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Immunology CCMLS > HIV and Hepatitis > Flashcards

HIV and Hepatitis Flashcards

1
Q

How might the following error reflect itself in testing result on an assay for anti-HIV 1 & 2: if you forget to perform the initial dilution and used straight patient serum

A

Too much antibody could be associated with prozone and a false negative result; also interfering substances in higher concentration than normal can cause false positive reactions.

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2
Q

How might the following error reflect in testing results during analysis for anti-HBc in patient serum:. In this procedure you add patient serum to a well containing a bead coated with HBc. The bead is washed and then an antibody to anti-HBc with an enzyme tag is added to the system. You forget to add the OPD tablets to the diluent used as the substrate (OPD reacts with the enzyme alkaline phosphatase to cause a color change)

A

No ODP, no color development; since this is a double antibody technique, the entire run appears non-reactive, the assay is falsely negative

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3
Q

How might the following error reflect in testing results on an assay for HBsAg: You were interrupted while adding conjugate (anti-HBsAg with a fluorescent tag) in the assay which tests for patient HBsAg and you missed adding conjugate to a whole row of beads (the beads contain anti-HBsAg on their surface)

A

No conjugate, no color development. This would produce all negative reactions in the row in question which could result in false negatives

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4
Q

Which of the following represent the hepatitis testing which MUST be performed on blood donor units prior to placing blood into the general supply.

A

HBsAg
Anti-HBc
Anti-HCV

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5
Q

HBsAG description

A

initial detectable marker found in serum during incubation period of HBV infection

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6
Q

HBeAG description

A

found in the serum of some patients who are HBsAg positive; marker for level of viral infectivity

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7
Q

Anti-HBc

A

indicator of recent HBV infection; may be the only serologic marker during the “window” phase

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8
Q

Anti-HBe

A

in cases of acute hepatitis it is the first serologic evidence of the convalescent phase

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9
Q

Anti-HBs

A

a serologic marker of recovery and immunity; its presence means the patient has seroconverted

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10
Q

The following serological marker is a reliable test for the presence of high levels of circulating hepatitis B virus (HBV) and an indication of high infectivity?

A

HBe Ag

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11
Q

All of the following are likely immunologic manifestations of HIV infection EXCEPT:
A. decreased absolute CD4 T-cell count
B. increased absolute CD8 T-cell count
C. anti-HIV is produced within 3 days of initial exposure
D. Patient demonstrates increased susceptibility to opportunistic infections

A

C. anti-HIV is produced within 3 days of initial exposure

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12
Q

A positive Western blot for HIV is represented by antibodies to which set of antigens?

A

gp41 or gp24 and gp120 or gp160

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13
Q

Which test is currently our most sensitive indicator of recent infection with hepatitis C

A

NAT testing for HCV

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14
Q

The typical profile for chronic active hepatitis due to hepatitis B virus is
positive for which of the following?

A

HBsAg
IgM Anti-HBc
IgG Anti-HBc

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15
Q

The core protein of the HIV-1 virus corresponds to

A

p24

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16
Q

The disappearance of HBsAg and HBeAg, the persistence of anti-HBc, the appearance of anti-HBs, and often of anti-HBe indicate

A

recovery phase of acute HBV hepatitis

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17
Q

The presence of HBsAg, anti-HBc (IgM) and often HBe Ag is characteristic of

A

early acute phase HBV hepatitis

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18
Q

Which serological marker of HBV infection indicates recovery and immunity?

A

anti-HBs

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19
Q

Which of the following is the best indicator of EARLY acute infection with the hepatitis A virus?

A

the presence of IgM antibodies to hepatitis A virus

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20
Q

Patient has?
HBsAg; negative
AntiHBc IgM: positive
Anti-HAV IgM: negative

A

acute hepatitis B infection

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21
Q

HIV 1 groups

A

Group M: the main group
Group N: the new group
Group O: the outlier group
(N & O W. Central Africa)

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22
Q

Which HIV group is less pathogenic with lower transmission rate?

