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Microbiology > Lecture 17: Hepatitis Virus > Flashcards

Lecture 17: Hepatitis Virus Flashcards

0
Q

Which 2 hepatitis viruses provide immunity to one preventing infection with the other?

A

HBV and HDV

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1
Q

What is hepatitis?

A

An inflammation of the liver that can be caused by infections and by other means.

Causes: Viruses, drugs, and auto immunity

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2
Q

True or False? Over 4 million carriers of hepatitis viruses, HBV and HDV exist in the US and many are unaware of their carrier status

A

False! HBV and HCV

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3
Q

HCV causes more deaths than HBV?

A

Yes, 12,000 (HCV) and 3,000 (HBV)

-Worldwide 1.5 million die each year

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4
Q

What two hepatitis viruses cause mild acute disease, but can lead to carrier status, chronic liver damage, and liver carcinoma

A

HBV and HCV

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5
Q

What is the result of liver damage?

A

1) increase in plasma transminase (SGOT)

2) Increase in Bilirubin –> Jaundice and 75% non-jaundiced = Anicteric

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6
Q

Which two hepatitis viruses are stable, Non-Enveloped and transmitted via Fecal/oral?

A

HAV and HEV

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7
Q

Which viruses that cause hepatitis are enveloped and unstable?

A

HBV, HCV, HDV

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8
Q

Where do hepatitis viruses replicate?

A

in hepatocytes and can initiate their destruction

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9
Q

Which hepatitis viruses are DNA and which are RNA?

A

DNA= HBV

RNA= HAV, HCV, HDV (incomplete RNA virus), HEV

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10
Q

How are HBV, HCV, and HDV transmitted?

A

Through exchange of “Percutaneous, permucosal “ AKA bodily fluids (Blood, semen, saliva, mother’s milk, etc)

***Less hardy they have envelope and will easily dry out.

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11
Q

Which hepatitis viruses cause chronic infection?

A

B, C, and D

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12
Q

Which hepatitis viruses cause acute infection?

A

A and E

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13
Q

Which hepatitis viruses require clean blood supply for prevention?

A

B, C, D

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14
Q

What is the primary measure for prevention of hepatitis B?

A

1) immunization
2) Pre-exposure prophylaxis with hepatitis BN vaccine or post exposure prophylaxis with hep B immuno globulin (HBIG) and hepatitis B vaccine—-> This will also PREVENT HDV infection.

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15
Q

Are there products to prevent hep C?

A

No, but primary strategies are blood donor screening and risk behavior modification.

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16
Q

In persons who are chronically infected with HBV what can be done to prevent HDV superinfection?

A

risk behavior modification is primary measure

17
Q

Is there specific products available for prevention of Hep E?

A

No, primary measure to prevent disease is to ensure the safety of drinking water as well as sanitation procedures.

18
Q

Which hepatitis viruses can lead to chronic infections and persons that become carriers capable of further spreading these infections.

A

a substantial percentage of HBV, HCV, and HDV

19
Q

Which hepatitis virus is very rare in the USA, is relatively common is some “developing” countries, where it takes a substantial toll among pregnant women

A

HEV ( about 20-25 % fatality)

20
Q

What are some characteristics of Hep A ?

A
  • RNA Picornavirus
  • Noneveloped (sturdy)
  • fecal oral transmission
  • single serotype worldwide (1 major strain)
  • no chronic infection; acute and asymptomatic !!!!!!
  • protective antibodies develop in response to infection = lifelong immunity
  • vaccine (inactivated) available since 1996
21
Q

Which two viruses are similar in pathology?

A

HAV and HEV are similar and primarily cause diseases in the developing world.

  • Can lead to jaundice (about 2 weeks)
  • Both are spread via fecal-oral.
  • Outbreak is due to contaminated food and water because of undercooked shellfish and daycare centers.
  • Can be also spread from mucosa –>mucosal contact & Blood–>Iv transfer.
22
Q

What is the treatment of HAV?

A
  • Treat with pooled IgG
  • vaccine available
  • no carriers
23
Q

Characteristic of Hep B

A

-DNA hepadnaviridae
-Enveloped (unsturdy)
-Transmission
1) Sexual 2) Parenteral 3) Perinatal
- single serotype worldwide
-Acute disease and asymptomatic infection (90%)
-Chronic infection 10 %
-Protective antibodies develop = lifetime immunity
-Vaccine (inactivated) available since 1981
or if you make Abs you are protected.

24
Q

What does the outer membrane of Hep B contain? (Think spikes)!

A

contains hepatitis B surface antigen (HBsAg) which circulates in blood as particles.

25
Q

What is the primary component of hepatitis B vaccine?

A

HBsAg; this antigen induces a protective neutralizing antibody that provides long-term protection.

26
Q

The inner core of the virus contains hepatits B core antigen called what?

A

HBcAg

27
Q

Who is the high risk population for HBV?

A
  1. health care personnel
  2. dialyses patients
  3. people from high risk areas
  4. military personnel
  5. people with multiple sex partners
  6. IV drug abusers
28
Q

How is HBV transferred?

A
  • Transfusions (blood)
  • Sexual contact (blood)
  • poor sanitation(blood)
  • I.V drugs
  • Birth canal
29
Q

How are neonates affected?

A

90 % infected
90 % become carriers
(cant clear infection)

30
Q

What are the results of severe chronic hepatitis?

A
  1. Liver tumors

2. cirrhosis (loose functions bc of scarring)

31
Q

What two things are responsible for both the pathology of HBV and eliminating the viral infection?

A

Cell mediated immunity and inflammation

32
Q

What percent of individuals with HBV develop an insufficient immune response, and the infection becomes chronic?

A

5-10% these individuals are “carriers” and will shed HBV indefinitely.

33
Q

What are the three results of chronic HBV infection?

A

1) asymptomatic, mild chronic hepatitis, or severe chronic hepatitis. (later results in cirrhosis or cancer)

34
Q

HCV causes a similar pathology to which virus , but has a higher carrier & death rate?

A

HBV is less severe than HCV because HCV does not have a vaccine.

35
Q

What genes, and proteins does the Hep B viral genome contain?

A

GAG, POL, ENV = Genes
HBcAg(capsid protein) ,HB?Ag, HBsAg, and X-protein
Functions: Capsid, polymerase and spike, and regulation respectively.

36
Q

What determines the course of disease for Hepatits B?

A

The immune response; in majority of individuals immune repsponse can eliminate the virus infection with no lasting effects

37
Q

When does the HBV infection become chronic?

A

In a minority of individuals this occurs when an individual doesn’t mount a sufficient immune response–>leading to cirrhosis and hepatoma (cancer)

38
Q

What can be used diagnostically in HBV infections?

A

Liver enzymes m HBcAg, HBeAg, and HBsAg, and antibody to HBcA, HBeAg, and HBsAg

  • in 80-90% of individuals the immune response will effectively resolve the infection.
  • These individuals will develop significant anti HBsAg antibody with a corresponding drop in HBsAg.

*** Spike level of Ag most important.

39
Q

How is a HBV carrier determined?

A

In these individuals the anti-HBsAg antibody level stays low (not a lot of Ab’s against spikes), while HBsAg remains high. If this goes on for over 6 months then person is diagnosed as a carrier.

Microbiology (10 decks)

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