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Gastrointestinal System > Viral Hepatits - Microbiology > Flashcards

Viral Hepatits - Microbiology Flashcards

1
Q

What is viral hepatitis ?

A

Liver inflammation caused by a cirus

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2
Q

What are the specific hepatitis virus labels?

A

A
B
C
D
E
All these viruses are not from the same family but belong to different families; however, liver is their common site of infection

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3
Q

Which other virsuses can cause hepatitis?

A

Epstein-Barr virus
Cytomegalovirus

But liver is not their main target

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4
Q

How many people are living with viral hepatitis globally?

A

354 million people globally

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5
Q

How many deaths did viral hepatitis cause globally in 2015?

A

1.34 million deaths

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6
Q

What was the main cause of death for hepatitis?

A

Chronic liver disease

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7
Q

What are the numbers of people affected with HBV and HCV?

A

HBV = 257 million
HCV = 71 million

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8
Q

Which hepatitis virus kinds are the ones responsible for 96% of mortality rates?

A

Hep B
Hep C

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9
Q

What are the symptoms of viral hepatitis?

A

Fatigue and flu-like symptoms
Dark urine and light-coloured stool
Fever
Jaundice

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10
Q

What is the clinical presentation of acute hepatitis like?

A

Occurs with minimal symptoms

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11
Q

What are the symptoms of chronic viral hepatitis like? What effect does that have on diagnosis?

A

Mild and nonspecific
Diagnosis of chronic hepatitis is delayed

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12
Q

What is hepatitis A?

A

A single-stranded RNA virus that belongs to the picornavirus family
Non-enveloped

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13
Q

How many capsid polypeptides does the HAV version contain?

A

4 virons, VP1 to VP4
That makes HAV the main atigen

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14
Q

What is the transmission route of HAV?

A

Fecal-oral

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15
Q

What is the incubation period of HAV?

A

Four week

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16
Q

Where is the replication site of HAV? Where is it present?

A

Replication is limited to the liver
Virus found in the liver, bile, stools, and blood

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17
Q

What happens when jaundice becomes apparent in HAV?

A

Fecal shedding, viremia, and infectivity diminish rapidly

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18
Q

What is the replication cycle of HAV like? (6)

A
  1. Viral attachment (receptor binding) to hepatocytes and entry
    2.RNA uncoating
  2. Translation and polyprotein processing
  3. RNA replication
  4. Viron assembly and packaging
  5. Maturation and release
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19
Q

What are the receptor that HAV binds to in order to enter the cell?

A

HAV cellular receptor, mucin-like cass 1 integral membrane glycoprotein

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20
Q

What is HBV?

A

A circular DNA virus enveloped (double shell virion), which belongs to the hapadnavirus family

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21
Q

What are the main HBV antigens?

A

HBsAg
HBcAg
HBeAg

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22
Q

What is the route of transmission of HBV?

A

Parenteral
Percutaneous
Sexual

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23
Q

What is the incubation period of HBV?

A

50 to 180 days

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24
Q

What is the percentage of chronic HBV cases?

A

5 to 10%

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25
Q

What does concentrated serum from patients with HBV show?

A

Tubular and spherical particles of HBV surface antigens

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26
Q

What is the HBV replication cycle like? (11)

A
  1. Viral attachment to hepatocytes
  2. Fusion into the plasma membrane
  3. Release of nucleocapsids
  4. Cytoplsamic release of viral circular DNA with its polymerase
  5. Synthesis of DNA strands
  6. Transcription of viral RNA needed for protein production
  7. Translation of pregenomic RNA to core protein and viral polymerase
  8. Self-assembly of pgRNA containing nucleocapsids
  9. Reverse transcription of pgRNA to circular DNA production
  10. cccDNA-containing nucleocapsids are either imported to nucleus for more DNA replication
    OR
  11. Enveloped and secreted as complete virus
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27
Q

What is HCV?

