positive - HCV RNA - Positive
39
HCV Assay results - Cleared/resolved prior HCV infection: - Anti-HCV (EIA) - RIBA - HCV RNA
HCV Assay results - Cleared/resolved prior HCV infection: - Anti-HCV (EIA) - Positive - RIBA - Positive - HCV RNA - Negative
40
HCV Assay results Interpretation: - Anti-HCV (EIA) - Positive - RIBA - Neg./Indeterminate - HCV RNA - Neg.
False Positive anti-HCV EIA
41
What is the endpoint of treatment for HCV infection?
Sustained Virologic Response (SVR): | -Undetectable HCV RNA for 24 weeks after the end of treatment
42
What is the most common HCV genotype in the US? | -Subclass?
HCV genotype 1 (70%) - Type 1a (60%) - Type 1b (10%)
43
Which HCV genotype is more likely to develop resistance to treatment?
HCV genotype 1a
44
Is Hepatitis E virus (HEV) a DNA or RNA virus
RNA (HEV)
45
How is HEV transmitted? | Who does it typically affect?
- fecal-oral | - young adults (15-35 y/o)
46
HEV is more virulent in what population?
Pregnant women -mortality rate of 30% *overall mortality is 1%
47
T/F: Chronic HEV infections are rare.
True
48
Hepatitis G virus (GBV C virus): - DNA or RNA - Virus Family - Transmission - Chronicity
- RNA - Flaviviridae family - Parenteral transmission - Chronic infection is common *Not clearly demonstrated to cause clinical hepatitis
49
What are other viruses that cause hepatitis? (5)
- EBV - CMV - HSV - VZV - Yellow Fever

Boards.CP.Micro (28 decks)

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