Serology Day 4 - HIV and Hepatitis

Question 1

HIV background

Answer 1

Retrovirus, antisense ssRNA

Question 2

3 encoding genes of HIV

Answer 2

Gag, pol, env

Question 3

HIV surface glycoproteins

Answer 3

Gp120 and Gp41

Question 4

3 HIV enzymes

Answer 4

Protease, reverse transcriptase, integrase

Question 5

HIV transmission

Answer 5

Body fluids (sexual, open wounds, transplacental), usually more infectious if there is blood in it

Question 6

Affect of having other STD’s on HIV risk?

Answer 6

More likely to get HIV with other STD’s due to disruption of mucus membranes in genital area

Question 7

HIV targets what cells?

Answer 7

T cells, monocytes, NKC, dendritic cells (organ specific ones, microglial, etc)

Question 8

HIV co-receptors that work with Gp120/42

Answer 8

CXCR4 (entry to T cells), CCR5 and CCR2 (entry to macrophages)

Question 9

HIV screening test

Answer 9

ELISA assay

Question 10

What is procedure after getting positive ELISA for HIV?

Answer 10

Rerun ELISA, if still positive perform Western Blot for P24, Gp41, and Gp120/160, 2 of 3 need to be seen to be positive

Question 11

4 laboratory tests for HIV

Answer 11

CD4 T cell enumeration
HIV antibody detection
HIV antigen detection
HIV nucleic acid detection

Question 12

Hepatitis lab findings

Answer 12

Bilirubin, elevated liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferate (AST)

Question 13

Hepatitis clinical presentation

Answer 13

Flu-like symptoms, pain in upper right quadrant of abdomen, hepatomegaly w/ tenderness, jaundice, dark urine, light feces

Question 14

Why don’t we use increased liver enzymes to diagnose hepatitis?

Answer 14

Liver enzymes can be increased due to age, alcoholism, and treatments for other diseases

Question 15

What do we use hepatitis panels for?

Answer 15

Screen, diagnose, monitor

Question 16

Anti-HBc

Answer 16

Against hepatitis B core antigen, first antibody to show up

Question 17

Anti-HBe

Answer 17

Against hepatitis B protein Be, second antibody to form

Question 18

Anti-HBs

Answer 18

Against hepatitis B surface antigen, last antibody to form, will be the only antibody in vaccinated patients

Question 19

What antigens/antibodies are present in acute hepatitis B?

Answer 19

Anti-HBc, HBe-Ag (+/-), Anti-HBe, HBs-Ag, Anti-HBs

Question 20

What antigens/antibodies are present in chronic hepatitis B?

Answer 20

Anti-HBc, HBe-Ag, HBs-Ag

Question 21

What antigens/antibodies are present in recovered hepatitis B?

Answer 21

Anti-HBc, Anti-HBe, Anti-HBs

Question 22

What antigens/antibodies are present in patients vaccinated against hepatitis B?

Answer 22

Only Anti-HBs

Question 23

Which hepatitis viruses are passed fecal-orally?

Answer 23

Hepatitis A and E

Question 24

Which hepatitis viruses are passed by blood/body fluids?

Answer 24

Hepatitis B, C, and D

Question 25

Which hepatitis vaccines do we immunize for?

Answer 25

Hepatitis A and B (D is covered by vaccinating for B)

Question 26

What are the chances of developing chronic liver disease when infected with hepatitis B? Hepatitis C?

Answer 26

Hepatitis B - younger age at time of infection, higher chance of developing chronic liver disease
Hepatitis C - doesn’t matter what age, 90% of patients will develop chronic liver disease

Question 27

Hepatitis D infection requirements? Risk for chronic infection in coinfection vs super infection?

Answer 27

Hepatitis D needs surface antigens to infect patient
Coinfection (B + D at same time) has low risk for chronic infection
Super infection (B then D later) has high risk of chronic infection/liver disease