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Virology 11-20 > #15 viral hepatitis > Flashcards

#15 viral hepatitis Flashcards

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1
Q

what is hepatitis

A

inflammation of the liver

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2
Q

what are symptoms of acute hepatitis

A
  • dark urine
  • pale faeces
  • jaundice
  • flu like symptoms
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3
Q

how long does acute hepatitis last for

A

weeks to months

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4
Q

how long does chronic hepatitis last for

A

years to lifelong

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5
Q

what cells are infected from hepatitis

A

liver cells called hepatocytes

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6
Q

what causes liver damage in hepatitis?

A

the immune response against the virus

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7
Q

how can hepatitis enter the hepatocytes?

A

via immune cells in the circulation
via the circulation
via DCS

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8
Q

what are later phase symptoms of hepatitis

A

cirrhosis of the liver from chronic liver damage - can damage and lose function of the liver
hepatocellular carcinoma

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9
Q

is hepatitis cytopathic

A

no - its non-cytopathic

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10
Q

what determines the outcome of hepatitis infection?

A

age related outcomes!
younger people will have a less severe acute infection but they will have a higher chance of developing a chronic infection (as they have a immature immune system)
older people will have severe acute infection vbut may clear the virus and not become chronic

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11
Q

is there cross reactivity between the hepatitis viruses

A

there is no cross reactivity

infection with one virus will not protect from another hepatitis virus

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12
Q

can you clear Hep. B?

A

no - lifelong infection

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13
Q

can you clear hep. c?

A

no - lifelong infection EXCEPT if you are treated with antivirals

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14
Q

where is the source of Hep A and Hep. E

A

faeces

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15
Q

how do you catch Hep A and E

A

contaminated water or food/ fecal oral route is the main source
however it can be transmitted by blood, and sexual activity!

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16
Q

what type of infection is Hep A and E

A

acute

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17
Q

how can you prevent hep. E

A

clean drinking water

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18
Q

how can you prevent hep. A

A

pre or post immunisation

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19
Q

how is Hep. B transmitted

A

percutaneous
or
permucosal

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20
Q

how is Hep. C transmitted

A

percutaneous
or
permucosal

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21
Q

how is Hep. D transmitted

A

percutaneous
or
permucosal

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22
Q

what type of infection is Hep. B C and D

A

chronic

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23
Q

where is the source of Hep B C and D

A

blood and bodily fluids

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24
Q

how do you determine an acute infection?

A

ELISA serological test: test for high IgM - IgM presence or rising IgG to viral proteins is an indicator of a acute infection

