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Infection > Lecture 8.1: Viral Hepatitis > Flashcards

Lecture 8.1: Viral Hepatitis Flashcards

1
Q

What is Hepatitis?

A

It is a general term referring to inflammation of the liver

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2
Q

Causes of Hepatitis: Infectious (4)

A

• Viral
• Bacterial
• Fungal
• Parasitic

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3
Q

Causes of Hepatitis: Non-Infectious (7)

A

• Alcohol
• Drugs
• Chemical
• Autoimmune
• Metabolic Diseases
• Genetic
• Radiation

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4
Q

Signs & Symptoms of Hepatitis (11)

A

• Fever
• Malaise
• Upper Abdominal Discomfort/ RUQ tenderness
• Jaundice
• Development of Ascites (very uncommon)
• Oedema (very uncommon)
• Spider Naevi
• Mild Hepatomegaly
• Splenomegaly
• Persistent Nausea & Vomiting
• Hepatic Encephalopathy (in severe cases,
suggests liver failure)

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5
Q

What are the most common causes of Viral Hepatitis?

A

5 unrelated hepatotropic viruses:
• Hep A
• Hep B
• Hep C
• Hep D
• Hep E

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6
Q

What are some other viruses that can cause liver inflammation? (3)

A

• Cytomegalovirus
• Epstein–Barr Virus
• Yellow Fever

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7
Q

Hepatitis A Virus: Structure

A

• Naked RNA virus (naked icosahedral capsid, single-stranded RNA genome)
• Only 1 stable serotype
• 4 genotypes exist, but in practice most of them are group 1

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8
Q

Hepatitis A Virus: Transmission Types

A

• Close Personal Contact
• Contaminated Food
• Contaminated Water
• Blood Exposure (rare)

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9
Q

How does Hepatitis A invade the human body?

A

• Faecal-Oral Route
• Multiplies in the Intestinal Epithelium
• Reaches the Liver by Haematogenous spread

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10
Q

What is the Incubation period of Hepatitis A?

A

2 to 6 weeks

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11
Q

Diagnosis of Hepatitis A (8)

A

• Examination of Patient
• Patient History
• Complete Blood Count
• Biochemical Blood Test
• Coagulogram
• Liver Function Test
• Viral Hep Marker Analysis
• Urine and Faeces Analysis

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12
Q

Hepatitis E Virus Structure

A

• Calicivirus-like viruses
• Unenveloped RNA virus
• 32-34nm in diameter
• Positive stranded RNA genome (7.6 kb in size)
• Very labile and sensitive

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13
Q

Transmission of Hepatitis E

A

• Eating Raw Shellfish
• Sexual Contact
• Use of Non-Sterile Syringes
• Consumption of Contaminated Food and Water
• Swimming in Dirty Water
• Contact with Sick People

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14
Q

Hepatitis B Virus Structure

A

• It is a double-stranded DNA hepadnavirus
• The whole virus is called the Dane particle
• Replication involves a reverse transcriptase
• 42nm enveloped virus
• 22nm spheres and filaments other forms- no DNA in these forms so they are
not infectious (composed of surface antigen)
• These forms outnumber the actual virions

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15
Q

Can you culture Hep B

A

Not yet

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16
Q

HBV Antigens

A

HBsAg = surface (coat) protein ( 4 phenotypes : adw, adr, ayw and ayr)
HBcAg = inner core protein (a single serotype)
HBeAG = e antigen; an indicator of transmissibility
(minor component of the core- antigenically
distinct from HBcAg) secreted protein; function
unknown

17
Q

Transmission of Hepatitis B (7)

A

• Sexual Contact
• Blood Transfusions
• Re-use of contaminated needles and syringes
• Through wounds/insect bites/animal bites
• From mother to child (MTCT) during childbirth
• Intrauterine (through placenta)
• Breastfeeding

18
Q

Hepatitis B: Mechanism of Invasion

A

• Virus enters hepatocytes via blood
• RNA intermediate: HBV replicates through an RNA intermediate
• This produces and release antigenic decoy particles
• Reverse transcription: mRNAs is converted into the DNA
• This DNA will eventually be the core of the progeny virion
• Integration: Some DNA integrates into host genome causing carrier state

19
Q

Hep B Decoy Particles: What are they? Importance?

