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Hugh's MD1 Abdominal > Viral Hepatitis > Flashcards

Viral Hepatitis Flashcards

1
Q

What is the most common mode of transmission of HBV in high prevalence areas?

A

Perinatal

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2
Q

How does HBV and HCV get from the intestinal epithelium to the liver?

A

Via the blood

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3
Q

What are the symptoms of chronic viral hepatitis?

A

General malaise

(Cirrhosis, liver cancer)

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3
Q

Which population gets the most severe acute diseaes from HBV infection?

A

> 5 years old

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4
Q

What are the symptoms of acute viral hepatitis?

A

Non specific, flu-like symptoms

Jaundice

Black urine

Pale faeces

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4
Q

How does HCV make protein?

A

Translates a single large polyprotein which it cleaves into different proteins

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5
Q

How long do symptoms last in Hep A infection?

A

2-3 weeks

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5
Q

What does HBV package with it in its virion?

A

DNA polymerase

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5
Q

Hepatitis B can lead to what type of cancer?

A

Hepatocellular carcinoma

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6
Q

What is a marker of active replication of HBV?

A

HBeAg

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7
Q

What family of virus is Hep E?

A

Hepeviridae

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8
Q

Which is more infectious, Hep A or E?

A

A

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9
Q

What is the incubation period of Hep E?

A

40 days average, 2-10 weeks

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10
Q

What are the symptoms of viral fulminant hepatitis?

A

Acute-like symptoms followed by liver failure and death

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10
Q

What does HCV virion associate with when excreted from cells?

A

Lipid droplets

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11
Q

Which virus particle is more fragile, Hep A or E?

A

E

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11
Q

What is the incubation period of HCV?

A

6-7 weeks average

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12
Q

Name some treatments for Hep E infection

A

Supportive therapy only

No immunoglobulin

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12
Q

What percentage of Intravenous drug users have HCV?

A

50-60%

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13
Q

Which virus family is Hep A from?

A

Picornaviridiae

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13
Q

Do HCV and HBV replicate in the intestinal epithelium?

A

No

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14
Q

What is a limitation of the Hep A vaccine?

A

It’s expensive to produce (requires diploid cells)

Requires 2-3 shots

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15
Q

How does Hep B infection lead to hepatocellular carcinoma?

A

Random integration into the hepatocyte genomes

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16
Q

Hepatitis infection in younger people tend to be what?

A

Less severe

Greater chance of chronic infection

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17
Q

T/F Hepatitis is cytolytic

A

False, damage is done by the immune response

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18
Q

How often does cholestasis occur in Hep E?

A

50%

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19
Q

When do you get Hep D infections?

A

When you already have HBV because HBD uses HBV surface ag

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20
Q

What type of HBV particles are there?

A

Double walled, infectious virion

Incomplete particles containing only surface protein

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20
Q

How many Australians are infected with HCV?

A

200,000

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22
Q

What translational technique utilised by HBV limits its ability to mutate?

A

Translation of the surface protein and the polymerase off the same transcript by using multiple reading frames

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23
Q

What are some sequelae of Hep C?

A

Liver fibrosis

Cirrhosis

Liver failure

Hepatocellular carcinoma

24
Q

What are some complications of hep A infection?

A

Fulminant hepatitis

Cholestatic hepatitis (blockage of bile flow from liver to duodenum)

24
Q

When is virus secreted in faeces in Hep E infection?

A

2 week before and 1 after symptoms

25
Q

What percentage of infected individuals clear HCV infection?

A

30%

26
Q

What ELISA results indicates an acute hep infection?

A

IgM ab

Rising IgG titre

26
Q

Which hepatitis virus has the greatest amount of sexual transmission?

A

Hep B

28
Q

What happens to the RNA progenome during HBV replication?

A

It acts as a template for reverse transcriptase

29
Q

What percentage of >14 y.o. get symptoms in Hep A infection?

A

70-80%

31
Q

What percentage of Hep B infected individuals develop hepatocellular carcinoma?

A

2-10%

32
Q

What type of virus is Hep E?

A

Non-enveloped

+ ssRNA

isocosahedral

33
Q

Which group of people is most at risk of death with Hep E infection?

A

Pregnant women (25-30% case fatality rate)

34
Q

How many Australians develop cirrhosis each year?

A

5300

36
Q

What anti-virals are available vs HBV?

A

Interferon-alpha

Nucleoside/tide analogues

37
Q

An increase is ALT in the blood during hepatitis indicates what viral behaviour?

A

The virus is replicating

38
Q

How many serotypes of Hep A are there?

A

1

40
Q

What do the new antivirals for Hep C target?

A

Non-structural proteins

41
Q

Why is it so difficult to develop a vaccine for Hep C?

A

It induces a weak immune response

42
Q

Where does Hep A virus replicate in the body?

A

Intestinal epithelia

Hepatocytes

43
Q

What viral proteins does the HBV genome encode?

A

Core

Polymerase

Surface

“X”

45
Q

What type of genome does HBV have?

A

dsDNA

47
Q

What type of virus of Hep A?

A

Non-enveloped

+sense ssRNA

30nm

49
Q

Which ab’s are detectable in chronic HBV infection?

A

anti-HBcAb IgG

51
Q

What type of vaccine is the hep A vaccine?

A

Inactivated

52
Q

Which is more prevalent in Australia, HBV or HCV?

A

HCV

54
Q

What type of virus is Hep C?

A

+ sense, ssRNA

Flavivirus

55
Q

What is the problem with IFN-alpha treatment for Hepatitis?

A

It gives flu-like side effects

Only 30-40% response rate

57
Q

What is the serological sign of a chronic HBV carrier?

A

Positive serum HBsAg

58
Q

What is the incubation period of HBV?

A

60-90 days average

59
Q

In which fluids is HBV most concentrated?

A

Blood

Serum

Wound exudates

60
Q

How can the HCV polymerase be described?

A

Highly error prone

61
Q

What is the incubation period of hep A infection?

A

Average 30 days, 15-50 days

62
Q

Which hepatitis virus has the greatest perinatal transmission?

A

Hep B

63
Q

What is the lifetime mortality of HCV infection?

A

~5%

64
Q

How many carriers of are there of HBV worldwide?

A

350 million

65
Q

What ag are detectable in chronic HBV infection?

A

HBeAg

HBsAg

66
Q

What is the best diagnostic test to diagnose hepatitis?

A

Serology - ELISA

67
Q

What is marker for acute HBV infection?

A

Anti-HBc IgM

68
Q

What is a marker for recovery/immunity/vaccination against Hep B?

A

Anti-HBs Ig

69
Q

What is the problem with the new HCV antivirals?

A

They’re extremely expensive

70
Q

Which type of hepatitis is the most common is Australia?

A

Hep A

71
Q

What occurs inside the host nucleus during HBV replication?

A

The epigenome is closed by covalent bonding and transcribed into a RNA progenome which is exported out of the nucleus

72
Q

What is the rate of premature mortality from chronic liver disease?

A

15-25%

73
Q

What treatment options are available for Hep A infection?

A

Immunoglobulin - only within 2 weeks of infection though

74
Q

What is the difference between nucleotides and nucleoside analogues?

A

Nucleotide analogues have a phosphate group added

75
Q

What percentage of HCV infections are due to intravenous drug use in Australia?

A

80%

Hugh's MD1 Abdominal (21 decks)

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