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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

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
E1
HCV | envelope protein
26
E2
HCV envelope protein glycoprotein that hypermutates: immune system recognizes then antigenic variation then recognize then variation, etc.
27
NS3
HCV protease to chew up polyprotein into individual proteins credit for cure
28
quasi species
HCV | antigenic variants due to E2
29
HCV 6 genotypes divided into subtypes 1. world wide 2. most common in US
1. 1a, 1b, 2a, 2b | 2. 1a, 1b
30
Risk factors for HCV
1. born between 1945-1965 2. IV drug abuse 3. perinatal infection at birth
31
HBV vs. HCV infection
acute: HCV milder chronic: multiple bouts (reinfection, emergence of quasi species)
32
What causes liver damage in Hepatitis virus infection?
NOT cytolytic | IMMUNE destruction by CD8 cells of hepatocytes
33
Chronic HBV | 3 stages
``` 6th decade more likely if got at younger age 1. immune tolerance 2. immune clearance 3. residual phase ```
34
HBV control
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
HCV control
screen supplies for Ab NO vaccine CURABLE Tx depends on genotype
36
What should you do for HCV/HBV patients?
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
How many untreated HCV infections will lead to chronic infection? HBV?
``` 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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