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Supplemental Micro > Hepatitis Viruses > Flashcards

Hepatitis Viruses Flashcards

1
Q

how many known hepatitis viruses are there?

A

6–not phlyogenically related

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2
Q

what do all hepatitis viruses have in common?

A

they all primarily affect hepatocytes and cause hepatitis on first infection

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3
Q

what should you do before doing a virology work up for hepatitis?

A

rule out pharmaceutical causes of hepatitis

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4
Q

what virus is Hep A caused by and how is it classified?

A

picornavirus. ssRNA with naked icosahedral capsid

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5
Q

can Hep A recur?

A

no

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6
Q

how is Hep A transmitted and what is the major cause of its symptoms?

A

fecal-oral and hepatitis is mostly immunogenic

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7
Q

what is the most likely scenario for Hep A contraction?

A

subclinical infection

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8
Q

what is a rare cause of mortality in Hep A patients?

A

fulminant hepatitis

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9
Q

what are the symptoms caused by Hep A?

A

fever, jaundice, gastroenteritis, dark unine and pale feces

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10
Q

what historical features of Hep A are relevant?

A

vaccination, foreign travel, daycare and shellfish consumption

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11
Q

what lab tests are available for Hep A?

A

serology (differentiate between acute and resolved with IgM vs IgG) and serum ALT (liver damage)

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12
Q

how do you treat Hep A?

A

fluids and monitoring while discontinuing other liver strains (alcohol and medications)

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13
Q

how is Hep A prevented?

A

vaccine and Ig prophylaxis

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14
Q

what virus is Hep B caused by and how is it classified?

A

hepadnavirus: small enveloped DNA virus (partially double stranded)

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15
Q

what viral particles are found in serum of a HBV infected person?

A

virions and incomplete decoys

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16
Q

a patient cannot be infected twice with hepatitis B. True or false?

A

true

17
Q

what does replication of HBV leave behind in the cell?

A

integrated viral DNA

18
Q

how is HBV transmitted?

A

blood, sex and birthing

19
Q

what is the most common course of HBV and what is the alternative?

A

most people have acute hepatitis and then clear the virus but some have a chronic infection (10%)

20
Q

what are some possible outcomes of chronic HBV?

A

cirrhosis (immunogenic), kidney damage and arthritis (accumulation of immune complexes) and hepatic cell carcinoma (integrated viral DNA)

21
Q

what laboratory tests are available for HBV?

A

serology (to test clearance), serum ALT and optional PCR and biopsy

22
Q

how should acute HBV be treated?

A

supportive care

23
Q

How should chronic HBV be treated?

A

if there is damaging infection, can treat with polymerase inhibitors and pegylated interferon

24
Q

how can HBV be prevented

A

vaccineation and Ig prophylaxis

25
Q

why does liver transplant fail with HBV carriers?

A

new liver cells will become infected with virions outside of the liver

26
Q

what virus is Hep C caused by and how is it classified?

A

flavivirus, enveloped +ssRNA

27
Q

what are two major differences between Hep B and Hep C?

A

there is no vaccine for HCV and there is a much higher potential for chronic infection (85%)

28
Q

how is HCV transmitted?

A

by blood and less efficiently by sex

29
Q

what is the treatment for acute HCV?

A

pegylated interferon to reduce risk of chronic infection

30
Q

what is the treatment for chronic HCV?

A

combined therapy to achive sustained viral response: ribavirin, protease inhibitors and pegylated interferon

31
Q

what determines the length of treatment for HCV?

A

the serotype
types 2 and 3 have >50% recovery with 6 months
types 1 and 4 have <50% recovery with 1-2 years

32
Q

what should be monitored during HCV treatment?

A

liver function, kidney function and blood and viral RNA levels

33
Q

why do many HCV patients discontinue treatment or reduce their dose?

A

interferon has many bad side effects

34
Q

what should be considered if HCV treatment fails?

A

living donor liver transplant

35
Q

why are living donor transplants usually more successful than cadaver transplants?

A

they can be scheduled so the patient can be treated with a short hard course of interferon to clear extra hepatic virus reservoirs

36
Q

what are some complications of chronic HCV?

A

liver failure, cirrhosis, hepatocellular carcinoma and death

37
Q

what laboratory tests are available for HCV?

A

diagnosa by EIA and genotype with RIBA

judge severity of disease by liver biopsy

Supplemental Micro (8 decks)

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