A

Single-stranded RNA virus enveloped, belongs to flavivirus family

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28
Q

What are the main antigens of HCV? (5)

A

HCV
C100-3
C33-C
C22-3
NSS

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29
Q

What is the transmission route of HCV?

A

Parenteral

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30
Q

What is the incubation period of HCV like?

A

40 to 120 days

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31
Q

What is the replication cycle of HCV like? (7)

A
  1. Viral attachment (receptor binding) to hepatocytes and entry
  2. Fusion into the plasma membrane and uncoating
  3. Translation and polyprotein processing
  4. RNA replication
  5. Viron assembly
  6. Maturation & transport
  7. Release
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32
Q

What is HDV?

A

A single-stranded RNA virus enveloped belongs to the Ribovria family

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33
Q

Which are the main antigens of HDV?

A

HDV and HBsAg

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34
Q

What is the transmission route of HDV?

A

Perenteral

35
Q

What is a specific characteristic of HDV?

A

It exists only with HBV as a co-infection or super-infetion

36
Q

What is HEV?

A

A single-stranded RNA virus non-enveloped, belongs to the Hepeviridae family

37
Q

What is the main antigen of HEV?

A

HEV

38
Q

What is the transmission route of HEV?

A

Fecal-oral route

39
Q

What is the incubation period of HEV like?

A

40 days

40
Q

Which hepatitis infection types are self-limiting ?

A

HAV
HEV

41
Q

In which cases does the severity of HEV increase?

A

In pregnancy

42
Q

Which hepatitis infection types cannot cause chronic infection?

A

HAV
HEV

43
Q

What is the serological diagnosis of HAV?

A

Early fecal shedding diagnosis: IgM anti-HAV
Previous infection: IgG ant-HAV

44
Q

What is the serological diagnosis of HBV?

A

Acute diagnosis: HBsAg, IgM anti-HBc
Chronic diagnosis: IgG anti-HBc, HBsAg
Markers of replication: HBeAg, HBV DNA

45
Q

What is the serological diagnosis of HCV?

A

Acute diagnosis: anti-HCV (C33c, C22-3, NS5), HCV RNA
Chronic diagnosis: anti-HCV (C100-3, C33c, C22-3, NS5) HCV RNA

46
Q

What is the serological diagnosis of HDV?

A

HBsAg, IgM-HDV

47
Q

What is the serological diagnosis of HEV?

A

Acute fecal shedding: IgM-anti HEV

48
Q

How are serological markers of viral hepatitis measured?

A

ELISA

49
Q

What else is measured by ELISA?

A

Viral protein antigens and antibodies

50
Q

How are molecular markers of viral hepatitis measured?

A

PCR

51
Q

How is the viral load of viral hepatitis measured?

A

Quantitative RT - PCR

52
Q

What are HCV infections like?

A

Mostly subclinical with mild or no symptoms

But account for about 75% of chronic viral hepatitis cases

53
Q

Why is it difficult to clear HCV infections with antibody response?

A

HCV has rapid genetic mutations, enabling immune evasion

54
Q

What are the serological tests like for a patient with Acute Hep B?

A

HBsAg: positive
IgM anti-HAV: negative
IgM anti-HBc: positive
Ant-HCV: negative

55
Q

What are the serological tests like for a patient with Chronic Hep B?

A

HBsAg: positive
IgM anti-HAV: negative
IgM anti-HBc: negative
Ant-HCV: negative

56
Q

What are the serological tests like for a patient with acute hep A superimposed on a chronic hep B patient?

A

HBsAg: positive
IgM anti-HAV: positive
IgM anti-HBc: negative
Ant-HCV: negative

57
Q

What are the serological tests like for a patient with acute hep A and acute hep B?

A

HBsAg: positive
IgM anti-HAV: positive
IgM anti-HBc: positive
Ant-HCV: negative

58
Q

What are the serological tests like for a patient with acute hep A?

A

HBsAg: negative
IgM anti-HAV: positive
IgM anti-HBc: negative
Ant-HCV: negative

59
Q

What are the serological tests like for a patient with acute hep A and acute hep B (HBsAg below detection threshold)?

