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micro unit 6 > hepatitis viruses > Flashcards

hepatitis viruses Flashcards

1
Q

Hep A viral type?

A

picornavirus

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2
Q

Hep A genome

A

ssRNA

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3
Q

Hep A capsid

A

naked icosahedral

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4
Q

is Hep A environmentally rugged

A

yes

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5
Q

Hep A serotypes

A

single

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6
Q

Hep A vaccine?

A

yes

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7
Q

how is Hep A transmitted

A

fecal-oral, infects hepatocytes

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8
Q

what is the usual l symptoms

A

asymptomatic. if there are symptoms then it is usually acute hepatitis. this is mostly immunogenic. the virus is often cleared with no chronic infevtion

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9
Q

what is the worst complication of Hep A

A

fulminant hepatitis. mortality 40%

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10
Q

what to look for on history for Hep A

A

vaccination, foreign travel, shell fish, daycare

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11
Q

what to look for on exam for Hep A

A

fever, jaundice, gastroenteritis, tenderness around the liver, dark urine, pale feces.

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12
Q

what is an IgM positive EIA for Hep A indicative of?

A

acute infection

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13
Q

what is an IgG positive EIA for Hep A indicative of>

A

resolution or vaccination

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14
Q

what determines liver damage on labs for Hep A

A

serum ALT

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15
Q

how do we treat Hep A

A

rest, fluids, monitoring, discontinue alcohol use and contraindicated medications.

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16
Q

prevention of Hep A

A

hand-washing, sanitation, vaccine (IgG long term protection), immune serum prophylaxis.

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17
Q

hep E capsid

A

small naked, icosahedral.

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18
Q

hep E genome

A

positive sense, single strand RNA

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19
Q

hep E serotypes

A

single

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20
Q

hep E transmission

A

fecal-oral, similar to A, acute usually resolves.

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21
Q

what is more deadly hep E or A

A

E is 10X more deadly. mortality in pregnant women is 15-20%

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22
Q

what to look for exam for hep E

A

fever, jaundice, gastroenteritis, tenderness around the liver, dark urine, pale feces. same as A

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23
Q

lab work for hep E

A

serum ALT, serodiagnostics

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24
Q

treatment for hep E

A

rest, fluids, monitoring, discontinue alcohol use and contraindicated medications. same as A

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25
Q

prevention for hep E

A

HEV239 vaccine

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26
Q

Hep B type

A

hepadnavirus

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27
Q

Hep B genome

A

small, enveloped DNA genome that is partly double stranded

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28
Q

what is the pathogenesis of Hep B

A

replication in hepatocytes is partial and leaves behind many decoys. also integrates into host DNA to establish chronic infection.

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29
Q

serotype for Hep B

A

single. with no reinfection.

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30
Q

is there a Hep B vaccine?

A

yes.

31
Q

how is Hep B transmitted

A

blood, sex, birthing.

32
Q

what is the infectious process of Hep B

A

90% are acute hepatitis then clear. others fulminant or chronic.

33
Q

what are the complications of Hep B

A

cirrhosis via immunogenic. there is kidney damage and arthritis due to complex formation. hepatocellular carcinoma due to integrated viral DNA and ongoing hepatocyte regeneration.

34
Q

what to look for on exam for Hep B

A

hepatitis and history of vaccine?

35
Q

labs for Hep B

A

serology for time course of infection. look for surface antigen, antibody, core antibody or E antigen. there is also optional PCR.

36
Q

what lab for incubation period? Hep B

A

HBsAg -surface antigen

37
Q

what to look for in Hep B prodrome or acute disease

A

HBsAg, anti-HBc

38
Q

what to look for on labs for Hep B convalescence early phase

A

anti-HBc

39
Q

what to look for on labs for Hep B convalescence late phase

A

anti-HBs (anti-HBc)

40
Q

treatment for Hep B acute infection

A

supportive

41
Q

treatment for Hep B quiescent chronic

A

monitor

42
Q

treatment for Hep B damaging chronic

A

discuss interferon therapy -1 year polymerase inhibitors, 4 months pegylated alpha-interferon.

43
Q

prevention of Hep B

A

vaccine and immune prophylaxis.

44
Q

what percentage of Hep B have resoluton?

A

90%

45
Q

what percentage of Hep B go fulminant hepatitis

A

1%

46
Q

what percentage have persistent surface antigen for >6 months

A

9%

47
Q

what are the common extrahepatic diseases associated with Hep B

A

polyarteritis nodosa and glomerulonephritis

48
Q

hep D is what?

A

viroid parasite of hep b. encodes single delta antigen. all other parts are obtained from coinfection with hep B.

49
Q

is hep D capable of solo infection

A

no

50
Q

how can hep D infect?

A

either coinfection or superinfection with hep b

51
Q

define superinfection for hep D

A

when hepatocytes already are infected with hepb but then become infected with hep D. this is more likely than coinfection

52
Q

how is hep D spread

A

blood, sex

53
Q

what is the hep D delta antigen

A

hepatotoxin f

54
Q

what is likely to happen with hep D infection

A

fulminant hepatitis

55
Q

how do we diagnose hep D

A

hepatitis with hep B + history,. EIA for delta or antibodies against it. follow up with PCR.

56
Q

what is the treatment for hep D

A

none that are effective. liver transplant if criteria.

57
Q

prevention of hep D

A

hep b vaccine and prophylaxis. stop IVDU

58
Q

hep C type

A

flavivirus

59
Q

is hep C enveloped

A

yes

60
Q

hep C genome

A

positive-sense RNA genome

61
Q

is there a vaccine for hep C

A

no

62
Q

how is hep C transmitted

A

blood, sex.

63
Q

what percentage of hep C is chronic

A

85%. maybe latent for many years. can proceed to liver failure

64
Q

what to look for when diagnosing hep C

A

mild acute hepatitis. EIA followed by RIBA and genotyping.

65
Q

how do we assess therapy for hep C

A

RT-PCR. judge severity by biopsy

66
Q

2nd generation treatment for acute hep C

A

pegylateed interferon to reduce risk of chronic

67
Q

2nd generation treatment for chronic hep C

A

attempt to sustain viral response by combination.

  1. ) ribavirin -viral chain terminator and immune modulant
  2. ) pegylated alpha interferon
  3. ) HCV protease inhibitors
68
Q

what are the HVC protease inhibitor drugs?

A

boceprevir or telaprevir

69
Q

which serotypes of hep c respond better to treatment

A

2 and 3 need only 6 months of therapy to have >50% SVR rate.

70
Q

what are the harder serotypes of hep c to treat

A

1 and 4. need 1-2 years of therapy for <50% of SVR.

71
Q

which hep c serotype are the 2nd generation protease inhibitors used for?

A

serotype 1

72
Q

what to monitor when treating hep c

A

liver, kidney, blood, viral load

73
Q

what is the main problem in treating hep c

A

the severe side effects usually cause discontinuation of treatment

74
Q

3rd generation treatments?

A

simeprevir claims cure for 1. sofosbuvir combination with ribavirin active against 2 nd 3

micro unit 6 (7 decks)

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