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Kat's Pathology > Viral Hepatitis > Flashcards

Viral Hepatitis Flashcards

1
Q

Where is there a high prevalence of hepatitis infections (3)

A

South America
Africa
South East Asia

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2
Q

How soon after infection does hepatitis A infection become symptomatic

A

2-6 weeks

Often subclinical

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3
Q

How is hepatitis A spread

A

Faeco-oral spread

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4
Q

Is hepatitis A a notifiable disease

A

Yes

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5
Q

What occurs during a hepatitis A infection (3)

A

Raised ALT
HAV in stool
IgM

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6
Q

What is left after the hepatitis A virus is cleared

A

IgG

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7
Q

Anti-HAV IgM

A

Recent infection (or vaccine)

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8
Q

Anti-HAV-IgG

A

Recent infection (or vaccine)

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9
Q

Where are HBeAg found

A

In the core of the virus

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10
Q

Where are HBsAg found

A

Viral envelope

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11
Q

How is hepatitis B spread (3)

A

Sexual
Vertical transmission
Blood products

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12
Q

How does hepB present (2)

A

Acute

Chronic

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13
Q

What is chronic hepB

A

Infection present for >6 months

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14
Q

What is present in the serum in chronic hepB infection (4)

A

Anti-HBc
Anti-HBs
Anti-HBe
Anti-HBc IgM

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15
Q

What are the long term consequences of hepatitis B infection (3)

A

Hepatic fibrosis
Cirrhosis of the liver
Liver cancer

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16
Q

What are the HBV disease stages (5)

A 
Immune tolerant 
Immune reactive 
Inactive HBV carrier state 
HBeAg negative chronic HBV
HBsAg negative phase
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17
Q

What did the REVEAL study discover related to HBV infection (2)

A

Increased incidence of cirrhosis with increasing baseline serum HBV DNA level
Increased incidence of HCC with increasing HBV DNA baseline viral level

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18
Q

What drugs are used to treat chronic HBV (6)

A 
Interferon alpha 
Lamiduvine 
Adefovir
Tenofovir
Entacavir
Emtricitabile
19
Q

What family of viruses does HCV belong to

A

Flaviviridae

20
Q

How is HCV spread

A

Mainly blood product spread

21
Q

What proportion of HCV infections are chronic

A

60-80%

22
Q

What are the two possible outcomes of acute hepatitis C infection (2)

A

Clears 20-40%

Chronic 60-80%

23
Q

What is the serology in acute HCV (2)

A

Sharp spike in ALT

Followed by rise in anti-HCV

24
Q

What are the long term effects of HCV infection on the liver (3)

A

Hepatic fibrosis
Cirrhosis
Liver cancer (HCC)

25
Q

What are the treatment targets for chronic HCV infection (3)

A 
NS3/4 serine protease, RNA helicase.
NS5A RNA(unknown action)
NS5B RNA dependent RNA polymerase
26
Q

What are some drugs used to target NS3/4 serine protease in hepatitis C (3)

A

Teleprevir
Boceprevir
SImeprevir

27
Q

What are somedrugs used to target NS5A RNA in hepatitis C (3)

A

Ledipasvir
Daclatasvir
Elbasvir

28
Q

What drugs are used to target NS5B RNA dependent RNA polymerase in hepatitis C infection (3)

A

Sofosbuvir
Dasabuvir
Beclabuvir

29
Q

What rises acutely following hepatitis D infection (3)

A

IgM anti-HDV
HDV RNA
HBsAg

30
Q

What is present after HDV infection

A

Anti-HBs

31
Q

What is required for HDV infection

A

HBV infection

32
Q

What family does HEV belong to

A

Hepeviradae

33
Q

Where is HEV present (2)

A

SE Asia

Africa

34
Q

What are the different HEV genotypes (2)

A

Genotypes 1 and 2 - human, epidemic

Genotype 3 and 4 - swine and other (humans accidental hose = zoonosis)

35
Q

Can HEV be transmitted person-person

A

Very rarely

36
Q

What is the incubation period for HEV

A

3-8 weeks

37
Q

What is a danger of HEV in pregnancy

A

Genotype 1 has a high mortality in pregnancy

38
Q

What are some rare complications of HEV (4)

A

CNS disease - Bell’s palsy, Guillain Barre, other neuropathy
Chronic infection

39
Q

What is the treatment for HEV (2)

A

Supportive

Ribavirin

40
Q

Is there a vaccine for HEV

A

Yes - trials with recombinant HEVg1 in Nepalese military and Chinese

41
Q

How is HEV detected

A

HEV antigen becomes detectable in stool and serum during the incubation period

42
Q

What is present in the late stages of HEV infection (2)

A

IgG anti-HEV antibody

IgM ant-HEV antibody

43
Q

What is an effective HCV treatment

A

Peginterferon combination therapy is the best

Kat's Pathology (105 decks)

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