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25
can you use nucleic acid tests to detect acute infection?
PCR yes - but it will not tell you how long the person has been infected for like ELISA can
26
what family is Hep. A and what is the genome | does it have an envelope
picornaviridae small +ssRNA no envelope (resistant to stomach acid)
27
is there a vaccine for Hep. A
yes | it can be cultured
28
describe the life cycle of Hep A and E
- virus ingested via food or water - replicates in the intestine epithelium then accesses blood to perform primary viremia - accesses hepatocytes - replicates in liver and is secreted into bile and faeces
29
what is the incubation period for Hep. A
30 days
30
what are the symptoms by age for Hep. A
- under 5 less than 10% will show symptoms | - over 14 70-80% will show symptoms
31
what are the symptoms of Hep. A
pale faeces dark urine jaundice vomiting
32
what is the chronic sequalae of Hep. A?
none. doesnt cause chronic infection
33
when can you measure virus in the faeces in Hep. A infected patient
virus can be measured in faeces before symptoms appear
34
what antibodies will be produced in a hep. a infection
firstly IgM will be produced then when the virus is being cleared they will class switch to IgG
35
what family is Hep. E in does it have an envelope what type of genome does it have
Hepeviridae its a Hepevirus no envelope +ssRNA
36
what are outbreaks of Hep. E associated with
outbreaks of fecally contaminated drinking water
37
how do you prevent Hep. E
clean sanitised drinking water
38
what is the incubation period for Hep. E
40 days
39
what is the chronic sequalae for hep E
none - does not cause a chronic infection
40
what does ALT mark
ALT is a marker of virus replication in the liver. increased ALT means increased virus replication
41
when do the symptoms of Hep. E show in comparison to when the virus is detectable?
the virus is detectable before the presence of symptoms
42
what family is hep b what is its genome is it enveloped
hepadnaviridae dsDNA enveloped
43
what are HBsAg
Hep. B surface antigens. they are produced as non-infectious particles they circulate in high levels in the blood contain only envelope proteins
44
what does the Pre-C region encode on Hep. B
it is the pre-core region on the genome encodes for HbeAg it is antigenic it determines replicating virus in cells
45
explain the lifecycle of Hep. B
- virus enters via blood or sex or needles - if its on the mucosa it will penetrate into the blood (if transmitted by needle it already enters the blood) - will access hepatocytes of liver and replicate there (it only replicates in the liver!!)
46
how much is Hep. B concentrated in secretions and blood?
highest in blood and serum moderate: semen, vaginal fluid and saliva low/not detectable: urine, faeces, sweat, tears, milk
47
what is the incubation period for Hep. B
60-90 days
48
what is the rate of chronic infection in people less than 5 yrs old for hep B
60-90% develop chronic infection due to immune system unable to clear the virus
49
what does the outcome depend on for hep. b infection?
the immune system under 5: low acute phase, high risk of chronic infection over 5: acute phase severe, and less likely to develop chronic hep. b
50
if a person develops chronic Hep. B what else can develop
- chronic > cirrhosis > liver cancer (end stage)
51
what is the serological response of a Hep. B acute infection?
- HbsAg rises as virus is replicating - immune response may cause symptoms - HbeAg will be measured in early stages - this will in the later stages switch to Anti-Hbe which indicates the virus is being controlled and will be cleared!!
52
what is the serological response of a Hep. B chronic infection?
- HbeAg will be ongoing and is showing that virus is replicating - indicator of chronic virus - no Anti-Hbe will be made - there are sustained levels of Ab for the core protein -AntiHbc - no viral clearance
53
what is the sequelae of Hep. B
chronic infection causes liver damage from the immune system cirrhosis, liver failure, hepatocarcinoma Hep. B is most common cause of liver cancer
54
how can hep. b infection be prevented
vaccination | it can be cultured
55
how is hep. b diagnosed
- A battery of serological tests are used for the diagnosis of acute and chronic hepatitis B infection. - HBsAg - used as a general marker of infection - Anti-HBs Ig - used to document recovery and/or immunity to HBV infection, but also successful vaccination - anti-HBc IgM - marker of acute infection - anti-HBc IgG - past or chronic infection - HBeAg - indicates active replication of virus and therefore effectiveness of therapy. - Anti-HBe Ig - virus no longer replicating. However, the patient can still be positive for HBsAg which is made by integrated HBV HBV-DNA - indicates active replication of virus, more accurate than HBeAg especially in cases of escape mutants. Used mainly for monitoring response to therapy
56
what does Hep. B vaccine protect against
Hep. B and D
57
what family is Hep. D | what is its genome
Deltavirus | +ssRNA - highly complimentary
58
what us unique about Hep. D infection
it only co-infects with Hep. B | it uses Hep. B surface antigen to gain access to hepatocytes
59
what family is Hep. C | what is its genome
flaviviridae | +ssRNA
60
80% of Hep. C infections occur through....
intravenous drug use
61
what percentage of people develop chronic hep. c infection
70% - high!
62
is there a vaccine for Hep. C
no - no animal model either
63
what proteins make up the viral RdRp of Hep. C
NS5B protein and NS3 protein make up the RdRp. it is highly error prone and introduces mutations
64
what is the incubation period for Hep. C
6-7 weeks
65
what percentage of people become infected with Hep. C
70% - high!
66
what is the sequalae of Hep C
liver damage - cirrhosis is the primary cause of hepatocellular carinoma
67
can Hep. C be cured?
yes - with antivirals

Virology 11-20 (8 decks)

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