13.2 Pathology: Infectious causes of hepatitis

Question 1

Where does hepatitis replicate?

How does damage occur?

Answer 1

Hepatocytes in the liver

Immune response causes liver damage

Question 2

Is hepatitis cytolytic?

Answer 2

No! Most disease is immune-mediated

Question 3

What does exposure to hepatitis in early life result in?

Answer 3

-Less severe acute disease

Higher rates of chronic -infection

Question 4

Which viruses cause chronic infection?

Answer 4

HBV, HCV

Question 5

Are hepatitis viruses related? Is there cross-protection?

Answer 5

Not related

No cross protection

Question 6

What family is HAV?

What kind of virus is it?

Answer 6

Picornaviridae-hepatovirus

Non-enveloped + ssRNA (resistant to stomach acid)

Question 7

What is the protection for HAV?

Answer 7

Immunisation (single serotype worldwide)

-Inactivated whole vaccine (highly effective, 100% after 2 doses)

Question 8

Where does HAV replicate?

Answer 8

Initially in intestinal epithelia, main site in liver

Question 9

What is the acute and chronic HAV serological response?

How can we determine this?

Answer 9

Acute: initial IgM increase
Chronic: IgG (rising titre)

Test via ELISA

Question 10

What family is HEV?

What kind of virus is it?

Answer 10

Hepeviridae (formerly Caliciviridae)

Non-enveloped + ssRNA (fragile)

Question 11

How is HEV transmitted?

How is it prevented?

Answer 11

Fecal contaminated water (minimal person to person transmission)

Sanitation (no vaccine yet, immune globulin not effective)

Question 12

What is the serological course of HEV?

Answer 12

Symptoms coincide with ALT end of increase, slow decrease.

IgM/IgG same as HAV