L26 BW (viral hep) Flashcards
HBsAg (-)
total anti-HBc (-)
anti-HBs (-)
susceptible
what makes fulminant (aka super severe) hepatitis more likely
HBV/HDV infection
what is a big concern about HBV and why
chronic infection b/c 10% will develop cirrhosis and liver failure
HBsAg
****HBV surface antigen *****
what is it called when you get HDV after you already have HBV
superinfection
what is a good test for HCV
OraQuick HCV- a new rapid test to reveal antibody
HDV prevention
the HBV vaccine
also PEG interferon to tx
which hep is far more likely to establish chronic infections
HCV
HBV complications
cirrhosis, liver cancer
what antibodies and antigens you will see in HBV window
anti HBe (anti- infectious surface fragments)
total anti-HBc
HAV transmission
food and water borne; virions are excreted in feces
continued detection of what antigens reveals a probably chronic state of HBV
HBeAg and HBsAg
acute icteric hepatitis consists of what phases
incubation
prodrome (fatigue, malaise, anorexia)
icteric phase (jaundice, hepatolmegaly, elev liver enzymes)
convalescent phase (disappearnace of sxs)
what increases the severity of HBV infections
HDV
what antibodies and antigens are you going to see there is
resolution after the onset of HBV and it
does NOT progress to chronic
antibodies to surface/ surface fragment antigens and totaly anti-HBc
IgG- anti HBs (anti-surface)
anti-HBe (anti- infectious surface fragments)
total anti-HBc
no antigens
which types are chronic
B, C, D *******
IgG anti- HBs
(antibody to surface antigen)
indicates
chronic disease
(with previous exposure)
what % of infants infected with HBV will become chronically infected
90%
HBsAg (+)
total anti-HBc (+)
IgM anti-HBc (-)
anti-HBs (-)
chronically infected
dont have IgM and anti HBs b/c
IgM anti-HBc would only be there if it were a new infection
anti-HBs doesn’t develop until way late in the game for people w/ chronic infection
convalescent phase
disappearance of jaundice and other sxs
what has reduced risk of infection from blood and blood products
serological screening
how many genotypes of HCV
6 genotypes and 50 subtypes
D incubation period
1-6 months
tx for HCV
direct acting antiviral agents that specifically antagonize virus functions
what is it called when you get HDV and HBV at the same time
coinfection
can be more rapid and severe
when is HBV shed
during asymptomatic periods
C incubation period
2-24 weeks (but mostly 6-7 weeks)
HBsAg (-)
total anti-HBc (-)
anti-HBs (+)
immune due to vaccine
what antibodies and antigens you will see in HBV onset
first
HBsAg- surface antigen (initial villain)
then
HBeAg- surface fragments (infectious particles)
IgM- anti HBc (anti-core) (police)
detection of what antigen is best ID an infectious HBV virus
HBeAg
hallmark of HCV
chronic infection
HBV dx
serum showing antibodies and antigens
total anti-HBc indicates
exposure
could be current, could be chronic, could be resolved
what do pts with HAV need to avoid
hepatotoxins- alcohol, drugs, anesthesia
what factors promote HCV progression
ETOH, infection after 40, male, HBV co-infection, HIV co-infection
for many cases of HCV, the source of infection is ___
unknown- many at risk pts don’t know they should be tested
Ig M- anti HBc
(antibody to core)
indicates
new exposure
only around for the acute exposure
won’t be present in chronic or w/ resolution
major risk factor for HAV
contact with infected family member
HCV drug regimens vary by
virus genotype
prodrome, aka what? sxs?
(aka pre-icteric phase) fatigue, malaise, anorexia
HBcAg
****HBV core antigen****
what is the infectious cause of primary hepatocellular carcinoma
HBV!!! ******* this was mentioned twice! 80% of hepatocellular carcinoma is linked to chronic HBV *****
anti-HBs
indicates
vaccine
or
resolved infection
***immunity***
you’ve got nothing SIMMERING
dane particle
infectious form of HBV
what does HBV tx do?
antagonizes viral replication, preventing extensive liver damage… NOT A CURE
how to prevent HAV
proper hand washing,
PEP early in infection (85% effective in 1st 2 weeks of exposure)
inactivated vaccine
why would tx of HBV be contraindicated?
depends on there liver function and virus replication status (viral load)
A incubation period
2-6 weeks
type of HBV vaccine
subunit
what antigens and antibodies are you going to see if you have someone who was vaccinated for HBV
antibodies to surface and surface fragment antigens:
IgG- anti HBs (anti-surface)
anti-HBe (anti-infectious surface fragments)
no antigens
what % of people with acute HCV develop chronic
85%
major reservoir for HBV
chronic hepatitis patients
HBsAg (+)
total anti-HBc (+)
IgM anti-HBc (+)
anti-HBs (-)
acutely infected
what equates to a poor prognosis for HCV
long time without detection
what is not a good test for HCV
ELISA because chronic state and viremic pts often escape detection because seroconversion is slowly after 24 weeks
the incubation period of hepatitis represents
a dose dependent range
IgM
anti-HBc
antibodies against core antigen
indicates new, ongoing HBV infection if present with HBsAg in serum (diagnostic)
Mr. Policeman, He’s the 1st responder
what can a pt be given for tx of HBV?
polyethylene glycol (PEG) interferon and or agents to inhibit the viral polymerase including nucleoside and nucleotide analogues
HAV dx
IgM antibody by ELISA
HBsAg (-)
total anti-HBc (+)
anti-HBs (+)
immune due to prior natural infection
HBsAg is present in
active disease
S = SIMMERING
(acute or chronic)
HBeAg
HBV surface antigen fragment-
presence indicates a pt is infectious *******
NANB hepatitis
not A not B
90% of the time this is C
is interferon required for chronic HCV infections
no- there are several tx options
populations at risk of HBV
*** HEALTHCARE WORKERS and IVDUsers**** also: gays, slutty straights, institutionalized ppl, family contacts of infected
tx for most HBV infections
most resolve spontaneously and do not require anti-viral tx
which populations of HBV pts are at high risk of becoming chronic
perinatal and peds
why is dx of HCV tricky
it often eludes immune mechanisms
most acute HCV infections present
asymptomatic and are therefore not diagnosed in the acute phase
what antibodies and antigens are you going to see if HBV progresses to chronic
HBsAg- surface antigen
HBeAg- surface fragments = infectious
total anti-HBC
(no IgM- anti HBc, he’s just around for the acute phase)
risk factors for HCV
CONTACT WITH HEALTHCARE PROVIDERS, IVDU, dialysis, tattoos, transfusions, transplants
in developed countries the peak of transmission of HCV occurred between what years
1960-1980
B incubation period
2-6 months
HDV is what type of virus
a viral parasite of HBV that uses HBsAg for its capsid
type of HAV vaccine
inactivated virus
with HDV often comes
chronic infection
up to __ in ___ people of what age group may be infected with HCV and may begin presenting with cirrhosis and or cancer soon
1 in 33 baby boomers
Type D Hepatitis
delta agent, ONLY in pts with active HBV infection
icteric phase sxs
JAUNDICE, dark urine, hepatomegaly, high ALT and AST
E incubation period
3-9 weeks
HCV dx
ELISA
+
a confirmatory test (ie western blot or direct nucleic acid test)
what is an EXTRA rapid and severe HDV outcome
when it co-infects with HBV in a previously uninfected individual
