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Microbiology > L39: Hepatitis > Flashcards

L39: Hepatitis Flashcards

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Biology 101 flashcards
1
Q

3 types of viral hepatitis

A
  1. Acute (main one)
  2. Chronic (doesn’t resolve after 6 months)
  3. Fulminant (rapid, severe form that affects brain function – often need liver transplant)
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2
Q

Symptoms of hepatitis

A

Jaundice, liver inflammation, dark stool, acholic stool (light/clay-colored due to reduced bile production), prodrome preceding jaundice

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3
Q

Importance of bilirubin

A

Formed when body recycles heme from red blood cells – secreted in bile in liver and excreted – gets into the body fluids (blood and urine) in liver disease

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4
Q

Importance of liver enzymes

A

ALT and AST are elevated with hepatitis (even in prodrome phase) – usually higher than other causes of liver disease

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5
Q

Chronic viral hepatitis

A

Does not resolve within 6 months – symptoms become milder but predisposes to hepatocellular carcinoma and cirrhosis due to immune response to infected cells that causes tissue damage – can take 15-40 years to cause other diseases

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6
Q

Fulminant viral hepatitis

A

Rapid, severe, causes massive hepatic necrosis, encephalopathy (confusion, disorientation, coma), edema, and other complications – liver transplant often necessary

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7
Q

Which types of viral hepatitis are NOT associated with chronic infections?

A

Hepatitis A and E

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8
Q

Which types of viral hepatitis are transmitted fecal-orally?

A

Hepatitis A and E

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9
Q

What types of viral hepatitis are transmitted via body fluids?

A

Hepatitis B, C and D

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10
Q

Hepatitis A characteristics

A

Picornavirus family, +ssRNA genome, fecal-oral, all age groups susceptible (children usually asymptomatic), incubates for about a month and resolves within 2 months

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11
Q

Diagnosis of Hepatitis A

A

Acute infection = IgM antibodies against HAV, later stages anti-HAV IgG antibodies for protective immunity

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12
Q

Prevention of Hepatitis A

A

Inactivated vaccine (HAVRIX and VAQTA), IM injection with 2 doses – infants and high-risk adults – vaccine or anti-HAV IgG antibodies given as prophylaxis

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13
Q

Hepatitis B characteristics

A

Hepadnavirus family, partially dsDNA, uses reverse transcriptase,

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14
Q

2 types of particles of Hepatitis B

A
  1. Noninfectious tubes and spheres – only contain HBsAg but indicate presence of disease
  2. Infectious (Dane) particle – have HBsAg covering them, HBcAg inside, and HBeAg found in DNA
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15
Q

Hepatitis B general serology

A 
Acute = HBsAg early in infection, goes away as virus cleared; anti-HBs increases when HBsAg goes away; IgG anti-HBc increases and stays high until resolution
Chronic = simiar HBsAg early on but is maintained throughout infection, anti-HBc is present (IgG) but IgM goes down
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16
Q

Diagnosis of Hepatitis B

A

Viral antigens and anti-HBV antibodies, presence of HBsAg is marker of active infection

17
Q

Serology for acutely infected (Hep B)

A

HBsAG: +
anti-HBsAg: -
Total anti-HBc: +
IgM anti-HBc: +

18
Q

Serology for chronically infected (Hep B)

A

HBsAG: +
anti-HBsAg: -
Total anti-HBc: +
IgM anti-HBc: -

19
Q

Serology for vaccinated (Hep B)

A

HBsAG: -
anti-HBsAg: +
Total anti-HBc: -

20
Q

Serology for previously infected (Hep B)

A

HBsAG: -
anti-HBsAg: +
Total anti-HBc: +

21
Q

Serology for susceptible (Hep B)

A

HBsAG: -
anti-HBsAg: -
Total anti-HBc: -

22
Q

Transmission of Hepatitis B

A

Via body fluids (sexual transmission, needle stick, perinatal transmission at birth)

23
Q

Chronic infection and age

A

The younger you are when you’re infected, the more likely you are to become chronically infected

24
Q

Treatment for Hepatitis B

A

None for acute infections, Lamivudine (reverse transcriptase inhibitor) or Famcylovir/Adefovir dipivoxil (nucleoside inhibitor) combined with interferon-a for chronic infections

25
Q

Vaccine for Hepatitis B

A

Composed of purified HBsAg protein (3 dose schedule, IM) – used to be from purified plasma of humans, now recombinant from yeast – recommended for all infants (also used for prophylaxis with HBIG)

26
Q

Hepatitis C characteristics

A

Flavivirus family, enveloped, +ssRNA genome – much milder than HAV or HBV

27
Q

Transmission of Hepatitis C

A

Bloodborne, through body fluids – INJECTION DRUG USE is a big one, along with tattos, accidental needle stick, perinatal, or sexual

28
Q

Diagnosis of Hepatitis C

A

Done when chronic infection suspected – screening test first (Ab-based) then confirmatory test (nucleic acid-based)

29
Q

What are the detectable lab features of acute Hepatitis C?

A

HCV RNA followed by ALT and anti-HCV

30
Q

Treatment for Hepatitis C

A

Always includes a sofosbuvir (across all genotypes) – very expensive treatments

31
Q

Prevention of Hepatitis C

A

No vaccine but can reduce high risk behaviors (drug use or unprotected sex), screening of blood supply

32
Q

Hepatitis D characteristics

A

Small circular ssRNA genome, encodes two proteins covering virion (Delta short and long), helper-dependent virus – DEPENDS ON HBV PROTEINS – directly injures hepatocytes

33
Q

Transmission of Hepatitis D

A

Body fluids – ONLY can cause disease in people infected with Hepatitis B

34
Q

Hepatitis D and fulminant hepatitis

A

More likely in double infection of Hepatitis B and D double infection than any other single infection

35
Q

Diagnosis of Hepatitis D

A

ELISA to detect anti-HDV antibodies

36
Q

Treatment of Hepatitis D

A

No specific antivirals

37
Q

Prevention of Hepatitis D

A

HBV infection is ABSOLUTELY required so HBV vaccine prevents HDV

38
Q

Hepatitis E

A

Hepevirus family, +ssRNA genome, fecal-oral transmission, does not cause chronic infection, normally travel-related in US – high risk of death in pregnant women – treatment alleviates symptoms and prevention is clean water/proper food handling

Microbiology (20 decks)

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