Viral hepatitis Flashcards
To learn about Viral hepatitis.
The prefix Hepa– means what?
Liver
What is the Livers function in Humans?
- Blood filter
- Synthesis of coagulation proteins and immunity molecules (complements)
- Digestion; bile secretion
- Metabolism and storage of nutrients (Sugars, fats, and vitamins)
What does Hepatitis mean?
Hepa = liver
itis = inflammation
Hepatitis = liver inflammation
Hepatitis is usually divided into groups named?
A, B, C, D, E or G hepatitis virus abbreviated by H_V.
___ and ___ are responsible together of more than 90% of all viral hepatitis
HAV and HBV are responsible together of more than 90% of all viral hepatitis
Hepatitis A virus (HAV) is a _____ virus and is very resistant.
Picornavirus
True or False:
Hepatitis A virus (HAV) is also called infectious hepatitis and may occur in the form of epidemics accounting for 40% of acute hepatitis cases.
True
Hepatitis A virus (HAV) has how many serotypes identified?
Only one human serotype has been identified
HAV causes an ____ (acute or chronic) liver disease, usually self-limiting and can be transmitted by the fecal-oral route and by saliva
HAV causes an acute liver disease, usually self-limiting and can be transmitted by the fecal-oral route and by saliva
Initial replication of Hepatitis A virus (HAV) is in the ____ and the ___, followed by ____ through the blood to reach the liver
Initial replication of Hepatitis A virus (HAV) is in the oropharynx and GI, followed by viremia through the blood to reach the liver
Main form of Immunity to Hepatitis A virus (HAV) is?
Humoral – destruction of hepatocytes by the immune system.
How long is Hepatitis A virus (HAV) present in the stool, urine and blood?
Hepatitis A virus (HAV) is present in the stool for many weeks, mainly in the preclinical stage and in the blood during the short viremia phase. Never present in the urine
Does Hepatitis A virus (HAV) have any prodromes?
Prodroms: fever, fatigue, nausea, loss of appetite, abdominal pain.
Can Hepatitis A virus (HAV) cause Jaundice? If so how often?
Hepatitis A virus (HAV) causes Jaundice 10-20% in children, 60% in adults and extreme fatigue due to an elevated serum liver enzyme aminotransferase.
What is a very rare complication of Hepatitis A virus (HAV)?
Fulminant hepatitis (0.2% of cases)
What are: – Hygiene, treatment of drinking water – No anti-viral drug – HAV-Ig – Inactivated vaccine is available (travelers)?
Examples of treatment, prevention and control of Hepatitis A virus (HAV)?
True or False:
Serology of High level of IgM on week after infection followed by a high level of IgG (protective and persist for years) is a great way to test for Hepatitis A virus (HAV).
True
Hepatitis B virus (HBV) belong to what family of viruses?
Hepadnaviruses
What kind of virus is Hepatitis B virus (HBV)?
Enveloped circular (Class VII) ds DNA with an icosahedral capsid positive sense Replicates with a RNA intermediate
What is unusual about Hepatitis B virus (HBV) in regards to enveloped viruses?
Hepatitis B virus (HBV) virions are unusually resistant for an enveloped virus
Hepatitis B virus (HBV) can cause ____ (chronic or acute) hepatitis?
Both HBV can cause chronic or acute hepatitis
True or False:
Hepatitis B virus (HBV) genome contains 5 sections that encode 5 main proteins types.
True
Hepatitis B virus (HBV) genome section HBsAg encodes 3 surface proteins called?
HBsAg encodes 3 surface proteins L, S and M
Hepatitis B virus (HBV) genome section HBc encodes?
HBc encodes Core proteins
Hepatitis B virus (HBV) genome section Hbe encodes?
Hbe encodes E protein (early appearance in serum)
Hepatitis B virus (HBV) genome section Hbp encodes?
Section Hbp encodes the polymerases needed for replication.
True or False:
One of the proteins encoded in the genome of Hepatitis B virus (HBV) is call Z protein.
False
It is called X protein.
True or False:
Hepatitis B virus (HBV)proteins can be present in large aggregates, as non-infectious sphere and form particles of 17-25 nm in diameter.
True
Hepatitis B virus (HBV) is often known as serum hepatitis, meaning HBV is found in all biological fluids of an infected individual. Who are few groups of people that are at a high risk?
High risk populations – Intravenous drug users – Male homosexuals–Prostitutes – Healthcare workers – Partners of infected individuals
Initial replication of Hepatitis B virus (HBV) takes places in the ____ nodes followed by viremia and infection of the ____.
Initial replication of Hepatitis B virus (HBV) takes places in the lymph nodes followed by viremia and infection of the liver.
