Lecture 10 - Hepatitis + Slow + Unconventional Viruses

Question 1

Hepatitis A virus (HAV) belongs to the ______ family. It infects liver _____ cells, but the virus itself is not killing the cells. It has the shortest _____ period of all hep viruses (about 30 days.) It is transmitted via ____/____ route (major outbreaks occur at daycares or restaurants.) There are no ____ infections or carriers. Effective vaccine is available.

Answer 1

Picornaviridae

Incubation

Fecal/Oral

Chronic

Question 2

All people infected with HAV produce Ig__ anti-HAV Ab which is replaced by Ig___ (which lasts throughout life.)

Answer 2

IgM

IgG

Question 3

HBV belongs to the ______ family, so it is an enveloped virus with a circular partially ______ genome. Viral replication is mediated by _____ transcriptase. This virus is associated with 80% of all Heptaocellular Carcinomas via aberrant ______ (normally doesn’t do this, unlike HIV.)

Answer 3

Hepadnaviridae

dsDNA

Reverse transcriptase

Integration

Question 4

HBV replicates in _______ (type of liver cell), kidneys, pancreas, and leukocytes. About 10% of cases become ____ (most are acute.) The _____ you are when initially infected (below 5yrs old), the more likely infection progresses to chronic. It is typically transmitted in the US via IV or _____.

Answer 4

Hepatocytes

Chronic

Younger

Sexually

Question 5

For HBV diagnosis, the presence of ______ at 6 month follow-up after initial diagnosis is indicative of progression from acute to _____ infection.

Answer 5

HBsAg

Chronic

Question 6

HDV is a _____ virus (cannot replicate in a cell without concurrent infection with HBV.) It is an enveloped virus with a circular ______ genome, though it replicates in the nucleus. It uses host _______ for replication. HDV contains a ______ that is capable of linearizing and re-circularizing its genome, which is necessary for replication. HBV virus provides ______ proteins necessary for budding.

Answer 6

ssRNA

RNA Pol II

Ribozyme

Envelope proteins

Question 7

HDV can only replicate in _______ (type of liver cell) given its necessity for concurrent HBV infection. ___-infection is when both HBV and HDV infect at the same time (most commonly transmitted via sharing IV needles), while ____-infection is when HDV infects a chronic HBV patient.

Answer 7

Hepatocytes

Co-infection

Super-infection

Question 8

Diagnosis for HDV is determined through serological test for anti-HDV Ig___.

Answer 8

IgG

Question 9

HCV virus belongs to the ______ family. There are ____ genotypes (genotype 1 most common in US.) It replicates in _____ (type of liver cell). It can form both acute and chronic cases, but unlike the other hepatitis viruses, ____ is more common (alcohol use, younger and older, and males are more likely to progress to this.) There is a strong correlation to Hepatocellular Carcinoma, but the mech is unclear. The host immune response does NOT clear the virus and does NOT prevent ______. Transmission is typically sexual.

Answer 9

Flaviviridae

6 genotypes

Hepatocytes

Chronic

Re-infection

Question 10

What’s significant about HCV diagnosis is that the anti-HVC Ig____ serological test will only be useful at ____ weeks or more after appearance of symptoms.

Answer 10

IgG

4 weeks or more after symptoms

Question 11

HEV belongs to the _______ family, and is a non-enveloped virus with a linear _____ genome. Symptoms are infected are very similar to _____, but it is characteristically fatal in _____ women. It produces a single ______ (from Open reading fame 1) and a couple individual proteins (from open reading frames 2 and 3.) It replicates in ______ (type of liver cell.) It’s incubation period is the same as _____, as is its mode of transmission (fecal/oral.) There is no chronic infection, cirrhosis, or carrier state, and minimal person-person transmission. It is most often associated with _____ contaminated drinking water. There is no vaccine.

Answer 11

Hepeviridae

HAV

ssRNA genome

Pregnant women

Polyprotein (ORF 1)

Hepatocytes

HAV

Fecally contaminated

Question 12

There is no treatment for _____ hepatitis beyond supportive care.

Answer 12

Acute

Question 13

Chronic hepatitis is typically treated with _____-alpha. Chronic HBV treatment involves Tenofovir and Entecavir, which are _____ RT inhibitors (NRTIs.) Chronic HCV is typically treated with _____-alpha and _____, but ______ is a CURE that is a combination of Sofosbuvir (kinase inhibitor) and Ledipasvir.)

Answer 13

Interferon-alpha

Nucleoside RT inhibitors (NRTIs)

Interferon-alpha

Ribavirin

Harvoni

Question 14

Abs as drugs work well for HAV and HBV. HAV Abs can be given prophylactically both _____ and _____ (the later within 14 days of exposure.) HBV Ab can be give _____ (within 7 days of exposure.)

Answer 14

Pre-exposure

Post-exposure

Post-exposure

Question 15

Prions are the etiological agents of _____ ______. Incubation can be from ____ to ____, and the immune response is indifferent. They only infect the ____. Cells present with ______ and potentially ____ plaques. There is also proliferation of _____ (gliosis.)

Answer 15

Spongiform Encephalopathies

Months to Years

CNS

Vacuolization

Amyloid plaques

Astrocytes

Question 16

_____ is only found in _____, and is associated with cannibalism.

Answer 16

Kuru

Papua, New Guinea

Question 17

____-_____ disease (CJD) typically results in fatality at around ____-____ years of age.

Answer 17

Creutzfeld-Jakob disease

50-60 years of age

Question 18

vCJD showed an average fatality age around _____ years of age, and was highly transmissible. It was discovered to be a protein that was resistant to formalin, proteases, nucleases, and UV.

Answer 18

20

Question 19

The PrP protein that causes vCJD is a _____ of normal PrP protein which has only a single _____. The difference between the normal and prion is the conformation (prion has more ___-pleated sheets.)

Answer 19

Variant

Intron

Beta-pleated sheets