Viral Hepatitis (JB)

Question 1

A general term used to indicate an infection of the liver caused by one of several major distinct viral agents.
Symptoms, which vary in severity and are not specific to the causative agent, include: Anorexia and weight loss; Hepatic tenderness; Jaundice and dark urine.

Answer 1

Viral Hepatitis

Question 2

Hepatitis B (HBV) – genus Hepadnavirus
(1) Viral structure -- \_\_\_\_\_, DNA virus

(a) Envelope – Hepatitis B ____ Antigen (HBsAg)
(b) Core – DNA and DNA polymerase

• Hepatitis B ____ Antigen (HBcAg)
• Hepatitis B “_” Antigen (HBeAg) (“e” antigen of the core) – presence is associated with relatively high infectivity

Answer 2

Enveloped

Surface (HBsAg)

Core (HBcAg)

“e” (HBeAg)

Question 3

HEP B
Transmission - ____ route most predominant mode. Contact with blood or blood products, usually via contaminated needles or syringes.

Answer 3

Parenteral

Question 4

HEP B
High risk groups
• Intravenous drug users; male homosexuals
• Patients with multiple transfusions; ____; Dialysis

Answer 4

Hemophiliacs

Question 5

HEP B
Incubation period
• Usually 45 to 180 days
• Replicates in ____

Answer 5

Liver

Question 6

HEP B
Immunological markers for diagnosis
(a) Terms:
• Prefix “anti-“ (e.g. anti-HBs) – Refers to an “antibody” or immunoglobulin for the antigen indicated
• ____: An antigen or antibody used to indicate the status of disease or recovery.

Answer 6

Marker

Question 7

HEP B
____ - An immune response that is characterized by a conversion from the absence of a specific antibody to the presence of that specific antibody.

Answer 7

Seroconversion

Question 8

HBsAg (i.e. ????)
• Earliest marker of acute infection; indicates infectious state
• Persistence over 6 months implies chronic disease (failure to seroconvert to anti-HBs)

Answer 8

Hepatitis B Surface Antigen

Question 9

HBeAg (core-associated “e” antigen)

• Early indicator of acute infection, active virus replication, and ___ ___ period

Answer 9

Most Infectious

Question 10

HBeAg (core-associated “e” antigen)• Persistence beyond 10 weeks indicative of progression to chronic carrier state and probable chronic ___ damage

Answer 10

Liver

Question 11

Anti-HBe (antibody to Hepatitis B “e” antigen of the core)
• Seroconversion from HBeAg to anti-HBe usually occurs during __ __ __ - suggests resolution of infection and lowering of transmissibility
• Chronic/carriers fail to ____ during acute phase

Answer 11

Anti-HBe (antibody to Hepatitis B “e” antigen of the core)
• Seroconversion from HBeAg to anti-HBe usually occurs during late acute phase - suggests resolution of infection and lowering of transmissibility
• Chronic/carriers fail to seroconvert during acute phase

Question 12

Anti-HBs (antibody to Hepatitis B surface antigen)
• Appears during ____ – indicates recovery and immunity
• Major protective antibody against ___ (also develops from vaccination)
• Failure to seroconvert indicative of chronic infection

Answer 12

Anti-HBs (antibody to Hepatitis B surface antigen)
• Appears during convalescence – indicates recovery and immunity
• Major protective antibody against HBV (also develops from vaccination)
• Failure to seroconvert indicative of chronic infection

Question 13

Type of HBV infection that resolves within 3-6 months?

Answer 13

Acute Infection

Question 14

Type of HBV infection that may last for several months to decades with or without symptoms

Answer 14

Chronic/chronic carrier infection

Question 15

Infection may progress with continued active secretion of ____ in the absence of apparent active viral replication

Answer 15

Infection may progress with continued active secretion of HBsAg in the absence of apparent active viral replication

Question 16

Is there a HBV vaccine?

Answer 16

HBV vaccine – Active, long term immunity (anti-HBs) (85-95% success)

Question 17

Hepatitis C (HCV) – genus ___, ___ family

Answer 17

Hepatitis C (HCV) – genus Hepacivirus, Flaviviridae family

Question 18

Hepatitis C (HCV) – genus Hepacivirus, Flaviviridae family

(1) Viral structure – Small, lipid-enveloped ___ virus
(2) Transmission - ____ route

Answer 18

Hepatitis C (HCV) – genus Hepacivirus, Flaviviridae family

(1) Viral structure – Small, lipid-enveloped RNA virus
(2) Transmission - parenteral route

Question 19

HCV:
Disease state/stages very similar to Hepatitis B
(a) Accounts for 15-40% of _____ acquired hepatitis; increased in IV drug users;
(b) High co-infection with ___
(4) No vaccine (too many antigenic subtypes)

Answer 19

HCV:
Disease state/stages very similar to Hepatitis B
(a) Accounts for 15-40% of community acquired hepatitis; increased in IV drug users;
(b) High co-infection with HIV
(4) No vaccine (too many antigenic subtypes)

Question 20

Hepatitis A – genus ____

1) Structure – Small, ______, RNA virus – Capsid protein (HA Ag

Answer 20

Hepatitis A – genus Hepatovirus

1) Structure – Small, nonenveloped, RNA virus – Capsid protein (HA Ag

Question 21

Hep A:
Epidemiology
(a) Transmission – ???

(b) High risk groups: ???

Answer 21

Epidemiology
HEP A:
(a) Transmission – fecal-oral route (enteric route) (primarily via food and water)

(b) High risk groups: Institutionalized persons
Children in Day care centers
WORLD TRAVELERS***
Military
Drug Addicts (CAN BE PARENTERAL***)

Question 22

HEP A:
Course of infection
(a) Incubation period - 15 to 45 days

(b) Replicates within ___ and ___ ___
(c) ___ and ___ are infectious during 2-6 week incubation and early illness period –

No chronic state or carrier state

Answer 22

HEP A:
Course of infection
(a) Incubation period - 15 to 45 days

(b) Replicates within liver and small intestines
(c) Blood and feces are infectious during 2-6 week incubation and early illness period –

No chronic state or carrier state