A

HIV 2

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23
Q

perinatal route of HIV

A

during pregnancy, during delivery, or through breast milk

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24
Q

virus family of HIV

A

Retrovirus subfamily lentivirus

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25
Q

physical characteristics of HIV

A

icosahedral (20 sided)
enveloped viral capsid contains RNA and reverse transcriptase enzyme

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26
Q

the envelope is…

A

the outer shell of the virus
lipid matrix w/ specific viral glycoproteins

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27
Q

HIV envelope

A

protein env (glycoprotein gp120 and stem gp41)

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28
Q

within the HIV viral envelope is….

A

p17 (matrix)

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29
Q

HIV core

A

core/capsid
p24 (core antigen)

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30
Q

structural genes for HIV

A

Group specific antigen (gag)
envelope (env)
polymerase (Pol)

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31
Q

located in the nucleocapsid of HIV virus

A

group specific antigen

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32
Q

icosahedral capsid is made up of

A

p24 & p17 antigens

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33
Q

envelope proteins of HIV

A

gp160
gp120
gp41

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34
Q

gp160 gets cleaved to become

A

gp120 & gp41

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35
Q

gp involved in fusion and attachment of HIV to CD4 Ag on host cells

A

gp120 & gp41

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36
Q

polymerase codes for what in HIV

A

p66 AND p51 of reverse transcriptase and p31 (endonuclease)

37
Q

HIV viral replication: HIV attaches to what host cells

A

t helper cells main ones
also macrophages, monocytes, bcells, microglial brain cells, intestinal cells

38
Q

attachment of HIV is mediated throught what antigen

A

cd4 antigen

39
Q

how is cd4 antigen involved in attachment of early HIV?

A

envelope glycoprotein p120 binds to cd4 molecules and chemokine receptors (ccr5) on macrophages

40
Q

HIV later infection attachment for viral replication

A

virus binds cd4 and cxcr4 markers on t4 lymphocytes gp41 fuses virus to cell membrane
viral particle taken into cell where genome is exposed
dna complimentary to viral rna is produced from reverse transcriptase

41
Q

4 stages of HIV

A

initial subclinical
clinical latency
symptomatic
AIDS

42
Q

initial subclinical phase of HIV clinical symptoms

A

flu like symptoms
fever lymphadenopathy, sore throat, arthralgia, myalgia, fatigue, rash, weight loss

43
Q

when can HIV patients infect others in the initial phase?

A

3-6 weeks after infection and resolution of symptoms
p24 Ag is detectable

44
Q

after 6 weeks of infection what Ab are produced with HIV infection?

A

p15
p17
p24
p31
gp41
p51
p55
p66
gp120
gp160

45
Q

clinical latency phase of HIV characteristics

A

asymptomatic
+ for HIV Ab
viremia decrease
HIV levels drop to very low levels but still replicates
cd4 count declines
lasts for years

46
Q

symptomatic phase HIV

A

symptoms mild
immune system begins to deteriorate
emergence of opportunistic pathogens and cancers

47
Q

AIDS

A

profound immunosuppression
onset 10yrs
decreased cd4/cd8 ratio
cd4 # <500= risk for opportunistic pathogens

48
Q

neurological symptoms of AIDS

A

Forgetfulness, poor concentration, apathy, psychomotor problems, dementia

49
Q

HIV cd4; cd8 ratio

A

ratio decreases below 1:1 as cd4 decreases

50
Q

EIA testing for HIV serological markers

A

p24 Ag first to appear then dissappears when Ab for p24 appears
Anti gp41, 120, 160 appear next at a higher level than Ant p24, 55
p24 Ag appears again in AIDS

51
Q

Viral load tests for HIV

A

measures the amount of HIV-RNA in 1mL of blood
Take 2 measurements 2-3 weeks apart to determine baseline
repeat every 3-6 mons along w/ cd4 counts

