Hepatitis Viruses

Question 1

Hep A Structure

Answer 1

Picorna – ss+RNA, naked, icosahedral, large polyprotein cleaved

Question 2

Hep A Transmission

Answer 2

Fecal-oral, shellfish

Question 3

Hep A Disease

Answer 3

Acute, jaundice (adults), ↑ALT, life immunity

Question 4

Hep A Tx

Answer 4

Inactivated vaccine

Question 5

Hep B Structure

Answer 5

Dane particle, surface antigen, core antigen, rev transcriptase, early antigen, dsDNA, circular

Question 6

Hep B Transmission

Answer 6

Parenteral

Question 7

Hep B Disease

Answer 7

HBeAg = acute infection
IgM = recent infection
IgG = old infection

Question 8

Hep B Tx

Answer 8

Vaccine (sAg), immunity = anti-HBsAg

Question 9

Hep C Structure

Answer 9

Flavi, enveloped ss+RNA, icosahedral, E1,E2 gp,

Question 10

Hep C Transmission

Answer 10

Parenteral

Question 11

Hep C Disease

Answer 11

Chronic, liver transplant, worse with alcohol

Question 12

Hep C Tx

Answer 12

Peg-interferon α + ribavirin, Protease inhibitors

Question 13

Hep D Structure

Answer 13

Uses Hep B surface antigen

Question 14

Hep D Transmission

Answer 14

Parenteral

Question 15

Hep D Disease

Answer 15

Co-infection (same time) → recovery, superinfection (chronic B +D later) → cirrhosis

Question 16

Hep D Tx

Answer 16

HBV vaccine

Question 17

Hep E Structure

Answer 17

ssRNA, icosahedral, orf2 → capsid gene

Question 18

Hep E Transmission

Answer 18

Fecal-oral

Question 19

Hep E Disease

Answer 19

Hx of travel, acute, ↑ALT, life immunity

Question 20

Hep E Tx

Answer 20

Safe water

Question 21

Hepatocellular carcinoma

Answer 21

– aggressive, caused mostly by HBV and HCV

Question 22

HCC Predisposing Factors

Answer 22

Predisposing factors – cirrhosis development with infection, alcohol consumption with HCV, older pts, ↑ AFP, diabetes

Question 23

HCC Pathogenesis

Answer 23

Pathogenesis – chromosome instability, block tumor suppressor genes, insertional mutagenesis