Infection 6) Viral hepatitis Flashcards

1
Q

Describe histological stage 1 of hepatic fibrosis

A

Fibrous expansion of some portal areas

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2
Q

Describe histological stage 3 of hepatic fibrosis

A

Fibrous expansion of most portal areas with occasional portal to portal bridging

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3
Q

Describe histological stage 4 of hepatic fibrosis

A

Fibrous expansion of portal areas with marker bridging

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4
Q

What areas of the world have high prevalence of hepatitis B?

A

Canada
Africa
China
India

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5
Q

What are the risk factors for hepatitis B?

A
Ethnicity
IVDU
MSM
HIV
Health care worker
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6
Q

Describe the immunology of hepatitis B

A

PAMP recognised by TLR3 leading to RIG-1 signalling. Interferon regulatory factors and NF-kB
Interferon stimulating genes
INF - alpha/beta
Downregulation of viral protein synthesis, inhibit viral replication, promote adaptive immunity via MHC class I expression on APC
Activates NK, CD8 and dendritic cells
Activate cell death through secretions of perforins

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7
Q

What leads to a persistent infection of hepatitis B?

A
Age at infection
Immunosuppression 
HBV X protein 
Foxp3
Programmed death-1 receptor up-regulated
Cytotoxic T-lymphocyte antigen 4
IL-10
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8
Q

What does IL-10 do?

A

Downregulates antiviral immune responses

Attenuates inflammatory response but reduces efficiency of antiviral immune responses

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9
Q

What is the treatment for chronic hepatitis 6?

A

Pegylated interferon
Tenofovir / tenofovir alafenamide
Entecavir

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10
Q

What are some mutations in the Pre-S/S HBV region?

A

Pre-S1/pre-S2
S promoter
S
S splicing

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11
Q

What % develop chronic hepatitis C virus?

A

80%

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12
Q

Why does hepatitis C have a high rate of chronicity?

A

High replicative rate and viral antigen load
High error rate of RNA-dependent RNA polymerase
HCV proteins interfere with immune response
Neutralising antibodies develop too slowly, too late

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