Hepatitis Viruses (4)

Question 1

Genome and capsid of Hep A virus? What type of virus is it?

Answer 1

ssRNA, naked icosahedral

Picornavirus

Question 2

How many serotypes of Hep A are there?

Answer 2

1

Question 3

What do neutralizing antibodies recognize on Hep A?

Answer 3

Virion proteins 1 and 3

Question 4

How is Hep A transmitted?

Answer 4

Fecal-Oral

Question 5

What are the symptoms of Hep A infection?

Answer 5

Frequently asymptomatic

Acute hepatitis (largely immunogenic symptoms, not caused directly by virus)–> fever, jaundice, gastroenteritis, dark urine, pale feces

Question 6

Risk factors for Hep A infection?

Answer 6

Elderly

Preexisting liver disease

Question 7

What are the EIA lab results for acute Hep A infection? For past Hep A infection? For Hep A vaccination?

Answer 7

Acute–> Anti- Hep A IgM

Past/ Vaccination–> Anti-Hep A IgG

Question 8

Genome and capsid of Hep E virus? What type of virus is it?

Answer 8

(+)ssRNA, naked virus

Hepevirus

Question 9

How many serotypes of Hep E?

Answer 9

1

Question 10

Where is Hep E endemic?

Answer 10

Asia, Africa, Mexico

Question 11

How is Hep E transmitted?

Answer 11

Fecal- oral

Question 12

What are the symptoms of Hep E virus?

Answer 12

Acute, self limited hepatitis with a biphasic presentation–>

Prodrome: Anorexia, N/V/D, fever

Icteric phase: jaundice, dark urine, pale feces

Question 13

Does Hep A or Hep E have a higher mortality rate?

Answer 13

Hep E (especially in pregnant women)

Question 14

What is the treatment for Hep A and Hep E?

Answer 14

Symptomatic treatment

Question 15

Does Hep E have a vaccine?

Answer 15

Yes…HEV239 vaccine

Question 16

Genome and capsid of Hep B virus? What type of virus is it?

Answer 16

DNA virus, partially double stranded; small, enveloped

Question 17

How many serotypes of Hep B virus?

Answer 17

1

Question 18

What is special about Hep B virus replication?

Answer 18

Replication produces 1000X more HBsAG decoys than virus

Question 19

How is Hep B transmitted?

Answer 19

Blood, sex, and birthing

Question 20

Describe the time course of antigens in HBV infection?

Answer 20

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)

Question 21

When is HBV E antigen detectable?

Answer 21

When the virus is most transmittable

Question 22

Is the HBV hepatotoxic?

Answer 22

No! The virus itself is not hepatotoxic. The cytotoxic T cell response against the HBV infected hepatocytes causes the liver damage

Question 23

What are some symptoms of chronic HBV infection?

Answer 23

Hepatosplenomegaly, kidney damage (from immune complexes), arthritis, angiomas, ascites/ caput medusa/ peripheral edema

Question 24

Treatment for chronic HBV?

Answer 24

1 year of polymerase inhibitors

4 months of Pegelated alpha IFN

Question 25

What is Hep D?

Answer 25

A "defective" virus or "viriod" that encodes a single delta antigen

Question 26

T/F: delta antigen is hepatotoxic

Answer 26

True

Question 27

How is Hep D virus spread?

Answer 27

Blood and sex

Question 28

What type of infection does Hep D (and Hep B coinfection/ superinfection) lead to?

Answer 28

Fulminant hepatitis

Question 29

Hep D superinfection is associated with which type of behavior?

Answer 29

IV drug use

Question 30

What is the treatment for Hep D infection?

Answer 30

No effective treatment....maybe a liver transplant if criteria are met

Question 31

Genome and capsid of Hep C virus? What type of virus is it?

Answer 31

(+)ssRNA virus, enveloped Human restricted flavivirus

Question 32

How is Hep C transmitted?

Answer 32

Efficiently by blood Inefficiently by sex

Question 33

What types of cells does Hep C infect?

Answer 33

Hepatocytes and B lymphocytes (both have CD81 receptor)

Question 34

What is red flag in the history of someone when Hep C infection?

Answer 34

Travel to Egypt

Question 35

What are the extrahepatic signs of Hep C infection?

Answer 35

Sicca syndrome, arthralgias, myalgias, pruritis, paresthesia, sensory neuropathy

Question 36

What is the RIBA process?

Answer 36

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

Question 37

Treatment for acute HCV?

Answer 37

short course of pegylated alpha IFN

Question 38

Treatment for chronic HCV?

Answer 38

Ribavirin Pegylated alpha IFN HCV protease inhibitors

Question 39

What is the goal of HCV treatment?

Answer 39

Sustained viral response (like remission)