MYCO & VIROLOGY L8 (Semis- Hepatitis Viridae) Flashcards
3 Possible Causes of Hepatitis
- Infectious Agents (virus, bacteria, parasite)
- Alcohol
- Drugs (Drug-induced hepatitis)
Primary Hepatitis (95%) includes:
Hepatitis A, B, C, D, E, G virus
Secondary Hepatitis include
Yellow fever virus, EBV, CMV, HSV, Rubella virus
Viral Hepatitis can cause:
- Chronic Hepatitis which leads to Cirrhosis and to Hepatocellular Carcinoma (w/ cirrhosis)
Forms of Viral Hepatitis:
Acute
Fulminant Acute
Subclinical
Chronic
No signs and symptoms
Subclinical
Leads to coma bec. of the accumulation of ammonia. Also leads to liver failure
Fulminant Acute
IDENTIFY:
Family: Picornaviridae
Genus: Enterovirus/Hepatovirus
Hepatitis A
IDENTIFY:
Family: Hepadnaviridae
Genus: Orthohepadnavirus
Hepatitis B
IDENTIFY:
Family: Flaviviridae
Genus: Hepacivirus
Hepatitis C
IDENTIFY:
Family: Hepeviridae
Genus: Hepevirus
Hepatitis E
Old Family and Genus Name of Hepatitis E
Family: Caliciviridae
Genus: Calicivirus
IDENTIFY:
Family: Flaviviridae
Genus: Flavivirus
Hepatitis G
IDENTIFY:
Family: Deltaviridae
Genus: Deltavirus
Hepatitis D
NOTE: family name ends with
-viridae, while genera ends with
-virus
Its other names include Infectious Hepatitis, Enterovirus 72, and Short Incubation Hepatitis
Hepatitis A
IDENTIFY based on the incubation period:
a) 40 - 180 days
Average 60 - 90 days
b) 30 - 50 days
c) 15 - 150 days
d): 2 - 9 weeks
e) 15 - 45 days
Average of 28 days
f) Not established
a) Hepatitis B
b) Hepatitis C
c) Hepatitis D
d) Hepatitis E
e) Hepatitis A
f) Hepatitis G
IDENTIFY: based on morphology
1) Enveloped, Icosahedral, Linear, ssRNA, 45 nm
2) Naked (resistant to ether, acid, heat at 60C for 1 hour), icosahedral, linear, ssRNA, 28 nm
3) Naked, Icosahedral, Linear, ss RNA, 30 nm
4) enveloped, Icosahedral, Circular, dsDNA, 42 nm
5) Enveloped, Circular, ssRNA, 37 nm
6) ssRNA. (Size not stated)
1) Hepatitis C
2) Hepatitis A
3) Hepatitis E
4) Hepatitis B
5) Hepatitis D
6) Hepatitis G
Indicates immunity in Hep A
IgG anti- HAV
The first one to appear in Hep A
HAV Ag
IgM anti-HAV is detected by?
Solid Ab ELISA
IgG anti-HAv is detected by?
Competitive inhibition ELISA
Treatment for Hep A
Supportive Care
Prevention/ Vaccine for Hep A
- Inactivated vaccine (Twinrix) 2 doses with 1 month interval
- Treatment of water
This hepatitis is subclinical, has no Chronic Disease, and is self-limiting
Hepatitis A
Other names of Hepatitis B (state at least two)
- Serum Hepatitis
- Dane Particle
- Long Incubation Hepatitis
- Australian Hepatitis
Identify based on MOT:
1) Parenteral, Sexual Intercourse
2) fecal-oral route
3) Parenteral, Perinatal, Sexual Intercourse
4) Parenteral, Sexual Intercourse, Co-infection with Hepa B virus (HBsAg needed by the virus)
1) Hepatitis C & G
2) Hepatitis A & E
3) Hepatitis B
4) Hepatitis D
Treatment and vaccine for Hepatitis B
Treatment:
- Supportive Care
- HB immunoglobulin
- Interferon
- Lamivudine
- Liver Transplant
Vaccine: Inactivated vaccine (3 doses)
First marker to appear during HBV
HBsAg
First antibody to appear in HBV
IgM anti - HBc
Lifelong marker of HBV infection
IgG anti - HBc
No serological significance; for liver biopsy.
HBcAg
Last to appear for immunity in HBV
Anti-HBs
Epidemiological Data:
Blood and blood products
transfusion, contact history, and inoculation history.
HB, HC, HD, HG
HBV window period
Anti-HBc
First Generation Serologic Test for Viral Hepatitis
Ouchterlony agar plate
Third Generation Serologic Test for Viral Hepatitis
- RIA, ELISA, Reverse Passive Hemagglutination
- Reverse Passive Latex Agglutination
Second Generation Serologic Test for Viral Hepatitis
Counter electrophoresis (countercurrent immunoelectrophoresis)
This is observed with an increase in liver function test (LFT)
Chronic Persistent Hepatitis
This is observed with a decrease in liver function test (LFT)
Chronic Active Hepatitis
Prevention/ Vaccine for Hepatitis C
No vax available
Treatment for Hepatitis C (SIRL)
- Supportive care
- Interferon
- Ribuvirin
- Liver Transplant
Indicates TB (mg/dL)
0.2-1.0 mg/dL
Major cause of liver cirrhosis plus alcoholic hepatitis
Hepatitis C
Indicates Jaunice (mg/dL)
> 2mg/dL
Clinical Findings of Viral Hepatitis
- Fever
- Anorexia
- Nausea
- Vomiting
- Jaundice
- Dark urine
- Pale feces
- Elevated transaminase
Used for diagnosis of Hepatitis C (2pts)
Anti – HCV and HCV - RNA
Its symptoms include jaundice, indigestion and difficulty sleeping, swelling of the feet and legs, and liver complications (e.g. liver failure or liver cancer)
Hepatitis C
Used for diagnosis of Hepatitis A (3pts)
- HAV Ag
- IgM anti - HAV
- IgG anti - HAV
Defective Virus - no gene or incomplete virus
Hepatitis D
Prevention/Vaccine for Hepatitis E
No vax available
Treatment for Hepatitis E
Supportive care
Self - limiting
Used for diagnosis of Hepatitis E (3pts)
- HEV Ag
- IgM Anti-HEV
- HEV RNA
Detected by ELISA, Western blot
and Fluorescence Antibody Blocking Assay
IgM Anti-HEV
Its symptoms include nausea, vomiting, pain in the right hypochondrium, intoxication, severe weakness, malaise, bleached feces
Hepatitis E
Detected using RT-PCR
HEV RNA
Treatment for Hepatitis G
Supportive care
Epidemiological Data:
Food, water, seasonal, age
HA, HE
Treatment for Chronic Hepatitis
- Symptoms Therapy
- Diet
- Rest
- Supporting Therapy
- Immunomodulator
Treatment for Fulminant Hepatitis
General and Supporting Therapy
Rest: strict bed rest, diet
Protection of Susceptible Population
- Active Immunity
- Passive Immunity
Prevention of Hepatitis
- Control of source of infection
- cost off route of infection
cut off guro??