ImmunoSero Lab (Midterms - Viral Hepatitis Serology) Flashcards
Hepatitis testing for antibodies and antigens in patient sera can determine: VSIs
- Reponsible virus
- Stage of infection
- Immune status of patient
Most widely used test method for hepatitis testing
ELISA
Hepatitis A Virus (HAV) is a member of the family:
Picornaviridae
HAV epidemiology
- Transmission by fecal-oral route
- Fecal contamination of food or water
Infections for HAV may either be:
Symptomatic or Asymptomatic (usually in children)
HAV incubation period
10 - 50 days
Symptoms for HAV include: FAV FAM J
Fever, Anorexia, Vomiting
Fatigue, Abdominal Pain, Malaise
Jaundice
Symptoms for HAV are more severe in
pregnant women
Recover for HAV may occur in how many weeks
2-4 weeks
Mortality rate of HAV
0.1%; chronic disease rarely occurs
Inactivated vaccine for HAV which are recommended for travelers, drug abusers, and children was first developed in this year
1995
These levels are increased and peaks before jaundice occurs
Aspartate Aminotransferase (AST) and especially Alanine Aminotransferase (ALT)
Other markers for HAV other than increased levels of ALT and AST
hyperbilirubinemia
decreased albumin
tea-colored urine
pale-colored stools
These are analyzed for an increase in anti-HAV antibodies
paired sera (acute collected at onset of symptoms and convalescent 3-4 weeks later)
This is considered diagnostic for acute infection with Hepatitis A
Higher titer of IgM compared to IgG
When are anti-HAV antibodies present?
onset of symptoms and for years afterward
Hepatitis B Virus (HBV) is a ________________ double-stranded DNA
partially
HBV is a member of this family
Hepadnaviridae
Complete HBV virus that causes infection
Dane particle
Size of dane particle
42 nm
Transmission of HBV
Via mucous membranes (sexual contact)
Wounds contacting blood and body fluids
Parenterally
This occurs through transfusion of contaminated blood products, hemodialysis, intravenous drug use, contaminated needle sticks, tattooing, acupuncture, or ear piercing.
Parenteral infection
High-risk groups for HBV
Intravenous drug users
Men who have sex with men
Hemodialysis patients
Healthcare workers
Incubation period of HBV
50 - 180 days
Symptoms for HBV develop abruptly, it includes: FAV FM JA
Fever, Anorexia, Vomiting
Fatigue, Malaise
Jaundice, Anthralgia
Acute infection for HBV can last up to
6 months
Approx. how many of infected patients develop a chronic infection in which patients remain hepatitis B surface antigen (HBsAg) positive?
5%
This happens when chronic infections are active and severe damage to the liver occurs.
Liver cirrhosis or
Hepatocellular carcinoma
T or F.
Most chronic carriers shed virus
False. All
This vaccine is recommended for healthcare workers
Recombinant HBV vaccine
First marker that appears at the end of the incubation period of Hepatitis B
Hepatitis B surface antigen (HBsAg)
The concentration of the surface antigen continues to rise and peaks about midway through the acute infection. Presence of this antigen indicates
infectivity
Soon after HBsAg is detected in the blood, this antigen appears.
Hepatitis Be antigen (HBeAg)
This peaks at about the same time as the surface antigen in Hepatitis B; this antigen disappears about 2/3 of the way through the acute infection phase
HBeAg
What antigen is the next marker to appear after HBeAg?
Hepatitis B core (anti-HBC)
Q1: This peaks at the end of the acute infection stage after HBsAg is no longer detectable and before antibody to hepatitis B surface antigen (anti-HBs) can be detected.
Q2: This period is reffered to as
Anti-Hbc
“core window’
This antibody peaks a few weeks after the acute infection stage and disappears in about 6 months
anti-Hbc IgM antibody
At the end of the acute stage, this begins to rise and peaks about 2-16 weeks later. The concentration of this antibody decreases slightly during a person’s lifetime but never disappears.
anti-HBe
The last marker to appear in Hepatitis B. It appears at the end of the acute stage and the beginning of the recovery stage. Its concentration peaks, then plateaus during recovery and never disappears.
anti-HBs
Presence of anti-HBs indicates
immunity
Order
Surface > Earth > Core > hole with earth > surface
- HBsAg
- HBeAg
- Anti-HBc
- Anti-HBe
- Anti-HBs
A single-stranded RNA virus and a member of the family Hepacivirus
Hepatitis C
Epidemiology of Hepatitis C
Most common - parenteral
Less common - sexual & perinatal
Incubation period for Hepatitis C
2-26 weeks
Symptoms for acute infection of Hepatitis C
Asymptomatic or mild - nausea, vomiting, abdominal pain, fatigue, malaise, and jaundice
This percentage of Hepatitis C become chronic, with ________________% leading to cirrhosis
50-80% become chronic
25% lead to cirrhosis
Diagnostic for HCV infection
Anti-HCV
T or F.
Anti-HCV IgM distinguishes acute and chronic disease because both IgM and IgG antibodies are detectable for years.
False. It does not distinguish
In Hepatitis C testing, ELISA tests have false positive results, so the best test to use for diagnosis is
an immunoblot assay
Unclassified, single-stranded RNA virus that requires HBsAg from HBV infection to replicate and infect host
Delta Hepatitis
Epidemiology of Delta Hepatitis
Worldwide
Parenteral and transmucosal routes
occurs when patients acquire HBV and HDV infections simultaneously
coinfection
Occurs in patients with an established HBV infection who acquire HDV infection; it can occur and progress to chronic HBV/HDV infection
Superinfection
This vaccination also prevents HDV
HBV vaccination
Only patients positive with this antigen are tested for HDV
HBsAg
First marker to appear in Delta Hepatitis, which is detectable about 1-4 days before symptoms start
HDV-Ag
After HDV-Ag, this appears next followed by low levels of IgG anti-HDV
IgM anti-HDV
Switch to high levels of IgG anti-HDV indicates
past HDV infection
Condition in which the skin, whites of the eyes and mucous membranes turn yellow because of a high level of bilirubin.
Jaundice
A yellow-orange bile pigment is due to
high level of bilirubin
Condition in which your liver is scarred and permanently damaged
Liver cirrhosis
Treatment for Hepatitis A and E
No treatment (self)
Treatment for Hepatitis B
Alpha interferon
Peginterferon
Treatment for Hepatitis C
Direct-acting antiviral drugs
Treatment for Hepatitis D
Interferon
Transmission is via eating contaminated food or drinking contaminated water
Hepatitis A and E
Transmission is via contact with the blood or bodily fluids of an infected person
Hepatitis B
Transmission is via blood-to-blood contact
Hepatitis C
Transmission is via contact with infected blood which only occurs in people already infected with Hepatitis B
Hepatitis D