Hepatitis A,E,C Flashcards
What are the families of A, E, C, respectively
A = picorna C = flavi E = hepe
A, C, E: naked or enveloped
A = naked C = enveloped E = naked
what do each of the viruses do mnemonic:
A= acute B = blood borne C = chronic D = defective E = enteric
Family and genetic material for HAV
Picornavirus family, +ssRNA, Naked
How can you kill HAV
heated to 185F for one minute to inactivate. (withstands heating to 140F for 10 hours)
What age group gets jaundice with HAV
Infection < 5 yo = no symptoms
Adult infx = jaundice
WHat is main transmission route for HAV
Person to person spread, though close personal contact or sex, is main transmission route.
Is there chronic HAV? does infx –> immunity?
no chronic infx
infx –> lifelong immunity
What is incubation time for HAV
Incubation Mean 4 weeks (2 to 6 weeks)
When is a person is very infectious with HAV
2 weeks before symptoms and one week after becoming jaundiced
When is someone Most infectious with HAV
MOST infectious 2 weeks before sx start!!!
What is the diagnostic test for acute HAV infection
IgM
What are the major complications of HAV? (3)
a. Relapsing Hepatitis
b. Prolonged cholestasis or cholestasis hepatitis
c. Fulminant hepatitis
Which age group has more serious infx?
over 50
What kind of vaccine is the HAV vaccine
whole killed-virus vaccine with alum added
How many doses are required for HAV vaccine
2
Which groups should get the HAV vaccine. (7)
- all children between the ages of 12 and 23 months.
- Travelers to endemic countries-
- Men who have sex with men
- IV and non-IV drug users
- People who have chronic liver disease, HBV or HCV
- close contacts of adopted children from countries with high or intermediate levels of HAV.
- People who receive clotting factors
Under 12 months or over 40 years what do you do instead of HAV vaccine?
give pooled IG.
What do they give you if you are exposed to HAV
vaccine and/or pooled immunoglobulin within 2 weeks of exposure.
What do they give you if you are exposed to HAV and are between 12 months to 40?
only vaccine
Major source of infection for HEV
sewage infected water = contaminated drinking water
in the developed world cases of HEV are from what source?
eating undercooked pig or deer meat
What 2 populations have the highest mortality rate in HEV?
- underlying chronic liver dz
2. pregnant women
What populations get chronic infx (2)
solid organ transplant or immunosuppression.
Tx fro HEV
Ribavarin works. (Category X teratogen. )
How are all the different mutations of HCV classified
Divided in gentoypes and subgenotypes
What does vertical transmission of HEV cuase in fetus
Vertical transmission –> fetal hepatitis and death but not birth defects.
What is major transmission of HCV
IVDA
What age group has 2/3 of all cases of chronic HCV
people born between 1945 and 1965. 55-75 years old
HCV cases are on the increase in what population?
the younger 20-29 IVDAs.
HCV RNA is only present in what stage of infx
acute, chronic (not cleared)
HCV Ab is not present in what stage of infx
acute (is present in current and chronic)
What is HCV txx
Peg IFN@2, ribavarin
Who is cix in Peg IFN@2 tx? (2)
Decompensated hepatic disease or depression
What is the MOA of ribavarin
Inhibits inosine monophosphate dehydrogenase (IMPDH)-
ADE of ribavarinq
hemolytic anemia
Cix in ribavarin
preganat = category X
Protease Inhibitors end in ?
previr
NS5B polymerase inhibitors end in ?
NS5A inhibitors ending in?
NS5B = buvir
NS5A = asvir
NS5B polymerase inhibitors: MOA?
block replication of viral RNA
Protease Inhibitor MOA
prevents viral polyprotein cleavage and blocks replication of RNA because cannot cleave polyprotein to make active viral polymerase
Cannot use protease inhibitors in what condition?
decompensated cirrhosis.
What is goal of HCV tx?
Sustained Virologic Response (SVR)= absence of HCV RNA
Who to treat for HCV
everyone! too$$$$
