Hepatitis Viruses

Question 1

Give the old terms for HAV, HBV, and HCV

Answer 1

HAV - infectious hepatitis, HBV - serum hepatitis, HCV - Non-A/Non-B hepatitis

Question 2

How many serotypes of HAV are there and what type of virus is it?

Answer 2

Only one, it is a enterovirus (enterovirus 72)

Question 3

Transmission of HAV and HEV

Answer 3

Fecal-oral route

Question 4

What antibody persists after HAV infection?

Answer 4

IgG against the virus

Question 5

What contributes to the wide spread of HAV?

Answer 5

Its long incubation period (14 to 40 days)

Question 6

Why do pts with HAV infection have light, clay colored stool?

Answer 6

Lack of billirubin in the stool (immune system is damaging the liver)

Question 7

Fulminant, fatal hepatitis from HAV is very rare. When it does occur, what type of patient does it tend to be in?

Answer 7

Pregnant pts. Pregnancy can predispose to making HAV infection very serious

Question 8

Do HAV infections tend to be acute or chronic?

Answer 8

Almost always acute (chronic HAV infection virtually non-existant)

Question 9

What is the standard diagnostic test for HAV infection?

Answer 9

Anti-HAV IgM antibody

Question 10

Besides immunization, what treatment is given for HAV?

Answer 10

Immune Serum Globulin (ISG) - pooled Ig (80 to 90 percent effective)

Question 11

What is the configuration of HBV?

Answer 11

Enveloped DNA virus, partially double-stranded

Question 12

What are HBsAg, HBcAg and HBeAg?

Answer 12

Hep B surface antigen, Hep B core antigen, and Hep B e antigen respectively

Question 13

What is particularly unique about Hepatitis B virus?

Answer 13

It is a DNA virus that has reverse transcriptase

Question 14

How are the majority of US HBV cases transmitted?

Answer 14

Sexually. Remainder are IV drug abuse

Question 15

What is a symptom of HBV and HCV but not of HAV?

Answer 15

Rash or joint pain. Otherwise all the same symptoms between them all (fatigue, anorexia, nausea, pain in RUQ, clay-colored stool, dark urine, jaundice)

Question 16

Give (in this order) the HBsAg, anti-HBc, anti-HBs, and IgM anti-HBc status of a pt who is Hep B: susceptible, immune due to natural infection, immune due to vaccination, and acutely infected

Answer 16

Susceptible - negative, negative, negative, Immune due to natural infection - negative, positive, positive, Immune due to vaccine - negative, negative, positive, Acutely infected - positive, positive, negative, positive

Question 17

People who cannot make what cannot clear an HBV infection?

Answer 17

Anti-HBs

Question 18

Infants born to HBV infected mothers should receive what?

Answer 18

Both the passive immunization (HBIG) and the active immunization (which is what most pts get normally)

Question 19

What does HDV require to assemble?

Answer 19

Presence of HBV (specifically HBsAg)

Question 20

What is the clinical consequence of HDV infection in pts with chronic HBV infection?

Answer 20

Rapid progression of their HBV

Question 21

Which hepatitis has the highest carrier rate?

Answer 21

HCV

Question 22

What is currently the most common way to acquire HCV infection?

Answer 22

Needle sharing

Question 23

What treatment gives the best results for HCV infection?

Answer 23

Pegylated INF-a and ribavirin together

Question 24

Histopathology of HAV infection

Answer 24

Lymphoid cell infiltration, necrosis of liver parenchyma, proliferation of Kupfer cells

Question 25

Fulminant

Answer 25

Describes a disease or process that occurs suddenly and quickly. E.g. fulminant liver failure in Hepatitis A infection

Question 26

In HepB, which strand is the long strand and which is the short strand?

Answer 26

Positive-sense is short (complete) strand, negative-sense strand is packed incomplete (long)

Question 27

Is vertical transmission of HBV prenatal, perinatal, or postnatal?

Answer 27

Perinatal (contact with infected blood or secretions DURING birth)

Question 28

What cancer is strongly associated with HBV and what is the mechanism?

Answer 28

Hepatocellular carcinoma, mechanism unknown

Question 29

What antibody appears first in acute HBV infection?

Answer 29

IgM anti-HBc. Anti-HBs appears last

Question 30

What two compounds are used to treat acute HBV infection?

Answer 30

Interferon and lamivudine (a RT inhibitor)

Question 31

All persons testing positive for HepB are then screened for what?

Answer 31

Antibody to Delta antigen (HDV)