Viral hepatitis Flashcards

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1
Q

What is the key feature of fulminant hepatitis?

A

CNS effects

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2
Q

What virus family does Hep A belong to?

A

Picornavirus

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3
Q

What is the genome for Hep A?

A

+ssRNA

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4
Q

What is the incubation period for Hep A?

A

28 days

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5
Q

What is the association with Hep A and chronic and fulminant hepatitis?

A
  1. Does not cause chronic hepatitis 2. Rarely causes fulminant hepatitis
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6
Q

What is the diagnosis for Hep A?

A
  1. Acute - IgM against HAV 2. Anti-HAV IgG Abs seen in prior infections
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7
Q

What are the properties of the Hep A vaccine?

A
  1. IM - 2 doses 2. HAVRIX and VAQTA
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8
Q

What are Dane particles?

A

Infectious particles seen in HBV infection

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9
Q

What are the properties of the tubes and spheres seen in HBV infection?

A
  1. Incomplete, non-infectious 2. Indicate an active infection (Dane particles are present)
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10
Q

What virus family does hepatitis B belong to?

A

Hepadavirus

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11
Q

What is the Hep B genome?

A
  1. Partially dsDNA 2. Reverse transcriptase is part of life cycle
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12
Q

What are the components of the Hep B infectious (Dane) particle?

A
  1. Surface antigen 2. Core antigen 3. E antigen
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13
Q

What are the components of the Hep B non-infectious tubes and spheres?

A

Surface antigen only

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14
Q

What are the features of the Hep B core antigen?

A
  1. Separates genome from surface antigen 2. Non-soluble - not seen in blood stream 3. Anti-HBcAg Abs detected diagnostically
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15
Q

What are the features of the Hep B e antigen?

A
  1. Surrounds genome 2. Soluble - detectable in blood stream
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16
Q

What characterizes acute Hep B serology?

A
  1. 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
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17
Q

What characterizes chronic Hep B serology?

A
  1. 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)
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18
Q

What is the key feature of chronic Hep B serology?

A

Anti-surface Ag antibody is not produced (recovery is not occurring)

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19
Q

What is the diagnosis for Hep B?

A
  1. Viral antigens and anti-HBV Abs 2. Presence of HBsAg in blood
20
Q

What can be used to differentiate between chronic and acute Hep B infection?

A

Presence of HBsAg in blood

21
Q

If vaccinated against Hep B, antibody to what antigen would be seen?

A

HBsAg

22
Q

What is the transmission route for Hep B?

A

Body fluids

23
Q

What is the transmission route for Hep A?

A

Fecal-oral

24
Q

Young age of Hep B infection is correlated with what type of risk of chronic infection later in life?

A

High risk

25
Q

What are the treatments for chronic Hep B infection?

A
  1. Lamivudine - reverse transcriptase inhibitor 2. Famcylovir / Adefovir dipivoxil - nucleoside inhibitor 3. Interferon-alpha
26
Q

What is the Hep B vaccine composed of?

A

Purified HBsAg protein

27
Q

What virus family does Hep C belong to?

A

Flavivirus

28
Q

Is Hep C enveloped or non-enveloped?

A

Enveloped

29
Q

What is the Hep C genome?

A

+ssRNA

30
Q

What is the transmission for Hep C?

A

Bloodborne, body fluids

31
Q

What is the diagnosis for Hep C?

A
  1. Screening - Ab-based test for anti-HCV Abs 2. Confirmatory - nucleic acid based test for detection of viral genome
32
Q

Hep C infection will develop into chronic infection what percentage of the time?

A

70%

33
Q

What is the treatment for chronic genotype 1 Hep C?

A
  1. Ledipasvir / sofosbuvir 2. Paritaprevir / ritonavir / ombitasvir / dasabuvir, ribavirin 3. Sofosbuvir and semiprevir and/or ribavirin
34
Q

What is the treatment for chronic genotype 2 Hep C?

A

Sofosbuvir and ribavirin

35
Q

What drug is common to all Hep C treatments?

A

Sofosbuvir

36
Q

What is the Hep D genome?

A

Small circular ssRNA

37
Q

What proteins cover the Hep D virion?

A

Delta-short and delta-long

38
Q

What forms the external surface of the Hep D virion?

A

Hep B surface antigen

39
Q

What does Hep D require to replicate?

A

HBV proteins - only infects cells that have previously been infected with HBV

40
Q

What is the transmission for Hep D?

A

Body fluids

41
Q

Fulminant hepatitis infection is a more likely outcome with what type of infection?

A

HBV and HDV coinfection

42
Q

Which hepatitis virus directly injures hepatocytes?

A

Hep D

43
Q

What is the diagnosis for Hep D?

A

ELISA to detect anti-HDV Abs or delta antigens

44
Q

What virus family does Hep E belong to?

A

Hepevirus

45
Q

What is the Hep E transmission route?

A

Fecal-oral

46
Q

Does Hep E cause chronic infection?

A

No