Virology10 Flashcards
T or F
HBc antigen can be found in blood
While Hbe i can’t detect it
False
We should look for the anti HBc
It’s not soluble
Hbe is soluble and we can detect it
Window period is :
The gap between the disappearance of the sAg and the formation of antibody
State the case of each of the following patients:
HbsAg Anti-Hbs Anti-HBc Negative Negative Negative Negative Positive Negative Negative Positive Positive Positive Negative IgM pos Positive Negative IgG positive
Susceptible Vaccinated Past infection Acute infection Chronic infection
Stages of hepatitis B exacerbation:
Immune tolerant: viral load is high and we have HBe(soluble, indicator), normal LFTs
Inmune clearance: lowering of viral load and HBs become to disappear, increasing 5-fold of LFTs (not the case for HepC) , immunopathological damage
Immune control: seroconversion of HBe antigen, viral load is almost null
Immune active: high LFTs and high viral load.
Causes of reactivation of hepB (immune active):
1-
2-
3-
1- hepD
2- immunosuppresion(HIV)
3- stress
HepC
Fam:
Envelope:
Genome:
Flavivirus
Enveloped
+ ss RNA
Hep B risk of infection as an infant is to —— while as an adult ——-
Develop adulthood chronic disease
And to develop hepatocarcinoma
95% is the percentage to recover fully (good)
T or F
Hep B and C don’t have extra hepatic manifestations
False they have (rash , vasculitis, arthritis, glomerulo nephritis)
MOT of hepC:
Contaminated blood
Snorting (injury of nasal mucosa in drug dealers) (epistaxis)
Darb l haidar
Genotypes in hepatitis C are called—– and the most aggressive one is—–
Clades
1b
In religous rituals what infectious agents should be asked:
The ones transmitted by body fluids HIV B C Syphilis
Role of NS5A protein:
Inhibits apoptosis and this will lead to more cytokine release and consequently more damage (immune-mediated cytolysis)
Management of HCV infection:
Ask for serum test to look for Anti-HCV
HCV genotyping to know which genotype and treat upon the result
Characteristics of chronic HCV:
Not a very high LFTs (like in B)
80% byaamlu chronic
20% mn l acute hepatitis hene HCV
T or F
HepC causes hepatocarcinoma
True
It constitutes 25% of the hepatocarcinoma patients around the world
T or F
Cirrhosis will happen after 10 years of infection with hepC
False
After 20-30
Highly predisposed to chronic hepC: 1- 2 3 4 5 6
Older than 40 Alcohol HIV-HBV Immunosuppresion Diabetes or obesity Schistosomiasis ( bilharzia) le met feha abd l halim hafez allah yrham ruhu
All pateints should be treated(after hepC infection) except:
Pregnant
Liver transplant list
End of life ( baadelu 6 months la ymut)
Sustained viral remission:
After 4 months of completing treatment we do pcr if it’s negative then i cleared the virus from the body
Tx for hepC
1-Interferon alpha with PEG (polyethylene glycol) (provide long half life)
2-We can add ribavirin (as synergistic) (discontinued because of it’s side effects)
3- Direct acting antivirals
4- we should always take into consideration genotype- renal status and medications
HepD
Genus: Fam: Envelope: Genome: Active or defective: Surface antigen:
Deltavitus (D for Delta) No fam Enveloped Ss- circular RNA Defective ( as it's name D for defective) HBsAg (mtl men ya helu?)
T or F
Hepatitis D can’t infect unless it’s with B, and this will cause very severe hepatitis
True
MOT of hep D
Same as B
Coinfection
Superinfection
T or F
Hep E is same as A but it doesn’t cause fulminant hepatits
False
It causes fulminant hepatitis especially in pregos
Varicella causes—– and can be severe in pregnant woman.
Pneumonia
T or F
Both hep A and E don’t have vaccines
False
Hep A has while E doesn’t
