Microbiology 5s: Viral Hepatitis

Question 1

What are the different hepatitis viruses?

Answer 1

• Hep A
• Hep B
• Hep C
• Hep D
• Hep E
• Hep G

Question 2

Which hepatitis viruses are transmitted faecorally?

Answer 2

fAEcal-oral = Hep A + Hep E

Question 3

Which is the most common hepatitis virus globally?

Answer 3

Hep B

Question 4

Route of transmission of Hep B?

Answer 4

• Sexually transmitted,
• IVDU,
• blood products,
• vertical

Question 5

Route of transmission of Hep D?

Answer 5

• Sexually transmitted,
• IVDU,
• blood products

not vertically

Requires co-hepatitis B infection (satellite virus) !

Question 6

Which hepatitis virus is associated with shellfish & pork consumption?

Answer 6

Hep E

pork because zoonosis

Question 7

Which hepatitis viruses have vaccines?

Answer 7

Hep A, B, E

Question 8

What is the viral structure of hepatitis viruses?

Answer 8

All RNA viruses

except Hep B = DNA virus

Question 9

What is interesting about hepatitis B’s replication?

Answer 9

• 1st, only DNA virus of all the hepatitis viruses
• uses reverse transcriptase to replicate → some HIV drugs effective

Question 10

Which of the hepatitis viruses are part of the flaviviridae family?

Answer 10

Hep C

Question 11

Which of the hepatitis viruses are part of the hepeviridae family?

Answer 11

Hep E

Question 12

How many genotypes of Hep D are there?

Answer 12

• 6 genotypes
• 1,2,3 most common

Question 13

How many genotypes of Hep E are there?

Answer 13

• 4 genotypes
• 1,2 affects humans

Question 14

Order the incubation periods of the hepatitis viruses (shortest to longest)

Answer 14

shortest

• Hep A/E - 2-6wks
• Hep D - 3-7wks
• Hep C - 6-8wks
• Hep B - 2-6months

longest

Question 15

Which hepatitis infections are often subclinical?

Answer 15

• Hep A
• Hep B

Question 16

Which hepatitis infections are notifiable?

Answer 16

all of them

Question 17

What are the stages of Hep B infection?

Answer 17

Immune tolerant

• → Immune reactive
• → Inactive HBV carrier state
• → HBeAg -ve chronic HBV
• → HBsAg -ve phase (cleared infection)

Question 18

What are the 2 types of HDV infection?

Answer 18

• HBV + HDV co-infection (infected with both simultaneously) OR
• HDV-super infection (chronic HBV infected with HDV)

Question 19

Summarise the Ix for the different Hepatitis viruses

Answer 19

Question 20

Which hepatitis infections are acute?

Answer 20

Only acute:

• Hep A
• Hep E

Mostly acute, can be chronic:

• Hep B
  
  • Adults = 5-10% chance of developing chronic
  • Babies = 95% chance
• Hep B/D coinfection
  
  • 2% chronic

Question 21

Which hepatitis infections are mostly chronic?

Answer 21

• Hep C
  
  • Higher rate of chronicity (60-80%) than other types of simple hepatitis
• HDV superinfection (on chronic Hep B)
  
  • 90% chronic

Question 22

Summarise Tx for different types of hepatitis

Answer 22

Question 23

What is a major complications associated with Hep B?

Answer 23

Hepatic fibrosis → cirrhosis → HCC (hepatocellular carcinoma)

Question 24

What are some rare complications of Hep E infection?

Answer 24

• CNS Disease (Bell’s, GBS)
• Chronic infection
• Genotype 1 = high mortality in pregnancy (3^rd trimester)