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Immunology and Microbiology > Hepatitis (Exam 2) > Flashcards

Hepatitis (Exam 2) Flashcards

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1
Q

Hepatitis

A

Inflammation of the liver

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2
Q

Two types of hepatitis

A

Acute (<6 months)
chronic (>6 months)

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3
Q

Causes of Hepatitis

A

VIRUSES
drug toxicity
alcohol
autoimmune diseases
bacteria
parasites

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4
Q

Symptoms of Hepatitis

A

Swelling of liver
Jaundice
dark urine
Transaminase- alkaline phosphate levels increased

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5
Q

Symptoms of Viral Hepatitis

A

Yellowing skin and eyes, dark urine, loss of appetite, fatigue

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6
Q

Compensated Cirrhosis

A

Liver can still function, no signs or symptoms

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7
Q

Decompensated Cirrhosis

A

Liver is too damaged to function normally, symptoms such as jaundice and ascites are present

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8
Q

Progression of Hepatitis

A

Normal liver –> chronic hepatitis –> hepatitis with fibrosis –> bridging fibrosis –> cirrhosis with hepatocellular carcinoma

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9
Q

Which hepatitis have a vaccine?

A

Hepatitis A and B
No vaccine for Hepatitis C (good luck)

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10
Q

Which hepatitis cause liver cancer?

A

Hepatitis B and C

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11
Q

How long does Hepatitis A last?

A

Few weeks to several months (2 months), most recover with no lasting liver damage, very rare but death can occur

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12
Q

How long does Hepatitis B last?

A

Few weeks to serious, life-long condition with individuals developing chronic liver disease - cirrhosis, failure, cancer

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13
Q

How long does Hepatitis C last?

A

Few weeks to serious, life-long condition
Most develop chronic hepatitis C
5%-25% with ^ will develop cirrhosis over 10-20 years

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14
Q

Unimmunized infants who get infected by hepatitis B

A

Develop chronic INFECTION

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15
Q

Older children and adults who get infected by hepatitis B

A

Develop chronic hepatitis B

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16
Q

How is Hepatitis A spread?

A

Ingesting fecal matter from contaminated sources/people
Food, drinks including ice, blood, stool, direct sex contact, poor sanitation

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17
Q

How is Hepatitis B spread?

A

Blood, semen, bodily fluids from infected person enter body of uninfected, sex, sharing of personal items, needles. can also be transmitted from birth to an infected mother

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18
Q

How is Hepatitis C spread?

A

Blood from infected person enters body of someone uninfected

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19
Q

Global mortality from viral hepatitis is…

A

INCREASING o_o

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20
Q

HAV virus

A

ssRNA
No envelope - Capsid
Picorna/hepatovirus
Fecal-oral
Not chronic
heat and acid stable
high prevalance/contagious

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21
Q

HBV virus

A

dsDNA
Envelope
Hepadnaviridae
Parenteral
Chronic

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22
Q

HCV virus

A

ssRNA
Envelope
Parenteral
Flaviviridae + Hepacivirus
Chronic

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23
Q

HDV virus

A

ssRNA
Envelope
Parenteral
Delta virus

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24
Q

HEV virus

A

ssRNA
No envelope - Capsid
Waterborne, animals
Togavirus and alpha virus-like
Chronic - immunocompromised

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25
Q

who is at risk for HAV?

A

close contacts of HAV-infected individuals, recreational drug users, travelers to endemic areas, homeless individuals, MSM

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26
Q

prevention of HAV

A

vaccination - HepA (inactivated/killed vaccine)
post-exposure prophylaxis within 14 days - immune globulin

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27
Q

HAV pathogenesis

A

ingestion
replication in oropharynx/GI tract
transported to liver
sited in bile
transported to intestines
shed in feces
brief viremia
cellular immune response-clinical disease and control
uses liver cell for viral replication; interferes with liver function

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28
Q

major site of replication

A

liver

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29
Q

incubation of HAV

A

15-45 days

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30
Q

incubation of HBV

A

45-160 days

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31
Q

incubation of HCV

A

15-150 days

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32
Q

incubation of HDV

A

30-60 days

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33
Q

incubation of HEV

A

15-60

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34
Q

leading cause of liver cancer worldwide from which infection?

A

Hepatitis B infection
- no cure, infants and children most likely to develop this
- vaccine preventable

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35
Q

HBeAg

A

HBV e-antigen (expressed when actively replicating)

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36
Q

HBsAg

A

HBV surface antigen

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37
Q

HBcAg

A

HBV core antigen

38
Q

HBV care for adults and children

A

see liver specialist every 6 months.
- physical exam
- blood tests for Hep B markes
- blood tests for liver enzymes (ALT/AST)
- blood tests for liver cancer screening (AFP)
- imaging studies of the liver (ultrasound, CT scans, FibroScan)

39
Q

HBV treatments

A

direct anti0viral medications (nucleoside analogs):
- Entecavir
- Lamivudine
- Adefovir dipivoxil
- Telbivudine
- Tenofovir alafenamide
-Tenofovir

Immune boosters:
- interferon alpha 2b
pegylated interferon

40
Q

who is at risk for Hepatitis A?

A

close contacts of HAV infected
recreational drug users
travelers
homeless individuals
MSM

41
Q

Does HAV cause chronic infections?

