Hepatitis viridae Flashcards
what are the primary viruses that infect liver
RNA:Hep A Hep C Hep D Hep E Hep G DNA: HepB
What hepatitis are fecal-oral route
A and E
what hep viruses can lead to chronic hepatitis
B C and D
presentation of acute viral hepatitis
flue, fatigue, low fever, aches, cough, rhinitis and pharyngitis
1-2 weeks late jaundice (high bliirubin)
increase in AST ALT GGt and alkaline phosphatase
Why is chronic viral hep hard to Dx
asymptomatic with enlarged tender liver and mildy elevated liver function enzymes
describe the liver enzyme levels in viral hepatitis in relation to each other
the ALT and ASt will be high
GGT and alkaline phosphatase, bilirubin moderately high
bilirubin continues to rise
describe liver enzyme levels in say gallstone obstruction
bilirubin, alkaline phosphatase and GGT are higher than AST ALT
Describe composition of Hep A
naked cosahedral capsid with + ss RNA
part of Picornaviridae
fecal-oral route
how long is the incubation period for Hep A before signs of acute hepatitis
15-40 days
How do you Dx Hep A
serologic tests for HepA capsid Ag
What is the composition of Hep B
large, enveloped icosahedral capsid with ds circular DNA
What is the name of the intact Hep B virus
Dane Particle
What are the filamentous structures on the Dane Particles of Hep B
hepatitis B surface Ag HBsAg
What is HBeAg
the component of the Hep B core that is released in active infection
How is HBV spread
blood to blood,
parenteral
What disease states can be caused by HBV
acute hepatitis
fulminant hepatitis
chronic hepatitis
co-infection with hep D virus
what is fulminant hepatitis
severe acute hep with rapid destruction of liver
what are the 3 states of chronic hepatitis
asymptomatic
chronic persistent- low grade
chronic active- acute hepatitis 6-12 months
how does liver injury occur in hepatitis
cell mediated because Viral Ag are targets for CTLs and the IC can deposit leading to arthritis and kidney damage
Why are immunocompromised patients usually carriers without symptoms of Hep B
because their immune system does not attack
what can occur if HBV is incorporated into Host DNA
primary hepatocellular carcinoma
cirrhosis
Detection of what Ag means there is a live Hep B virus and infection
HBsAg
detection of anti HBsAg means what in hep B
immune, cure, no active disease
If patient has IgM anti HBcAg what does this say?
What about IgG antiHBcAg
IgM is new infection
IgG is old infection