Microbiology 2 Flashcards

1
Q

Hep A Virus

A

enterically-transmitted “infectious” hepatitis

  • family Picornaviridae, genes Enterovirus
  • nonenveloped icosahedral capsid, <7kb ss RNA +
  • single serotype
  • spread: fecal-oral rout, replicates in GI tract
  • incubation: 15-30 days (fastest)
  • spreads to liver, kidney, spleen, isolated from feces
  • onset of jaundice marks end of virus shedding
  • in US, 33% have had HAV, and accounts for 33% of hepatitis cases
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2
Q

Hep B Virus

A

parenterally-transmitted “serum” hepatitis

  • Hepadnavirus, virus partical (Dane particle)
  • enveloped, dsDNA, 3200bp, L(-) full-length, S(+) 15-60% of L(-) strand
  • ONLY ONE THATS DNA*
  • patient blood has trillions of 20nm particles & filaments that have HBsAg & phospholipid (no genome)
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3
Q

Hep C Virus

A

“nonA, nonB PT-hepatitis

  • Flaviviridae (hepacivirus), enveloped icosahedral
  • 9.4kb genome ssRNA + (3,000aa) polyprotein is co & posttranslationally cleaved into 10 smaller (by NS3 protease, target for antiviral drugs)
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4
Q

Hep D Virus

A

dependent on co-infection with HBV

  • delta virus, encodes delta Ag, found only in patients with chronic or severe HBV hepatitis
  • defective circular ssRNA of 1.7kb
  • requires HBV for transmission
  • particles contain delta Ag and HBsAg which facilitates hepatocyte infection
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5
Q

Hep E virus

A

“nonA, nonB” ET-hepatitis

  • calicivirus: nonenveloped icosahedral capsid, 7.5kb ss RNA +
  • single serotype
  • most in development countries
  • 15-20% fatality rate seen in pregnant women
  • swine/other animal reservoir (Japan)
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6
Q

HAV and HEV cause what?

A

acute hepatitis only

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7
Q

HBV and HCV cause what?

A

chronic hepatitis and leads to hepatocellular carcinoma

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8
Q

During Hep A outbreaks, who’s at highest risk?

A
  • diners (employees not washing hands)
  • day care center workers
  • gay men
  • injecting drug users
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9
Q

What 4 proteins, does Hep B encode?

A
  1. DNA polymerase w/reverse transcriptase activity
  2. HBsAg: surface antigen, attachment protein
  3. HBcAG: core antigen, capsid protein (HBeAg is secreted form of HBcAg, seroconversion is important to make chronic cases)
  4. X antigen: influences gene expression
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10
Q

Hep B Virus: Replication

A
  1. attachment/fusion at plasma membrane
  2. virus DNA reaches nucleus, completes dsDNA circle using host enzymes
  3. host cell DNA-dept. RNA polymerase transcribes DNA to make mRNAs & full-length RNA copies (called pregenomic RNA) which are the same sense as mRNA
  4. RNAs sent to cytoplasm, core protein made & encapsidates pregenomic RNA/DNA polymerase
  5. polymerase acts as reverse transcriptase of pregenomic RNA to give DNA L(-) strand
    - buds out
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11
Q

Hep B Virus Transmission

A
  • fecal-oral

- sexual

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12
Q

Hep B Virus Epidemiology

A
  • endemic to China/Sub-Saharan Africa (early, 10-20% population)
  • late infection in US/Europe, <1%
  • replicated in liver
  • incubation: 45-160 day, blood becomes infectious
  • virus present in semen/vaginal secretions
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13
Q

Hep B Virus Chronic

A

-if not resolved in 6 months
Resolved: loss of HBV DNA, seroconverson of HBsAg to HBs abs
Chronic: HBV DNA & BBsAg remain, monitor for seroconverstion of HBeAg to HBe abs
-chronic patients remain asymptomatic until cirrhosis-related complications or hepatacellular carcinomas appear

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14
Q

Hep D Virus co-infection with Hep B

A
  • provides surface antigen to Hep D
  • severe acute disease
  • low risk for chronic HDV infection
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15
Q

Super-infection of HBV patient (give Hep D)

A
  • high risk for severe chronic disease

- tip off is often chronic HBV patient who is suddenly worse

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16
Q

Hep C Virus Pathogenesis/Epidemiology

A
  • enters parenteral route w/incubation time 7-9week
  • 40% parenteral route, mostly drug use
  • 15% sexual, 5% blood transfusions
  • US 2% incidence
  • 50-60 year old males
  • > 70% untreated patients will be chronic carriers
17
Q

Hep A virus: High Risk Groups

A
  • household/sexual contacts of infected people
  • international travelers
  • American Indian Reservations
18
Q

Hep B Virus: High Risk Groups

A
  • homosexual men
  • IV drug use
  • healthcare workers
  • hemophiliacs
19
Q

Hep C Virus: High Risk Groups

A
  • IV drug use
  • healthcare workers
  • hemophiliacs
  • HIV infected people
  • dialysis patients
  • alcohol abusers
20
Q

Chronic Hepatitis: HBV

A

-depends on age 5 2% chronicity rate
3 stages
1. immune tolerance phase (adults skip this stage)
2. immune clearance phase (adults=healthy carriers)
3. residual phase (lower risk cirrhosis, longer survival)

21
Q

Chronic Hepatitis: HCV

A

85% of untreated HCV patients will be chronic carriers

-happens in 10 years, cirrhosis in 20 years, hepatocellular carcinoma in 30 years

22
Q

Control HAV spread?

A
  • hand washing

- vaccine (killed)

23
Q

Control HBV spread?

A
  • screen blood supplies
  • vaccines
  • alpha 2b interferon (FDA approved)