Viral Hepatitis Flashcards
Are there elevated or decreased hepatic enzymes in hepatitis?
Which types of hepatitis are there vaccines for?
elevated
A, B, and E
When is IgM anti-HAV initially detectable associated with infection and stage?
How long does it stay detectable for?
IgM anti-HAV: detectable ~2 weeks from infection (when sx start) associated with acute phase
stays detectable for 3-6 months
When is IgG anti-HAV initially detectable associated to infection and stage?
How long does it stay detectable for?
IgG ant-HAV: detectable ~1-2 months AFTER infection associated with early convalescent phase
stays detectable for DECADES; associated with life long immunity
If you have a previous HAV or vaccination which Ig is detectable?
IgG
How is Hepatitis B “serum” transmitted?
via body fluid exposure, blood transfusion, IV drug abuse, needlestick contamination
Describe the HBV structure?
What are their respective antigens?
What are their respective antibodies?
inner core and outer capsule
- core antigen (HBcAG); antibody (anti-HBc)
- surface antigen (HBsAG); anti-HBs)
***Which antigen can we not measure but measure its antibody? (as compared to both being measured in the other)
core antigen (HBcAG)***
1) When is HBcAG produced?
2) What can be detected during the window period of HBV infection? What is the window period?
1) ONLY via immune response to ACTUAL infection (not vaccination)
2) IgM anti-HBc; resolving acute infection
TOTAL anti-HBc is the sum of what two things?
how do the two differ?
IgM and IgG
*IgG anti-HBc (past or chronic infection)
*IgM anti-HBc (seen in window period = acute infection
What are other markers for Hep B?
Which marker is more sensitive/precise for viral replication/infectivity?
What are they most useful for?
HBeAG and HBV-DNA
- used in chronic HBV to determine if antiviral therapy is indicated
What is HBeAG associated with?
How can HBV DNA be qualified?
- high levels of HBV DNA (ie. replication and infectivity)
- PCR tests
What does anti-HBs indicate?
IMMUNITY via vaccination or infection
Interpret serology on slide 41
HBsAg
if positive?
if Negative?
+ means ACTIVE infxn (acute or chronic)
- means they usually DONT have active infection… this is not absolute –> look at anti-HBs
(+) Anti-HBs means?
IMMUNITY; can be from vaccine or previous infxn
(+) Anti-HBc means?
does not confer disease immunity or mean infection has been cleared (can be past or present infection)
*IgG anti-HBc (past or chronic infection)
*IgM anti-HBc (seen in window period = acute infection
How is Hep C transmitted?
What is Hep C more likely to become?
What does testing for Hep C include?
- injection drug use, transfusions…
- chronic
- anti HCV antibodies; HCV RNA
1) When do Anti-HCV become detectable?
2) what anti-hcv results would you see in ACUTE?
3) what anti-hcv results would you see in CHRONIC?
1) 2-6 months
2) + OR - (in EARLY cases)
3) usually +
What could a + anti-hcv test indicate?
What is can a + Anti-HCV test NOT tell you?
- past OR current infection
- cannot differ from acute, chronic, or prior; cannot confer immunity
1) When is HCV RNA first detectable?
2) what HCV RNA results would you see in ACUTE?
3) what HCV RNA results would you see in CHRONIC?
4) what does a + HCV RNA test indicate? and not?
1) 8 weeks earlier than anti-hcv
2) acute: RNA levels fluctuate and could even be transiently undetectable in which you need to repeat the test
3) +
4) + indicated CURRENT infxn; not differ between acute and chronic
Review charts on slides 46 and 47
