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Micro final > Lect 27 viral hep and HIV > Flashcards

Lect 27 viral hep and HIV Flashcards

1
Q

List the 4 of 6 types of hepatitis viruses and what they cause

A
  • type A: infectious hepatitis
  • type B: serum hepatitis
  • type C: transfusion associated hepatitis
  • type D: delta agent, only in patients with active HBV infection
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2
Q

subclinical and aniceteric course of viral hepatitis is recognized by

A

seroconversion

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3
Q

prodrome (pre-icterus) stage of typical acute icteric hepatitis has what symptoms

A
  • fatigue
  • malaise
  • anorexia
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4
Q

icterus stage of typical acute icteric hepatitis has what symptoms

A
  • dark urine, jaundice
  • hepatomegaly
  • elevation ALT and AST
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5
Q

3 phases of typical acute icteric hepatitis

A
  1. prodrome
  2. icteric phase
  3. convalescent phase
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6
Q

unique about Fulminant hepatitis

A

high fatality rate

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7
Q

what type of hepatitis viruses are able to become chronic

A
  • B
  • C
  • D
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8
Q

transmission of Hepatitis A virus

A
  • food and water borne transmission
  • primarily seen in closed populations with poor hygiene at risk
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9
Q

how is Hepatitis A virus diagnosed

A
  • IgM antibody by ELISA
    • many asymptomatic infections occur, antibody is common
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10
Q

Hepatitis A virus prevention

A
  • handwashing
  • avoidance of caontaminated food (uncooked shellfish)
  • water chlorination
  • post exposure prophylaxis with immunoglobulin
  • killed virus vaccine is available
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11
Q

What is the most common and widespread cause of chronic hepatitis and also the infectious cause of primary hepatocellular carcinoma

A

Hepatitis B virus

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12
Q

Key Hepatitis B virus antigens

A
  • HBsAg: HBV surface antigen
  • HBcAg- HBV core antigen
  • HBeAg: surface antigen
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13
Q

presence of which HBV antigen indicates patient is infectious

A

HBeAg: surface antigen

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14
Q

HBV virus is present in what parts of body? how is transmissited?

A
  • serum
  • blood
  • semen
  • transmission
    • needle sharing
    • acupuncture
    • ear piercing
    • tattooing
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15
Q

reservoir of HBV

A

chronic hepatitis patients

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16
Q

when is HBV shed

A

during asymptomatic periods

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17
Q

HBV can cause perinatal-congenital infection. what is the greatest risk factor

A
  • chronic infection in mother
  • HBeAg positive mother
  • 90% of infected infants will become chronically infected
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18
Q

what populations are at risk for HBV infections

A
  • healthcare workers
  • IV drug users
  • homosexuals
  • promiscuous heterosexuals
  • prison
  • family contacts of infected individuals
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19
Q

HBV replicates almost exclusively in what organ

A

liver

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20
Q

prodrome of HBV infection has what symptoms

A
  • fever
  • urticarial rash
  • symmetrial arthraligias
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21
Q

10% of patients with chronic HBV will develop

A

cirrhosis and liver failure

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22
Q

80% of what cancer is linked to chronic HBV

A

primary hepatocellular carcinoma

23
Q

Which HBV antigens are secreted into blood stream during infection

A
  • HBsAg
  • HBeAg
24
Q

What is the hallmark of initial ongoing HBV infection if present with HBsAg

A

IgM anti-HBc

25
Q

which indicates past infection, and if present with HBsAg indicates chronic infection

A

IgG anti-HBc

26
Q

What is the best indications of the presence of infectious HBV

A

HBeAg

27
Q

rapid hepatitis virus tests detects

A

HBV surface antigen

28
Q

HBV prevention

A
  • subunit vaccine available
  • immunoglobulin available for prophylaxis
    • within 1 week of exposure
    • given to newborn infants of HBsAg + mothers (plus vaccination)
29
Q

Hepatitis D virus has the delta agent which is

A

a viral parasite of another virus

  • replication requires the presence of HBV for helper functions
30
Q

Hepatitis D infection is possible under what 2 conditions

A
  1. co-infection with HBV
  2. superinfection in patients with chronic HBV hepatitis
31
Q

Hepatitis D infection does what to severity of HBV infection

A
  • increases the severity of HBV infections
    • fulminant hepatitis is more likely
32
Q

reservoir for HDV

A
  • individuals persistently infected with HBV and HDV are reervoir
33
Q

how is HDV detected

A
  • ELISA for delta antigen or antibodies
34
Q

HDV prevention

A
  • HBV vaccine prevents both HBV and HDV infection
35
Q

this agent is becoming an important form of postransfusion viral hepatitis in the US

A

HCV

36
Q

what percentage of patients with HCV develop chronic infections

A
  • 70-85%
    • often progress to cirrhosis and liver failure
37
Q

list the factors that promote HCV infection progression

A
  • alcohol use
  • infection at age > 40 yo
  • male
  • HBV co-infection
  • HIV co-infection
38
Q

risk factors of HCV

A
  • IVDU
  • hemodialysis
  • tattoos
  • blood transfusions
  • organ transplants
    • **transmission not well understood
39
Q

how is HCV diagnosed

A
  • Enzyme immunoassay detection of antibody against HCV
  • seroconversion at 24 weeks after infection
  • chronic state and acute phase viremic patients often escape detection
  • direct assays for virus
40
Q

why is HCV uncommonly discovered in acute stage

A

infections are asymptomatic

41
Q

initial HIV infection may be asymptomatic or associated with

A

a mononucleosis-like condition

42
Q

when are patients with HIV contagious

A

continuously

43
Q

when is AIDS diagnosed

A
  • severe damage to immune system is evident
    • CD4 T cell counts < 200 uL
44
Q

list the HIV indicator diseases

A
  • Kaposis sarcoma
  • pneumocystitis pneumonia
  • MAC infection
  • severe CMV disease
45
Q

describe HIV agent

A
  • human retrovirus
  • RNA genome
    • 2 copies of RNA in virion
  • enveloped
  • reverse transcriptase
    • ​RNA dependent DNA polymerase
46
Q

origins of HIV

A
  • zoonosis!
    • contact with primates may be entry means
      • bushmeat
47
Q

HIV infects and replicates in what cells

A
  • infects cells with CD4 and chemokine co-receptor molecule displayed as surface
    • T helper cells, monocytyes, macrophages
48
Q

how does HIV replicate

A
  • reverse transcription of viral genome
  • integration into host chromosome (using viral integrase)
  • latency established
49
Q

how does HIV cause immunosuppression

A
  • T helper cell loss
  • apoptosis of immune cells
50
Q

HIV is able to form mutant forms called which complicates treatment

A

swarms

51
Q

how is HIV transmitted

A
  1. sexual contact
  2. parenteral (IVDU, needle sticks)
  3. perinatal: high risk with infected mother
52
Q

How is HIV diagnosed

A
  • detection of HIV antibody in patient ( 2 steps)
  1. EIA screen
  2. western blot for confirmation
  • NAT test detects and quantifies virus
53
Q

screening for HIV

A
  • rapid HIV test
    • 20 min test
54
Q

points of interference for treatment of HIV infections

A
  • reverse transcriptase
  • integrase
  • TAT antagonists
  • protease

Micro final (7 decks)

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