Viral hepatitis Flashcards
What is the key feature of fulminant hepatitis?
CNS effects
What virus family does Hep A belong to?
Picornavirus
What is the genome for Hep A?
+ssRNA
What is the incubation period for Hep A?
28 days
What is the association with Hep A and chronic and fulminant hepatitis?
- Does not cause chronic hepatitis 2. Rarely causes fulminant hepatitis
What is the diagnosis for Hep A?
- Acute - IgM against HAV 2. Anti-HAV IgG Abs seen in prior infections
What are the properties of the Hep A vaccine?
- IM - 2 doses 2. HAVRIX and VAQTA
What are Dane particles?
Infectious particles seen in HBV infection
What are the properties of the tubes and spheres seen in HBV infection?
- Incomplete, non-infectious 2. Indicate an active infection (Dane particles are present)
What virus family does hepatitis B belong to?
Hepadavirus
What is the Hep B genome?
- Partially dsDNA 2. Reverse transcriptase is part of life cycle
What are the components of the Hep B infectious (Dane) particle?
- Surface antigen 2. Core antigen 3. E antigen
What are the components of the Hep B non-infectious tubes and spheres?
Surface antigen only
What are the features of the Hep B core antigen?
- Separates genome from surface antigen 2. Non-soluble - not seen in blood stream 3. Anti-HBcAg Abs detected diagnostically
What are the features of the Hep B e antigen?
- Surrounds genome 2. Soluble - detectable in blood stream
What characterizes acute Hep B serology?
- Surface antigen goes up early then drops upon clearance 2. Ab to surface Ag goes up as Ag disappears 3. Igm seen against core antigen initially, then IgG as it progresses
What characterizes chronic Hep B serology?
- Surface antigen starts out high (similar to acute) 2. Maintenance of high surface Ag levels (different from acute) 3. Anti core Ag present but IgM goes down early 4. Primary Ab seen is IgG 5. Anti surface Ag Ab is not produced (key feature)
What is the key feature of chronic Hep B serology?
Anti-surface Ag antibody is not produced (recovery is not occurring)
What is the diagnosis for Hep B?
- Viral antigens and anti-HBV Abs 2. Presence of HBsAg in blood
What can be used to differentiate between chronic and acute Hep B infection?
Presence of HBsAg in blood
If vaccinated against Hep B, antibody to what antigen would be seen?
HBsAg
What is the transmission route for Hep B?
Body fluids
What is the transmission route for Hep A?
Fecal-oral
Young age of Hep B infection is correlated with what type of risk of chronic infection later in life?
High risk
What are the treatments for chronic Hep B infection?
- Lamivudine - reverse transcriptase inhibitor 2. Famcylovir / Adefovir dipivoxil - nucleoside inhibitor 3. Interferon-alpha
What is the Hep B vaccine composed of?
Purified HBsAg protein
What virus family does Hep C belong to?
Flavivirus
Is Hep C enveloped or non-enveloped?
Enveloped
What is the Hep C genome?
+ssRNA
What is the transmission for Hep C?
Bloodborne, body fluids
What is the diagnosis for Hep C?
- Screening - Ab-based test for anti-HCV Abs 2. Confirmatory - nucleic acid based test for detection of viral genome
Hep C infection will develop into chronic infection what percentage of the time?
70%
What is the treatment for chronic genotype 1 Hep C?
- Ledipasvir / sofosbuvir 2. Paritaprevir / ritonavir / ombitasvir / dasabuvir, ribavirin 3. Sofosbuvir and semiprevir and/or ribavirin
What is the treatment for chronic genotype 2 Hep C?
Sofosbuvir and ribavirin
What drug is common to all Hep C treatments?
Sofosbuvir
What is the Hep D genome?
Small circular ssRNA
What proteins cover the Hep D virion?
Delta-short and delta-long
What forms the external surface of the Hep D virion?
Hep B surface antigen
What does Hep D require to replicate?
HBV proteins - only infects cells that have previously been infected with HBV
What is the transmission for Hep D?
Body fluids
Fulminant hepatitis infection is a more likely outcome with what type of infection?
HBV and HDV coinfection
Which hepatitis virus directly injures hepatocytes?
Hep D
What is the diagnosis for Hep D?
ELISA to detect anti-HDV Abs or delta antigens
What virus family does Hep E belong to?
Hepevirus
What is the Hep E transmission route?
Fecal-oral
Does Hep E cause chronic infection?
No