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Hepatitis Virus Flashcards

1
Q

rules regarding blood borne pathogens are established by which of the following

CDC
ADA
OSHA
PHS
NASA
NWA
A

OSHA

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2
Q

what is hepatitis

A

inflammation of the liver

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3
Q

acute hepatitis

A

associated with fatigue, abdominal pain, loss of appetite, nausea and vomiting, darkening of the urine, followed by jaundice

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4
Q

jaundice

A

yellowing in skin and eyes caused by the build up of bilirubin in the blood

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5
Q

bilirubin

A

a byproduct of hemoglobin metabolism due to liver not lover properly metabolizing and excreting it

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6
Q

chronic hepatitis can lead to

A

fibrosis

cirrhosis

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7
Q

HAV
HBV
HCV
HDV

A

infection hepatitis
serum hepatitis
formerly nonA nonB hep
delta particle

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8
Q

what causes >90% of viral hepatitis

A

A,B,C

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9
Q

what can also cause hepatitis

A

HSV
CMV
EBV
Yellow Fever Virus

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10
Q

what can cause or worsen hepatitis

A 
alcohol abuse
some drugs (acetaminophen)
toxic chemicals (some organic solvents)
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11
Q

HBV family

A

ss/ds DNA
hepadna-
icosohedral
enveloped

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12
Q

HAV family

A

+ssRNA
pircorna
(entero, polio, ring are also in this family)
icosohedral
not enveloped
hard to decontaminate: resists heat and disinfectants
released by exocytosis

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13
Q

HCV familt

A 
\+ss
flavi
(also west nile, dengue, yellow fever, zika)
icosohedral
enveloped
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14
Q

HAV

A

fecal oral transmission
localize outbreaks
contaminated food: vegetables and shellfish

short incubation:15-45 days
shedding virus in stool 2 weeks prior to symptoms

acute infection only
no fulminant hepatitis
lifelong ab protection after infection

symptoms last 8 wks
-fatigue,
-abdominal pain
-loss of appetite
-nausea, vomiting
-dark urine
-jaundice (70-80% of adults)
90% of childhood infections are asymptomatic
<0.5% mortality
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15
Q

HAV pathogenesis

A

there is some lysis but is result of T cell immune response in the liver

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16
Q

testing for HAV

A

IgM and IgG

elevated liver enzymes (Aminotranferases) (general hepatitis)

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17
Q

prevention and treatment of HAV

A

-hygiene- hand washing by food preparers
-Vaccine- inactivated HAV
100% effected and recommended for people traveling to developing nations
life long immunity
-immune serum containing antibodies that can be given pre-exposure.if traveling too soon for a vaccine to become effective
this can also be given post exposure
Vaccine can be given up to 2 weeks post exposure

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18
Q

Hep B

A 
serum hepatitis
long incubation hepatitis
~90days (with 4-25 weeks variation)
symptoms began ~90 days (60-150 days) after exposure
30% of people are asymptomatic
Endemic in many developing countries
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19
Q

stats on Hep B

A

102 million people infected In US
240-350 million have chronic HBV
~25% of people worldwide will be infected with HBV at some point

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20
Q

how is HBV spread

A
  • mother to fetus or childhood where there is endemic

- sexually of blood transmitted disease in the developed world

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21
Q

which virus led to the development of universal precaution recommendations of the ADA and CDC for dentists in the 70s following a series of disease clusters in dental practices

A

HBV

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22
Q

what type of virus is HBV and what is the implication of that

A

it is a DNA virus and therefore it can integrate into cell DNA

we know this because of genome sequencing. it was found in 11000 year old human remain, integrated into the DNA

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23
Q

Hep B infection

A

acute with resolution (90% in adults)
Chronic- can be a carrier or persistent
carrie can continue to spread infection despite the lack of symptoms

24
Q

what is the risk of chronic infection for infants and children?

