Hepatitis B, D

Question 1

HAV: what cuases damage in HAV?

Answer 1

the virus does not kill hepatocytes. The immune response (CD4, CD8 Tcells) causes hepatits

Question 2

Ig is given in place of HAV vaccine in populations that can’t get vaccine. WHat are those pops?

Answer 2

under 12 months

over 40

Question 3

HCV tx: 3 classes plus ribavarin. What are the 3 classes?

Answer 3

protease inhibitors
NS5B polymerase inhibitors
NS5A inhibitors

Question 4

WHat is the suffux for
protease inhibitors
NS5B polymerase inhibitors
NS5A inhibitors

Answer 4

protease inhibitors- previr
NS5B polymerase inhibitors - buvir
NS5A inhibitors - asvir

Question 5

What is a cix of protease inh

Answer 5

decompensated cirrhosis

Question 6

WHat is target and outcome of HBV tx?

Answer 6

Treatment for HBV targets HBeAg –>

Treatment rarely results in resolution of infection and treatment may be life-long.

Question 7

What are the 2 tx classes for HBV

Answer 7

PEGylated IFN

Nucleoside (tide) RT inhibitors-

Question 8

What is cix for PEGylated IFN

Answer 8

decompensated cirrhosis

Question 9

WHat are the 2 First Line tx of HBV and their class?

Answer 9

NRTIs: Entecavir or Tenofovir disoproxil

Question 10

Wht kind of vaccine is HBV vaccine

Answer 10

subunit vaccine containing the HBs protein only and alum

Question 11

How many and timing of vaccine doses for HBV

Answer 11

3 doses: 0, 1, and 6 months

Question 12

WHo should get HBV vaccine? 4 categories

Answer 12

i. Sexually transmitted:
	□ Have HBsAg (+) partner
	□ Anyone who has STD
	□ MSM
ii. HCW, anyone who handles blood
		Ever taken IV drugs
		Live with HBsAg (+) person
		End stage renal disease
		Person with Diabetes mellitus (infection with glucose monitoring)
iii. Travel to endemic high or intermediate endemic area
iv. HIV +, HCV+

Question 13

for HBV: b. If not vaccinated or post-vaccine titers are low What do you give?

Answer 13

give one shot HBIG and one shot of vaccine

Question 14

HBV: If you never had good response to the vaccine, what do you give

Answer 14

give 2 shots of HBIG one month apart

Question 15

genetic info of HDV

Answer 15

-ssRNA

Question 16

What happens to levels of HBV-DNA/HbsAg in co-infection between HDV and HBV?

Answer 16

HDV often suppresses HBV such that HBV-DNA can be very low or absent in a co-infection. HBsAg is present

Question 17

What is the pattern oif ALT in HBV/HDV co-infection

Answer 17

double peak of ALT

Question 18

What is a tx that works and one that doesn’t for HBV/HDV DNA

Answer 18

Peg-IFNa works

NRTIs against HBV do not work.