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Virology > V7 > Flashcards

V7 Flashcards

1
Q

Describe the pathogenesis of HIV

A
  • Primary target of HIV: CD4 T-helper cells
  • These cells are important in the co-stimulation and the regulation
    of the humoral and cellular immunity.
  • Activated CD4 cells are preferentially infected.
  • Viral infection of CD4 cells disables CD4 cell function.
  • Virally infected CD4 cells are destroyed by cytotoxic CD8 cells that target virally infected cells.
  • Pyroptosis: inflammatory programmed cell death of cells with abortive HIV infection destroys large proportion of CD4 cells.
  • HIV-specific CD4 cells are eliminated very early during infection.
  • A drop in the number and function of CD4 cells leads to the AIDS
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2
Q

Describe the epidemiology of HIV

A
  • 1 in 4 South Africans 15-49 have HIV

- South Africa has the highest number of people living with HIV in the world

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3
Q

What is the presentation of acute retroviral syndrome?

A
  • Common symptoms: Fever, Lethargy, Myalgia, Rash, Headache, Pharyngitis, Adenopathy.
  • Asymptomatic in up to 70% of patients.
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4
Q

List some common HIV-associated diseases

A
  • Candida infections – oropharyngeal and oesophageal (thrush)
  • Herpes zoster (shingles)
  • Chronic diarrhoea
  • Cryptococcal meningitis
  • Toxoplasmosis
  • Pneumocystis pneumonia
  • Hepatitis B
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5
Q

Describe the epidemiology of Hepatitis A

A
  • Standard of living important: incidence and age of acquisition related to socio-economic status.
  • Worldwide distribution.
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6
Q

Describe the transmission of Hepatitis A

A

Faeco-oral transmission:
■ Person to person.
■ Water/ Food.
■ Certain occupations.

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7
Q

How does Hepatitis A present?

A
  • Often no symptoms

- 1-6 week incubation period

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8
Q

What are the complications of Hepatitis A?

A

Fulminating hepatitis (liver failure), rare

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9
Q

Describe the epidemiology of Hepatitis B

A

More than 370 million people world wide infected

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10
Q

Describe the transmission of Hepatitis B

A

Blood and blood products, vertical, horizontal

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11
Q

How does Hepatitis B present?

A
  • Incubation period: 6-24 weeks (12-14 average)
  • Virus replicates in liver cells.
  • Acute hepatitis.
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12
Q

What are the complications of Hepatitis B?

A
  • Liver: cirrhosis, hepatocellular carcinoma.
  • Extra-hepatic: polyarteritis nodosa, glomerulonephritis.
  • Risk of chronicity: Neonates: 90%, infants and children: 30%, healthy adults: 1-4%
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13
Q

Describe the epidemiology of Hepatitis C

A
  • > 170 million Worldwide.
  • 1-4 million deaths per year of chronic liver disease: 20% hepatitis C.
  • South Africa about 12%, but data is limited
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14
Q

Describe the transmission of Hepatitis C

A 
○ Intravenous drug use.
○ Nosocomial (originates in hospital)
○ Tattoos
○ Sexual: MSM (men who have sex with men)
○ Perinatal
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15
Q

How does Hepatitis C present?

A
  • Average incubation period 6-7 (2-26) weeks.
  • Acute infection: Asymptomatic in 60-70% of patients, 20-30% will develop jaundice,
  • 50-85%: Chronic infection.
  • Course usually insidious; few symptoms for first 20 years.
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16
Q

What are the complications of Hepatitis C?

A
  • Hepatic: cirrhosis and hepatocellular carcinoma.
  • Extrahepatic:
    ■ Arthralgia.
    ■ Myalgia.
    ■ Pruritus.
    ■ Sicca Syndrome.
    ■ Raynaud’s phenomenon.
    ■ Systemic vasculitis as a result of
    cryoglobulinaemia.
17
Q

Describe the epidemiology of Hepatitis D

A

Highest rates in Italy, Southern Europe, Middle East,

Amazon basin, Parts of Africa, Taiwan.

18
Q

How is Hepatitis D transmitted?

A

Transmitted through blood and blood products, including IVDU (IV drug use) and sexual contact

19
Q

How does Hepatitis D present?

A

Only as co-infection or superinfection with hepatitis B virus
infection.
○ Co-infection: both viruses transmitted simultaneously.
○ Superinfection: HBV infection precedes HDV infection.

20
Q

How is Hepatitis E transmitted?

A
  • Faeco-oral spread:
    ○ Genotypes 1 and 2: water-borne outbreaks.
    ○ Genotypes 3 and 4: food borne (pigs and other animals).
  • Low rate of secondary transmission.
21
Q

Which populations are most at risk for Hepatitis E?

A
  • Pregnant patients.
  • Immunosuppressed.
  • Underlying liver disease.
22
Q

What are the complications of Hepatitis E?

A

fulminant hepatitis

23
Q

Which 2 forms of Hepatitis are most similar?

A

A and E

Virology (8 decks)

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