Hepatitis Viruses (4) Flashcards
Genome and capsid of Hep A virus? What type of virus is it?
ssRNA, naked icosahedral
Picornavirus
How many serotypes of Hep A are there?
1
What do neutralizing antibodies recognize on Hep A?
Virion proteins 1 and 3
How is Hep A transmitted?
Fecal-Oral
What are the symptoms of Hep A infection?
Frequently asymptomatic
Acute hepatitis (largely immunogenic symptoms, not caused directly by virus)–> fever, jaundice, gastroenteritis, dark urine, pale feces
Risk factors for Hep A infection?
Elderly
Preexisting liver disease
What are the EIA lab results for acute Hep A infection? For past Hep A infection? For Hep A vaccination?
Acute–> Anti- Hep A IgM
Past/ Vaccination–> Anti-Hep A IgG
Genome and capsid of Hep E virus? What type of virus is it?
(+)ssRNA, naked virus
Hepevirus
How many serotypes of Hep E?
1
Where is Hep E endemic?
Asia, Africa, Mexico
How is Hep E transmitted?
Fecal- oral
What are the symptoms of Hep E virus?
Acute, self limited hepatitis with a biphasic presentation–>
Prodrome: Anorexia, N/V/D, fever
Icteric phase: jaundice, dark urine, pale feces
Does Hep A or Hep E have a higher mortality rate?
Hep E (especially in pregnant women)
What is the treatment for Hep A and Hep E?
Symptomatic treatment
Does Hep E have a vaccine?
Yes…HEV239 vaccine
Genome and capsid of Hep B virus? What type of virus is it?
DNA virus, partially double stranded; small, enveloped
How many serotypes of Hep B virus?
1
What is special about Hep B virus replication?
Replication produces 1000X more HBsAG decoys than virus
How is Hep B transmitted?
Blood, sex, and birthing
Describe the time course of antigens in HBV infection?
Surface antigen–> appears early, then disappears and then resumes in chronic infection
Surface antibody–> becomes detectable as surface antigen decreases
Core antibody–> arises later (IgM in acute and IgG in resolved or chronic)
When is HBV E antigen detectable?
When the virus is most transmittable
Is the HBV hepatotoxic?
No! The virus itself is not hepatotoxic. The cytotoxic T cell response against the HBV infected hepatocytes causes the liver damage
What are some symptoms of chronic HBV infection?
Hepatosplenomegaly, kidney damage (from immune complexes), arthritis, angiomas, ascites/ caput medusa/ peripheral edema
Treatment for chronic HBV?
1 year of polymerase inhibitors
4 months of Pegelated alpha IFN
What is Hep D?
A “defective” virus or “viriod” that encodes a single delta antigen
T/F: delta antigen is hepatotoxic
True
How is Hep D virus spread?
Blood and sex
What type of infection does Hep D (and Hep B coinfection/ superinfection) lead to?
Fulminant hepatitis
Hep D superinfection is associated with which type of behavior?
IV drug use
What is the treatment for Hep D infection?
No effective treatment….maybe a liver transplant if criteria are met
Genome and capsid of Hep C virus? What type of virus is it?
(+)ssRNA virus, enveloped
Human restricted flavivirus
How is Hep C transmitted?
Efficiently by blood
Inefficiently by sex
What types of cells does Hep C infect?
Hepatocytes and B lymphocytes (both have CD81 receptor)
What is red flag in the history of someone when Hep C infection?
Travel to Egypt
What are the extrahepatic signs of Hep C infection?
Sicca syndrome, arthralgias, myalgias, pruritis, paresthesia, sensory neuropathy
What is the RIBA process?
1- vendor provides recombinant HCV antigens which are run on a gel and blotted onto a membrane
2- patient serum sample is laid over blot (anti HCV antibodies present find HCV antigen)
3- Patient serum is washed off and replaced with a secondary antibody that lights up bright
Treatment for acute HCV?
short course of pegylated alpha IFN
Treatment for chronic HCV?
Ribavirin
Pegylated alpha IFN
HCV protease inhibitors
What is the goal of HCV treatment?
Sustained viral response (like remission)