52
Q

HIV western blot

A

uses lysate from HIV
Ag separated by electrophoresis
lysate paper cut into stips and rxt w/ anti-sera specific to each Ag
after incubation& washing w/ Anti-Ab tagged w/ enzyme added
specific bands form where Ag rxt w/ Ab
Ag: p17, p24, p31, gp41, p51, p55, p66, gp120, gp160

53
Q

which Ab appear first in HIV

A

p24 and p55
decrease and become undetectable later

54
Q

what Ab are present throughout all stages of HIV

A

gp31, gp41, gp120, gp160

55
Q

indeterminate results in the western blot test for HIV can be due to

A

prior blood transfusions
prior/ current infec. w/ syphilis
prior/ current infec w/ malaria
autoimmun. disease
infec. w/ other retroviruses
2+ pregnancies in women

56
Q

NAT testing

A

nucleic acid testing
for HIV nd Hep C
performed on blood supply
monitor HIV patients
& used for viral load testing of HIV-1 patients

57
Q

rapid testing for HIV

A

fingerstick most commonly used
uses EIA sandwich

58
Q

blood supply screens for what

A

Hep B &C
HIV
HTLV-1
West Nile
Chagas Disease
CMV
syphilis

59
Q

causes of hepatitis

A

virus
exposure to toxic chemicals
exposure to ionizing radiation

60
Q

Forms of hepatitis

A

asymp
mild
clinical
fulminant
chronic carrier state

61
Q

liver enzymes

A

ALT
AST
ALP
LD

62
Q

ALT is present in

A

hepatocytes

63
Q

fulminant hepatitis

A

liver failure
death
rare but acute

64
Q

chronic carrier state of hepatitis

A

carry the virus in the body- leads to liver carcinoma

65
Q

which liver enzymes are not specific to the liver?

A

AST
LD

66
Q

most common cause of hepatitis

A

Hepatitis A

67
Q

hepatiits lab results

A

increased bilirubin direct>indirect
10-100x increase AST & ALT
ALP slight increase
LD increase (LD5)
reactive lymphs

68
Q

Hep A virus family

A

picornoviridae family
single stranded RNA

69
Q

hep a transmission

A

fecal oral route, person-person, contam. water

70
Q

hep a incubation

A

28 days after exposure
symp. 1-8 wks

71
Q

hep a detection

A

HAV in feces during incubation period and acute phase
virus declines once symptoms appear

72
Q

hep a dectection antibodies

A

anti=HAV (IgM)
anti-HAV (IgG)

73
Q

hep b virus family

A

hepadnaviridae family
Dane particle
ds-DNA

74
Q

hep b virus structure

A

core has: dsDNA, DNA polymerase, and 2 proteins HBc & HBe
on outer envelope HBsAg

75
Q

parenteral route of transmission in hep b

A

blood
transfusions
needles
iv
tattooing
breast milk/ birth process

76
Q

hep b clinical manifistations

A

1-2% fulminant liver disease w/ hepatis necrosis
chronic: 6-10% of adults
25-50% kids
90% infants
25% of chronic become carriers

77
Q

hep c virus family

A

flaviviridae family
ss-RNA

78
Q

hep c is hard to make a vaccine for because?

A

high mutation rate

79
Q

seriological testing for hep c

A

test for anti-HCV

80
Q

epidemology of hep c

A

transmitted perenterally
50-80% become chronic
cirrhosis devleops slowly over 20 yrs

81
Q

hep d virus family

A

delta virus
incomplete RNA
ss RNA coated in HBs Ag
cannot cause infection by itself

82
Q

hep d transmission

A

direct contact
iv drug users
sex

83
Q

hep b incubation

A

3-13 wks

84
Q

hep d is not routinely tested whY?

A

don’t test for Hep d if don’t have Hep B

85
Q

hep E virus family

A

RNA containing virus

86
Q

hep E transmission

A

fecal-oral route

87
Q

hep E is mostly deadly in what population of people?

A

pregnant women

88
Q

is there testing for hep E?

A

not routine commercial- special request by patient

Immunology CCMLS (12 decks)

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