A

NO!
infection usually resolves within 2 months

42
Q

HAV is preventable by

A

vaccination and post exposure prophylaxis

43
Q

HAV pathogenesis

A

ingestion –> replication in GI tract –> transported to liver –> shed in bile –> transported to intestines –> shed in feces

44
Q

prevention of HAV preexposure? post exposure?

A

pre - HepA vaccine (inactivated/killed vaccine)
post - immune globulin (within 14 days)

45
Q

what part of the virus is used for vaccine?

A

the surface antigen

46
Q

HBV viral genome

A

3.2 kb
core and surface antigens

47
Q

Hepadnaviral replication

A

RC-DNA transported to nucleus –> repaired to form cccDNA –> transcription to pgRNA –> pgRNA is encapsidated and reverse transcribed in nucleocapsid

48
Q

Hepatitis B infection is the

A

leading cause of liver cancer worldwide

49
Q

is there a cure for hepatitis B?

A

no :(

50
Q

how is hepatitis B transmitted?

A

parenteral via infected body fluids
unprotected sex
needle sticks
mother to fetus

51
Q

global viral hepatitis B

A

257m global

52
Q

acute hepB serology

A

total anti-HBc stays for a long time
IgM anti-HBc goes down

53
Q

chronic hepB serology

A

HBsAg stays around for some time and is larger than total anti-HBc (antibodies)

54
Q

standard recommendation for care to visit a liver specialist is

A

every six months
can be more/less depending on medical situation

55
Q

testing during liver specialist recommendation

A

physical exam
blood tests for hepb markers
blood tests for liver enzymes
blood tests for liver cancer screening
imaging studies of the liver

56
Q

persons who are HBsAg positive should not

A

not share toothbrushes/razors
not share injection equipment
not share glucose testing equipment

57
Q

persons who are HBsAg positive should have

A

household and sexual contacts vaccinated

58
Q

so blood doesn’t spread, persons who are HBsAg positive should

A

cover open cuts and scratches
clean blood spills with bleach solution
not donate blood, organs or sperm

59
Q

subunit recombinat vaccine

A

first dose given at birth

60
Q

HEV is transmitted via

A

fecal oral route, principally via contaminated water

61
Q

what happens if someone is infected with hep B at birth?

A

progress to chronic HBV infections

62
Q

is there a vaccine for HEV?

A

yes but it is not approved in the US
only in China

63
Q

Treatment for HEV

A

Ribavirin
treatment of severe acute HEV and chronic HEV infections
symptomatic treatment

64
Q

HEV infections usually

A

resolve on their own within 4 to 6 weeks

65
Q

blood donor screening is done for which hepatitis?

A

hepB and hepC

66
Q

Hepb treatment

A

interferon (PegIFN)

67
Q

the cure rates for chronic HCV

A

rising

68
Q

progression of hepatitis C can take

A

25-30 years

69
Q

serologic pattern of acute HCV infection

A

anti-HCV is still present even if the virus isn’t
might not have active virus over time

70
Q

HBV post exposure prophylaxis

A

anyone who is non-HBV-immune of unknown HBV status should receive prophylaxis and initiation of HBV vaccination WITHIN 24 HOURS of suspected exposure

71
Q

prevalence by risk based of HCV is

A

MSM
long term kidney dialysis
healthcare workers exposed
children born to HCV infected mothers
incarceration
recipient of a unsterile tattoo
recipients of blood transfusion

72
Q

In the United States, Hepatitis C is

A

under diagnosed (75%)

73
Q

how much of the world has viral hepatitis C

A

71m global (1/4 of the amount of hepB)

74
Q

chronic infection of HCV can lead to cirrhosis which leads to

A

liver failure or hepatocellular carcinoma

75
Q

North America is not really affected by hepC because of

A

screening in blood banks

76
Q

Hepatitis C virus is associated with

A

flavivirus (dengue, west nile, yellow fever, zika)

77
Q

heterogeneity of HCV

A

no proofreading in the polymerase –> mutations –> viral diversity

78
Q

HDV is a

A

defective virus that consists of a protein capsule surrounding low molecular weight RNA

79
Q

heterogeneity of HCV allows for

A

escape from host immune system and medications

80
Q

how many genotypes and subtypes of HCV are there?

A

six major genotypes with over 15 subtypes

81
Q

there are multiple different types of hepC that differ

A

slightly in the genome

82
Q

HCV life cycle follows

A

APUMAR

83
Q

HBV-HDV

A

co-infection
getting infected simultaneously with HBV and HDV
low risk 5% of chronic infection, severe acute disease

84
Q

HDV superinfection in HBV Carrier

A

being chronically infected with HBV and contracting HDV
usually develop chronic HDV infection
high 70-90% chronic liver disease

85
Q

HDV therpahy

A

none, sucks to be u

86
Q

Lambda mechanism

A

immune response stimulator

87
Q

Myrcludex B mechanism

A

entry inhibitor

88
Q

Lonafarnib mechanism

A

prenylation inhibitor

89
Q

ezetimibe

A

NTCP inhibitor

90
Q

REP 2139
REP 2165

A

HBsAg Inhibitor

91
Q

GI- 18000

A

Immune response stimulator

92
Q

ALN-HDV

A

RNAi Gene Silencer

Immunology and Microbiology (20 decks)

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