A

90% and 25-50% respectively

25
what are acute HBV symptoms similar to?
HAV but with joint pain
26
how many virions per day are produced by HBV
E10-E11 per day mutates rapidly like HIB
27
Chronic hepatitis (B)`
> 6 months of liver inflammation detected by Alanin aminotransferase ALT in the blood eventual death from infection in 15-20% of chronically infected people
28
what is ALT and what is it indicative of
a liver-specific enzymes | its presence in blood indicates liver injury
29
what does chronic infection due to Hep B lead to?
cirrhosis of the liver liver cancer= heptocellular carcinoma chronic inflammatory response which damages DNA in liver cells
30
what exacerbates liver damage
alcohol
31
Hep B acute vs chronic asymptomatic vs symptomatic
outcome determined by the cellular (Tcell) immune response | strong response causes liver disease in the short term but resolution of infection in the mid-term
32
in hep b, acute vs chronic asymptomatic vs symptomatic Weak cellular response leads to
chronic infection and long term risk of advanced disease: liver scarring, cirrhosis, liver cancer- primary hetpatocellular carcinoma a person becomes a carrier carriers do not necessarily display overt symptoms but can spread the virus infection of infrequntly leads to them become chronically infected carriers
33
Hep B comes in 2 forms
1. infection virion= dane particle 2. Immune decoy there is a lipid envelope
34
what is tested for in an active Hep B infection
HBsAg
35
prevention and treatment of Hep B
safe sex, no iV drug use (needle sharing) there are no antivirals for acute infection chronic can be treated with RT inhibitors that is also used for HIV (Lamivudine) immune serum can be given after exposure and to newborns of HBV positive mothers
36
what is recombivax
a subunit vaccine uses recombinant DNA technology to make HBsAg particles 3 injections and a time test for antibodies to surface antigen
37
what does HBV vaccine do?
elicits an antibody response | prevent virus from reaching liver
38
can the HBV vaccine be give to pregnant women
yes and also can be given as a post-exposure prophylaxis
39
HCC vs PHC
hepatocellular carcinoma= primary heptocellular carcinoma
40
HCC is
- associated with HBV infection 50-70% of the time - HCC tumor DNA has HBV DNA sequences integrated in them - alcoholism is risk factor
41
what does chronic HBV and HCV infection cause?
ongoing inflammatory responses and oxidative damage to chromosomal DNA of hepatocytes
42
how does the integration of HBV DNA occur
occurs in breaks in the cellular DNA of hepatocytes
43
HCV acute symptoms
similar to other hepatitis virus infections | chronic fatigue is common
44
what happened before a blood screen for HCV was developed?
HCV was a risk factor in transfusion and transplants non-A and non-B hepatitis (NANBH)
45
facts about HCV
1989 - a new viral genius was found in hepatocytes but was impossible to grow in lab until recently 2.7-4 million infected inUS, 170 million in world
46
HCV spread
most spread through blood contact IV drugs, tattooing, unsterilized surgical equipment mother to child during childbirth
47
Hep C statistics - acute infection - chronic persistent infection - rapid disease progression - % of patients with liver cancer - % of heptocellular carcinomas associated with HCV
``` ~15% ~70% ~15% ~5% ~25% ``` Of every 100 persons infected with HCV, approximately • 75–85 will go on to develop chronic infection • 60–70 will go on to develop chronic liver disease • 5–20 will go on to develop cirrhosis over a period of 20–30 years • 1–5 will die from the consequences of chronic infection (liver cancer or cirrhosis)
48
Hep C structure
falvivirus +ssRNA enveloped Mutates rapidly because an RNA virus these is a great diversity in the glycoproteins which are the major antigens
49
how many visions produced per day
E10-E11 | just live HIV and HBV
50
how many major serotypes/genotypes
6 and there is no cross protection
51
what is tissue damage from HCV caused by
cell-mediated immune response of infected cells | the virus itself is apparently non-cytopathic
52
HCV prevention and treatment
alcohol worsens liver damage | no vaccine- in part due to variability
53
Ribavirin+ pegylated interferon alpha
was the standard of care for HCV until sofosbuvir side effects are severs cure rate 50%
54
Sofosbuvir- how it works
recently approve to treat HepC it inhibits the viral RNA polymerase- a chain terminator can cure Hep C in many cases could lead to complete elimination of HCV
55
chronic infections | HIV and HCV
``` enveloped icosahedral +strand single- stranded RNA viruses 9kb genomes transmitted through bodily fluids mutate rapidly causes chronic infection ```
56
can HCV be spread during medical or dental procedures?
As long as Standard Precautions and other infection control practices are used consistently, medical and dental procedures performed in the United States generally do not pose a risk for the spread of HCV. However, HCV has been spread in health care settings when injection equipment, such as syringes, was shared between patients or when injectable medications or intravenous solutions were mishandled and became contaminated with blood. Health care personnel should understand and adhere to Standard Precautions, which includes Injection Safety practices aimed at reducing bloodborne pathogen risks for patients and health care personnel. If health care-associated HCV infection is suspected, this should be reported to state and local public health authorities.

Micro (virology) (7 decks)

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