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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
which indicates past infection, and if present with HBsAg indicates chronic infection
IgG anti-HBc
26
What is the best indications of the presence of infectious HBV
HBeAg
27
rapid hepatitis virus tests detects
HBV surface antigen
28
HBV prevention
* **subunit vaccine available** * **immunoglobulin available for prophylaxis** * within 1 week of exposure * given to newborn infants of HBsAg + mothers (plus vaccination)
29
Hepatitis D virus has the delta agent which is
a viral parasite of another virus * replication requires the presence of HBV for helper functions
30
Hepatitis D infection is possible under what 2 conditions
1. co-infection with HBV 2. superinfection in patients with chronic HBV hepatitis
31
Hepatitis D infection does what to severity of HBV infection
* increases the severity of HBV infections * fulminant hepatitis is more likely
32
reservoir for HDV
* individuals persistently infected with HBV and HDV are reervoir
33
how is HDV detected
* ELISA for delta antigen or antibodies
34
HDV prevention
* HBV vaccine prevents both HBV and HDV infection
35
this agent is becoming an important form of postransfusion viral hepatitis in the US
HCV
36
what percentage of patients with HCV develop chronic infections
* **70-85%** * often progress to cirrhosis and liver failure
37
list the factors that promote HCV infection progression
* alcohol use * infection at age \> 40 yo * male * HBV co-infection * HIV co-infection
38
risk factors of HCV
* IVDU * hemodialysis * tattoos * blood transfusions * organ transplants * \*\*transmission not well understood
39
how is HCV diagnosed
* 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
why is HCV uncommonly discovered in acute stage
infections are asymptomatic
41
initial HIV infection may be asymptomatic or associated with
a mononucleosis-like condition
42
when are patients with HIV contagious
continuously
43
when is AIDS diagnosed
* severe damage to immune system is evident * CD4 T cell counts \< 200 uL
44
list the HIV indicator diseases
* Kaposis sarcoma * pneumocystitis pneumonia * MAC infection * severe CMV disease
45
describe HIV agent
* human retrovirus * **RNA genome** * 2 copies of RNA in virion * enveloped * **reverse transcriptase** * **​RNA dependent DNA polymerase**
46
origins of HIV
* zoonosis! * contact with primates may be entry means * bushmeat
47
HIV infects and replicates in what cells
* infects cells with CD4 and chemokine co-receptor molecule displayed as surface * **T helper cells, monocytyes, macrophages**
48
how does HIV replicate
* reverse transcription of viral genome * integration into host chromosome (using viral integrase) * latency established
49
how does HIV cause immunosuppression
* T helper cell loss * apoptosis of immune cells
50
HIV is able to form mutant forms called which complicates treatment
swarms
51
how is HIV transmitted
1. sexual contact 2. parenteral (IVDU, needle sticks) 3. perinatal: high risk with infected mother
52
How is HIV diagnosed
* detection of HIV antibody in patient ( 2 steps) 1. **EIA screen** 2. **western blot for confirmation** * NAT test detects and quantifies virus
53
screening for HIV
* rapid HIV test * 20 min test
54
points of interference for treatment of HIV infections
* reverse transcriptase * integrase * TAT antagonists * protease

Micro final (7 decks)

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