Viral hepatitis Flashcards by Rachel Muxlow

Enveloped, circular, partially dsDNA virus of the Hepadnaviridae family

HBV

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Marker of HBV envelope seen in serum, used for diagnosis

HBsAg

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Marker of HBV not seen in the serum, but seen in the liver

HBcAg

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HBV core associated antigen seen in serum

HBeAg

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HBV trans-activator of replication

HBxAg

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Forms of HBV

Dane particle
Spherical forms
Tubular forms

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Baltimore class VII replication type

DNA genome replicated via an RNA intermediate

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Incubation period of HBV

45-180 days, average of 60-90

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HBV markers positive in immune tolerant phase

HBeAg
HBsAg
High levels of HBV DNA

Minimal rise in LFTs

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First phase of HBV infection characterized

Immune tolerant phase

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Second phase of HBV infection

Immune active phase

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HBV markers seen in immune active phase

High levels of HBV DNA
HBsAg
HBeAg converted to Anti-HBe (IgM)

Increased LFTs

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Third phase of HBV infection

Immune control phase

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HBV markers seen in immune control phase

Anti-HBe (IgM)
HBV DNA low or undetectable
HBeAg negative
HBsAg

Normal LFTs

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Forth phase of HBV infection

Immune clearance phase

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HBV markers seen in immune clearance phase

HBeAg negative
Anti-HBe (IgM)
HBV DNA high
HBsAg

Increased LFTs

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When is HBsAg spot test able to be detected in serum and what does it indicate?

1-10 wks after exposure

Infectivity

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Marker present during the entire duration of acute HBV

HBsAg

Marker present during acute, chronic, and carrier states of HBV

HBeAg

What is indicated by present of IgM anti-HBc in serum?

Acute infection

What is indicated by Anti-HBs in serum?

Immunity to HBV

What is indicated by IgG anti-HBc in serum?

Marker of past or chronic infection

What specific antibody is used as marker for reduced replication of HBV?

Anti-HBe

Antivirals used for treating chronic HBV

Lamivudine
Entecavir
Telbivudine
Tenofovir

Active immunization against HBV and schedule

Recombinant HBsAg vaccine Given at 0, 1, and 6 mos

Passive immunization for HBV vaccine

Human immunoglobulin given within 1 wk of exposure

What HBV vaccine is given to neonates of HBV positive mothers?

Passive immunization with human immunoglobulin Combined

How many doses of the combined HBV vaccine are given?

Treatment for HBV contaminated materials

10% bleach

Spherical, enveloped, positive sense ssRNA virus of Flaviviridae family. Genotype 1a is major seen in US.

HCV

Predominant symptom of HCV infection

Chronic fatigue

Binds to CD81 antigen or LDL receptor on hepatocytes via E2 glycoprotein, leading to chronic disease.

HCV

Prodromal phase of HCV

6-7 wks after exposure

Viremia phase of HCV

1-3 wks up to 4-6 mos

Extrahepatic manifestations of HCV

Essential mixed cryoglobulinemia Porphyria cutanea retarda Membranoproliferative glomerulonephritis

Defective virus with negative sense ssRNA

HDV

Family of HAV

Picornaviridae

Incubation period of HAV

2-6 wks

How HAV travels to liver?

Via portal V

Gold standard for diagnosing HAV

Anti-HAV IgM by ELISA or RIA

Post-exposure prophylaxis for HAV

Anti-HAV antibody within 2 wks

HAV vaccine type

Killed HAV

Family and genus of HEV

Family Hepeviridae Genus Hepevirus