Hepatitis Viruses Flashcards
Hepatitis Viruses
all p/w
HAV & HEV
all p/w fever, jaundice, increased AST & AL
HAV & HEV naked => survive gut (F/O transmission)
HAV
tranmission incubation clinical course prognosis HCC risk Liver Bx *
unenveloped ss+RNA linear, icosahedral
F/O - shellfish, travelers, day care short (wks) usually asx but acute if present good prognosis no HCC risk Hepatocyte swelling, monocyte infiltrate, councilman bodies (ie yellow fever virus) *no carrier state
HBV
tranmission incubation clinical course prognosis HCC risk Liver Bx *
Extrahepatic manifestations
hematologic
renal
vascular
DNA hepadnavirus
parenteral, sexual, perinatal (Blood, baby-make, birth)
long (mo)
initially serum sickness (fever, arthralgias, rash); may progress to CA
adults: full resolution; neonatal: worse
yes HCC risk
granular eosinophilic “ground glass”; cytotoxic T cell mediated damage
carrier state common
DNA & RNA dependent DNA pol
incomplete circular dsDNA –> complete circular dsDNA –> +mRNA –> incomplete circular dsDNA
aplastic anemia
MPGN < membranous GN
polyarteritis nodosa
HCV
tranmission incubation clinical course prognosis HCC risk Liver Bx *
extra-hepatic manifestations hematologic renal vascular dermatologic endocrine
enveloped ss+RNA linear, icosahedral flavivirus
blood (IVDU, post transfusion) long (mo) may progress to cirrhosis or CA chronic HepC yes HCC risk Lymphoid aggregates w/ focal macrovesicular steatosis carrier state common; lack 3'-->5' endonuclearse activity =>no proofreading =>antigenic variation
autoimmune hemolytic anemia, ITP, Bcell NHL, essential mixed cryoglobulinemia
MPGN > membranous GN
leukocytoclastic vasculitis
sporadic prophyria cutane tarda, lichen planus
risk DM, autoimmune hypothyroidism
HDV
tranmission incubation clinical course prognosis HCC risk Liver Bx *
enveloped ss-RNA circular delta virus
parenteral, sexual, perinatal co-infxn: long; superinfection: short similar to HBV worse w/ superinfection yes HCC risk liver bx similar to HBV (eosinophilic ground glass via cytotoxic T cells)
depends on HBV HBsAg coat for hepatocyte entry
HEV
tranmission incubation clinical course prognosis HCC risk Liver Bx *
unenveloped ss+RNA linear, icosahedral
F/O (esp waterbourne) short fulminant hepatitis in pregnant women high mortality in pregnant women no HCC risk patchy necrosis enteric & epidemic; no carrier state
