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GI > Hepatitis Viruses > Flashcards

Hepatitis Viruses Flashcards

1
Q

enteric Hepatitis

A

HAV

HEV

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2
Q

parenteral Hepatitis

A

HBV, HDV

HCV

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3
Q

HAV

A 
Picornavridae enterovirus
ss + RNA, non-enveloped icosahedral
ONE SEROTYPE
reservoir: HUMAN only
fecal-oral
OUTBREAKS
Dx: anti0HAV IgM
prevent: HAND WASHING, passive immunization with gamma globulin, inactivated vaccine (2 yrs or older); combo vaccine for HAV/HBV (18 yrs or older)
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4
Q

HBV

A 
HepDNAvirus
DNA Hep virus: partially ds, enveloped
DANE particle
CHINA, sub-Saharan AFRICA
IV drug use, sex, perinatal at delivery
virus production prior to Sx
Dx: source of infection, ELISA
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5
Q

HCV

A 
Flaviviridae hepacivirus
ss +RNA, enveloped icosahedral
E1, E2, NS3
ASIA, MIDDLE EAST, North AFRICA
Dx: source of infection, ELISA: anti-HCV Ab, HCV RNA
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6
Q

HDV

A

circular ss RNA, enveloped
replicates on own but..
REQUIRES HBV infection: need HBsAg to infect hepatocytes

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7
Q

HEV

A 
Caliciviridae hepevirus
ss + RNA, non-enveloped icosahedral
developing countries
ONE SEROTYPE
high fatal rate in PREGNANCY
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8
Q

groups at risk for HAV

A
  1. houselhold/sex contacts
  2. travel
  3. live on Indian reservation
  4. outbreaks: diner, cay care, gay men, IV drug user
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9
Q

What makes HAV eradication possible?

A

one serotype
only in humans
not a priority: self resolves, incidence has already dropped a lot after vaccine made

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10
Q

dane particle

A

HBV

blebs with virus inside (hard to detect virus itself in blood)

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11
Q

HBV DNA pol

A

REVERSE TRANSCRIPTASE

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12
Q

HBsAg

A

HBV
surface antigen, attachement protein
CARRIER or ACUTELY INFECTED

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13
Q

HBcAg

A

HBV

core antigen, capsid protein

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14
Q

HBeAg

A

HBV
derivative of HBcAg
INCREASED RISK OF TRANSMISSION (active marker)

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15
Q

X antigen

A

HBV

influences gene expression

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16
Q

HBV replication

A
  1. pre-genomic (genome length) pos. strand RNA is used as template for reverse transcription
  2. rev. transcriptase makes complementary DNA
  3. then make second DNA strand that is not finished
    DNA virus that uses RNA intermediate to drive back to DNA
    DNA can integrate into genome; mostly maintained extrachromosomally in chronic infection
17
Q

Anti-HBs

A

HBV

previous HBV or VACCINE

18
Q

Anti-HBe

A

HBV

CARRIER with LOW risk of transmission

19
Q

Anti-HBc

A

HBV

PAST INFECTION

20
Q

IgM Anti-HBc

A

HBV

ACUTE or RECENT INFECTION

21
Q

delta antigen

A

HDV

22
Q

HDV superinfection

A

infection of HBV then HDV
makes chronic infection worse
do fine, then sudden ALT increase
anti-HDV remains elevates

23
Q

HDV coinfection

A

infection of HBV and HDV occur at same time

worse primary infection

24
Q

HCV replication

A

translates one large polyprotein that must be turned into individual proteins

25
Q

E1

A

HCV

envelope protein

26
Q

E2

A

HCV
envelope protein
glycoprotein that hypermutates: immune system recognizes then antigenic variation then recognize then variation, etc.

27
Q

NS3

A

HCV
protease to chew up polyprotein into individual proteins
credit for cure

28
Q

quasi species

A

HCV

antigenic variants due to E2

29
Q

HCV
6 genotypes divided into subtypes
1. world wide
2. most common in US

A
  1. 1a, 1b, 2a, 2b

2. 1a, 1b

30
Q

Risk factors for HCV

A
  1. born between 1945-1965
  2. IV drug abuse
  3. perinatal infection at birth
31
Q

HBV vs. HCV infection

A

acute: HCV milder
chronic: multiple bouts (reinfection, emergence of quasi species)

32
Q

What causes liver damage in Hepatitis virus infection?

A

NOT cytolytic

IMMUNE destruction by CD8 cells of hepatocytes

33
Q

Chronic HBV

3 stages

A 
6th decade
more likely if got at younger age
1. immune tolerance
2. immune clearance
3. residual phase
34
Q

HBV control

A

screen supplies for Ab
VACCINES
HBIg for exposed individuals (newborn, travelers)
antivirals: reduce chronicity, transmission, complications
criteria: more than 2000 units/mL HBV DNA; greater than 2x upper normal limit of ALT

35
Q

HCV control

A

screen supplies for Ab
NO vaccine
CURABLE
Tx depends on genotype

36
Q

What should you do for HCV/HBV patients?

A

immunize against HAV
discourage alcohol
leading reason for LIVER TRANSPLANTS
despite HBV vaccine: CA and deaths related to HBV hanve doubled in past decade

37
Q

How many untreated HCV infections will lead to chronic infection?
HBV?

A 
HCV
85%
HBV: age of infection matter
less than 1: 90%
1-5: 30%
older than 5: 2%

GI (12 decks)

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