Once in the liver Once in the liver Hepatitis B virus (HBV) undergoes non lytic replication in the liver, slow spreading and cell destruction undergoes ____ replication in the liver, slow spreading and cell destruction
Once in the liver Hepatitis B virus (HBV) undergoes NON LYTIC replication in the liver, slow spreading and cell destruction
Not always the same as Lysogenic
What immune cell can actually aid the spread of Hepatitis B virus (HBV)?
Cytotoxic T-Lymphocyte (CTL) can kill the infected hepatocytes; also responsible for pathology
The Hepatitis B virus (HBV) has a relatively long incubation period of?
45 days
Once infected with Hepatitis B virus (HBV) what are the differences between Efficient immunity and Weak immunity?
Efficient immunity :
• Acute hepatitis (25% of all cases) or subclinical (65%), followed by total remission
• Jaundice, dark urine, lasts 1-2 months
Weak immunity:
• Chronic hepatitis (up to 10%), often subclinical
• With or without active viral replication
True or False:
Hepatitis A virus (HAV) and Hepatitis B virus (HBV) have very similar prodromes and complications of Fulminant hepatitis?
True
Additional complications of Hepatitis B virus (HBV) include which of the following except:
– Liver cirrhosis after chronic infection.
– Primary hepatocellular carcinoma
– Extra hepatic manifestations
– Dizziness
Dizziness is not a complication all the rest are.
True or False:
All Contraception methods help prevent the spread of Hepatitis B virus (HBV).
False
Only Barrier methods that prevent fluid transfers. (i.e. Condoms)
What kind of Vaccine does Hepatitis B virus (HBV) have and is it effective?
Recombinant HBsAg vaccine Efficacy of 95% (80%-100%) for about 20 years
Once infected with chronic Hepatitis B virus (HBV) what can be administered to help treat it?
Interferon Alpha (IFN-α) or Administration of Hepatitis B virus Immunoglobulin (HBVIg)
What kind of virus is Hepatitis C virus (HCV) and what is it’s structure?
Flavivirus and is an enveloped (Class IV) ss(+) RNA
What is the long incubation period of Hepatitis C virus (HCV)?
Incubation: up to 3-4 months
True or False:
Although Hepatitis C virus (HCV) has similar prodromes as HAV and HBV it has a low risk of being chronic.
False
During acute phase, clinical symptoms resemble those of hepatitis A or hepatitis B , but milder, but have higher risk of chronicity than hepatitis B 10%- 50% of cases
Acute infection of Hepatitis C virus (HCV) is only in about __–__% of cases with the remaining __–__% of cases are chronic.
Acute HCV infection resolves in about 10-15% of individuals. The remaining 85-90% develop chronic infection with the virus.
What percentage new Hepatitis C virus (HCV) infected people will exhibit symptoms of acute viral hepatitis?
About 25% of patients newly infected with HCV will exhibit signs and symptoms of acute viral hepatitis.
Chronic Hepatitis C virus (HCV) infection is _____ _____ in the majority of patients
Chronic Hepatitis C virus (HCV) infection is clinically silent in the majority of patients
What is meant when it is said that Chronic Hepatitis C virus (HCV) infection is clinically silent in the majority of patients?
- Most infected individuals exhibit no symptoms, and have no or only modest biochemical indication of liver damage.
- Many individuals are unaware of their infection until they develop symptoms associated with the complications of advanced liver disease
Is there a vaccine for Hepatitis C virus (HCV)?
No vaccine is available, but Antivirals recently available. All patients with chronic hepatitis C are potential candidates for antiviral therapy
What combination therapy has shown the most promise in Hepatitis C virus (HCV) infected individuals?
Combination therapy: Highest response rates have been achieved with interferon in combination with ribavirin (nucleoside inhibitor)
Best prevention practices for Hepatitis C virus (HCV)?
Similar to Hepatitis B virus (HBV)
What is meant by saying Hepatitis D virus (HDV) is a co-virus of Hepatitis B virus (HBV)?
Hepatitis D virus (HDV) is incomplete, can only replicate in the presence of hepatitis B virus
What kind of virus is Hepatitis D virus (HDV)?
Agent d: circular ssRNA virus, incomplete,
True of False:
Hepatitis E virus (HEV) is Similar to Hepatitis A virus (HAV) in almost every way. except has no chronic chance.
True
what is the morbidity rate of Hepatitis E virus (HEV)?
Low morbidity except in pregnant women (cirrhosis)
Hepatitis G virus (HGV) is a newly discover virus and is a ____ like Hepatitis C virus (HCV)
Hepatitis G virus (HGV) is a newly discover virus and is a Flavivirus like Hepatitis C virus (HCV)
What dieses does Hepatitis G virus (HGV) cause?
None known yet.