A

• HBsAg-containing particles are released into the serum of infected peopl
• These outnumber the actual virions
• Spherical or filamentous
• They are immunogenic
• Were processed into the first commercial vaccine against HBV.

20
Q

Diagnosis of Hepatitis B

A

• Examination of Patient
• Patient History
• Complete Blood Count
• Biochemical Blood Test
• Liver Function Test
• Viral Hep Marker Analysis
• Ultrasonography of Abdomen

21
Q

Importance of HBeAg in HBV

A

Hepatitis B e antigen (HBeAg) is an indicator of viral replication

22
Q

Importance of HBsAg and HBsAb in HBV

A

HBsAg - used as a general marker of infection

HBsAb - used to document recovery and/or immunity to HBV infection

23
Q

Importance of Serum anti HBc

A

It is most useful & inexpensive marker for identification of occult HBV infection in HBsAg negative individuals

24
Q

What is an Occult HBV Infection?

A

• Presence of HBV DNA in the liver
• Detectable (< 200 IU/ml)
• Undetectable HBV DNA in serum
• HBs Ag negative
• Anti HBc antibodies

25
Q

Hepatitis D (Delta) Virus Structure

A

• Virion: spherical, 36-38 nm,
• HBV capsid, HDV nucleoprotein
• Delta antigen
• HBsAg
• Nucleic Acid: (-) ss RNA, circular
• Satellite virus : replicates only in the presence of HBV

26
Q

When can Hep D be contracted?

A

You can only contract this is you are also currently suffering from Hepatitis B

27
Q

Consequences of Hepatitis B & Delta Virus Infection: Co-Infection

A

• Co-Infection
• Severe acute disease
• Low risk of chronic infection

28
Q

Consequences of Hepatitis B & Delta Virus Infection: Superinfection

A

• Usually develop chronic HDV infection
• High risk of severe chronic liver disease
• May present as an acute hepatitis

29
Q

Hepatitis C Structure

A

• Hepatitis C virus (HCV) is a single-stranded RNA flavivirus
• Envelope
• Envelope Proteins (E1 & E2)
• Nucleocapsid
• RNA

30
Q

Transmission of Hepatitis C (7)

A

• Sexual Contact
• Blood Transfusions
• During Operations
• Re-use of contaminated needles and syringes
• From mother to child (MTCT) during childbirth
• Intrauterine (through placenta)
• As a consequence of Infectious/Bacterial Infection Complications

31
Q

Signs & Symptoms of Hep C: Acute Infection (7)

A

• Decreased Appetite
• Fatigue
• Nausea
• Muscle or Joint Pains
• Weight Loss
• Acute Liver Failure (rare)
• Jaundice

32
Q

Signs & Symptoms of Hep C: Chronic Infection

A

• Fatigue
• Mild Cognitive Problems
• Fatty Liver
• Cirrhosis
• Hepatocellular Carcinoma
• Ascites
• Easy Bruising/Bleeding
• Varices (enlarged veins)
• Hepatic Encephalopathy

33
Q

What is the Incubation Period of Hep C?

A

1-26 weeks

34
Q

Stages of Liver in Acute Hepatitis (3)

A

Healthy Liver
Acute Hepatitis
Recovered Liver

35
Q

Stages of Liver in Chronic Hepatitis (4)

A

Healthy Liver
Chronic Hepatitis
Liver Cirrhosis
Liver Cancer (hepatocellular carcinoma)

36
Q

How many Acute HCV turn into Chronic HCV?

A

C. 85%

37
Q

Treatment of Hep C

A

• Combination of pegylated interferon alpha and the antiviral drug ribavirin for.
period of 24 or 48 weeks
• Hepatitis C is a common reason for liver transplant
• Ribavirin

38
Q

What are 5- of the many- Functions of the Liver? (9)

A

• URH
• Bile Production
• Filtering of Toxins
• Excretion of bilirubin cholesterol, hormones, and drugs
• Breakdown of carbohydrates, fats, and proteins
• Activation of enzymes
• Storage of glycogen, minerals, and vitamins (A, D, E, and K)
• Synthesis of blood proteins
• Synthesis of clotting factors

Infection (21 decks)

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