A

HBsAg: negative
IgM anti-HAV: positive
IgM anti-HBc: positive
Ant-HCV: negative

60
Q

What are the serological tests like for a patient with acute hep B (HBsAg below detection threshold)?

A

HBsAg: negative
IgM anti-HAV: negative
IgM anti-HBc: positive
Ant-HCV: negative

61
Q

What are the serological tests like for a patient with acute hep C?

A

HBsAg: negative
IgM anti-HAV: negative
IgM anti-HBc: negative
Ant-HCV: positive

62
Q

What is the aim of the pharmacological therapy for viral hepatitis?

A

In chronic hep B and C therapy is recommended to reduce liver inflammation and fibrosis and to prevent progression to cirrhosis and its complications

63
Q

What is the pharmacological therapy for viral hepatitis?

A

Interferons, antivirals, and corticosteroids

64
Q

Which are the nucleoside analogies that have shown promising results in the treatment of hepatitis B?

A

Lamivudine
Adefocir

64
Q

What is the pharmacological treatment for HCV?

A

Pegylated IFN
Antiviral ribavirin

65
Q

What is the prophylactic immune therapy?

A

Specific immunoglobulins are derived from the plasma of donors with high titers of antibodies against hepatitis viruses

66
Q

What is the main benefit of prophylactic immune therapy?

A

Specific immunoglobulins provide rapid post-exposure protection

67
Q

What are HBIG and HAIG?

A

Specific immunoglobulin preparation against Hep B and specific immunoglobulin preparation against Hep A

68
Q

Which viral hepatitis kinds are there vaccines available for?

A

HAV & HBV

69
Q

What is the HAV vaccine like?

A

Inactivated virus that confers about 20 years of immunity against HAV, it is given in two doses, 6 months apart for longer protection

70
Q

Who is recommended the HAV vaccine?

A

Travelers to endemic areas
Children over one year of age
People at high risk of infection

71
Q

Who are the people considered at high risk of the HAV infcetion? (6)

A

Gay men
Drug users, both injection and non-injection
Family and caregivers before the arrival of international adoptees
People with chronic liver diseases
People who are treated with clotting factor concentrates
People who work with HAV-infected animals or in HAV labs

72
Q

What is the suitable age for the administartion of the HAV vaccine?

A

Individuals aged one year and older

73
Q

Who should receive the HBV vaccine? (9)

A
  1. All children at birth
  2. All children and teens < 19 yo who have not been vaccinated
  3. People who are sexually active with someone who is infected or share drug injection equipment
  4. People with chronic liver or kidney disease
  5. People with HIV
  6. People < 60 yo with diabetes
  7. People whose jobs expose them to human blood and other bodily fluids
  8. Residents and staff of facilities with people with developmental disabilities
  9. People who travel to parts of the world where HBV is common
74
Q

What is the suitable age for the HBV vaccine?

A

Can be administered to individuals of all ages, from newborns to adults

75
Q

Why is there no vaccine for HCV?

A

HCV has different genotypes
It mutates easily and changes
There is a lack of proper in-vitro cell culture model
Lack of proper animal model

76
Q

What causes HCV to have different genotypes?

A

It is a quasivirus with various types of genotypes due to rapid mutations.

77
Q

In which cases does HDV become chronic?

A

When with HBV

78
Q

What can chronic viral hepatitis infections lead to?

A

Liver cirrhosis and liver cancer

79
Q

What is liver cirrhosis?

A

A disease in which normal liver cells are replaced by scar tissue, which interferes with important functions in the liver

80
Q

Which hepatitis type is the leading cause of cirrhosis and liver cancer?

A

HCV

81
Q

What is the hepatocellular carcinoma?

A

Primary malignancy of the liver occurs predominantly in patients with underlying chronic liver disease and cirrhosis

82
Q

What is the epidemiology of hepatocellular carcinoma?

A

3rd leading cause of cancer deaths worldwide, over 500000 affected

83
Q
A

Gastrointestinal System (28 decks)

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