Viral Hepatitis Flashcards
What is the most common mode of transmission of HBV in high prevalence areas?
Perinatal
How does HBV and HCV get from the intestinal epithelium to the liver?
Via the blood
What are the symptoms of chronic viral hepatitis?
General malaise
(Cirrhosis, liver cancer)
Which population gets the most severe acute diseaes from HBV infection?
> 5 years old
What are the symptoms of acute viral hepatitis?
Non specific, flu-like symptoms
Jaundice
Black urine
Pale faeces
How does HCV make protein?
Translates a single large polyprotein which it cleaves into different proteins
How long do symptoms last in Hep A infection?
2-3 weeks
What does HBV package with it in its virion?
DNA polymerase
Hepatitis B can lead to what type of cancer?
Hepatocellular carcinoma
What is a marker of active replication of HBV?
HBeAg
What family of virus is Hep E?
Hepeviridae
Which is more infectious, Hep A or E?
A
What is the incubation period of Hep E?
40 days average, 2-10 weeks
What are the symptoms of viral fulminant hepatitis?
Acute-like symptoms followed by liver failure and death
What does HCV virion associate with when excreted from cells?
Lipid droplets
Which virus particle is more fragile, Hep A or E?
E
What is the incubation period of HCV?
6-7 weeks average
Name some treatments for Hep E infection
Supportive therapy only
No immunoglobulin
What percentage of Intravenous drug users have HCV?
50-60%
Which virus family is Hep A from?
Picornaviridiae
Do HCV and HBV replicate in the intestinal epithelium?
No
What is a limitation of the Hep A vaccine?
It’s expensive to produce (requires diploid cells)
Requires 2-3 shots
How does Hep B infection lead to hepatocellular carcinoma?
Random integration into the hepatocyte genomes
Hepatitis infection in younger people tend to be what?
Less severe
Greater chance of chronic infection
T/F Hepatitis is cytolytic
False, damage is done by the immune response
How often does cholestasis occur in Hep E?
50%
When do you get Hep D infections?
When you already have HBV because HBD uses HBV surface ag
What type of HBV particles are there?
Double walled, infectious virion
Incomplete particles containing only surface protein
How many Australians are infected with HCV?
200,000
What translational technique utilised by HBV limits its ability to mutate?
Translation of the surface protein and the polymerase off the same transcript by using multiple reading frames
What are some sequelae of Hep C?
Liver fibrosis
Cirrhosis
Liver failure
Hepatocellular carcinoma
What are some complications of hep A infection?
Fulminant hepatitis
Cholestatic hepatitis (blockage of bile flow from liver to duodenum)
When is virus secreted in faeces in Hep E infection?
2 week before and 1 after symptoms
What percentage of infected individuals clear HCV infection?
30%
What ELISA results indicates an acute hep infection?
IgM ab
Rising IgG titre
Which hepatitis virus has the greatest amount of sexual transmission?
Hep B
What happens to the RNA progenome during HBV replication?
It acts as a template for reverse transcriptase
What percentage of >14 y.o. get symptoms in Hep A infection?
70-80%
What percentage of Hep B infected individuals develop hepatocellular carcinoma?
2-10%
What type of virus is Hep E?
Non-enveloped
+ ssRNA
isocosahedral
Which group of people is most at risk of death with Hep E infection?
Pregnant women (25-30% case fatality rate)
How many Australians develop cirrhosis each year?
5300
What anti-virals are available vs HBV?
Interferon-alpha
Nucleoside/tide analogues
An increase is ALT in the blood during hepatitis indicates what viral behaviour?
The virus is replicating
How many serotypes of Hep A are there?
1
What do the new antivirals for Hep C target?
Non-structural proteins
Why is it so difficult to develop a vaccine for Hep C?
It induces a weak immune response
Where does Hep A virus replicate in the body?
Intestinal epithelia
Hepatocytes
What viral proteins does the HBV genome encode?
Core
Polymerase
Surface
“X”
What type of genome does HBV have?
dsDNA
What type of virus of Hep A?
Non-enveloped
+sense ssRNA
30nm
Which ab’s are detectable in chronic HBV infection?
anti-HBcAb IgG
What type of vaccine is the hep A vaccine?
Inactivated
Which is more prevalent in Australia, HBV or HCV?
HCV
What type of virus is Hep C?
+ sense, ssRNA
Flavivirus
What is the problem with IFN-alpha treatment for Hepatitis?
It gives flu-like side effects
Only 30-40% response rate
What is the serological sign of a chronic HBV carrier?
Positive serum HBsAg
What is the incubation period of HBV?
60-90 days average
In which fluids is HBV most concentrated?
Blood
Serum
Wound exudates
How can the HCV polymerase be described?
Highly error prone
What is the incubation period of hep A infection?
Average 30 days, 15-50 days
Which hepatitis virus has the greatest perinatal transmission?
Hep B
What is the lifetime mortality of HCV infection?
~5%
How many carriers of are there of HBV worldwide?
350 million
What ag are detectable in chronic HBV infection?
HBeAg
HBsAg
What is the best diagnostic test to diagnose hepatitis?
Serology - ELISA
What is marker for acute HBV infection?
Anti-HBc IgM
What is a marker for recovery/immunity/vaccination against Hep B?
Anti-HBs Ig
What is the problem with the new HCV antivirals?
They’re extremely expensive
Which type of hepatitis is the most common is Australia?
Hep A
What occurs inside the host nucleus during HBV replication?
The epigenome is closed by covalent bonding and transcribed into a RNA progenome which is exported out of the nucleus
What is the rate of premature mortality from chronic liver disease?
15-25%
What treatment options are available for Hep A infection?
Immunoglobulin - only within 2 weeks of infection though
What is the difference between nucleotides and nucleoside analogues?
Nucleotide analogues have a phosphate group added
What percentage of HCV infections are due to intravenous drug use in Australia?
80%
