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DEN303 - IHD > Hepatitis viruses > Flashcards

Hepatitis viruses Flashcards

1
Q

Hepatitis

A

Inflammation of the liver

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2
Q

Causes of hepatitis - 2

A

Infectious

Non infection

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3
Q

Infectious causes of hepatitis

A

Viral
bacterial
fungal
parasitic

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4
Q

Symptoms and signs of hepatitis

A 
Jaundice 
Malaise
Dark urine
Fatty stools 
Specific serology tests
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5
Q

Non infectious causes of hepatitis

A

Alcohol
Drugs
Autoimmune
Metabolic diseases

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6
Q

Virus structure recap

A

Strand of nucleic acid - DNA or RNA
surrounded by protective protein coat
further membrane of lipid

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7
Q

Major hepatitis viruses and spread

A 
HAV - FO
HBV - BB
HCV - BB, IV DRUG ABUSE
HDV - ASSOCIATED WITH HBV
HEV - FO
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8
Q 
Hep A 
Genotypes
Spread 
Duration 
Vaccine
A 
RNA
Picornavirus
7 genotypes 
I-III and VII related to human disease 
I and III most prevalent 
GI -> blood --> liver 
Liver bile --> faeces
Poor sanitation 
2 week incubation 
4-10 days early symptoms 
resolves in a few weeks
vaccine - formalin killed virus
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9
Q

Hep A
Global distribution
Epidemiology

A

1.5M worldwide
Children often asymptomatic
Severity increases with age

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10
Q

IgM/IgG

A

IgM produced first time host is exposed to an antigen
Eventually declines
Host produces IgG - lasts much longer
IgM detection indicates acute or primary infection
IgG indicates past infection or immunity

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11
Q

Hep B

A

Parenteral
dsDNA - resides in hepatocytes
Most patients recover in a few weeks
Some develop chronic carrier state

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12
Q

Two types of chronic carried hep B

A

Chronic persistent hepatitis

Chronic active hepatitis

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13
Q

3 forms of Hep B

A

Filament
Spheres
Dane particle (whole virion) - infectious
HbeAg is marker of Hep B
breakdown product of HbcAg (core protein)

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14
Q

Only core gene is…

A

transcribed to produced core antigen

Core antigen produced at same time as e antigen

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15
Q

Course of infection of Hep B

A

High Alt++ indicates damaged liver cells lysing
OR
chronic persistent viraemia

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16
Q

Lab diagnosis of Hep B

A

Detection of Hep B surface antigen HBsAg

17
Q

HBsAg

A

surface protein of virus
soluble
comes off and goes into blood and triggers immune response of IgM
HBcAg not detected on serological testing - found on core protein of virus

18
Q

HBeAg

A

Marker of high levels of replication of virus

Found on surface of infected liver cells

19
Q

Chronic infection of hepatitis B is characterized by the

A

persistence of HBsAg for at least 6 months (with or without concurrent HBeAg). Persistence of HBsAg is the principal marker of risk for developing chronic liver disease and liver cancer (hepatocellular carcinoma) later in life.

20
Q

Hep B epidemiology
transmission
infection early in life =
10% of chronic infection

A

5% carriage in africa/asia
vertical, parenteral, sexual
increased chance of chronicity
chronic liver disease

21
Q

Hep D

A 
Caused by defective RNA
co exists with HBV
small virus 
outer coat derived from HBsAg
5% HBV are HDV +ve
22
Q

HBV and HDV

SUPERINFECTION on HBV

A 
Infection co incident 
HDV influenced by replication of HBV
superinfection - Ideal for rapid HDV replication 
commonly chronic 
15 million cases of HDV worldwide
23
Q

Hep C
type of virus
released
core

A 
HEPACIVIRUS 
member of flavivirus 
10 genes - polyprotein 
virus released by budding
Small enveloped SSRNA virus 
core of genetic material RNA surrounded by capsid
two viral envelope glycoproteins
24
Q

HCV epidemiology

Transmission

A

180 million carriers worldwide
5 million in W Europe
IV drug abuse needle sticks, tattoos, ear piercing
Minor routes

25
Q 
HCV disease 
Diagnosis 
Chronic rates
Replication 
Treatment
A 
Diagnosis unreliable 
Mild disease 
50-85% become chronic 
Low replication rate
Interferon alpha and ribavirin
26
Q

NEW CURES Hep C

Cure rate depends on of

A

elbasvir-grazoprevir cure rate >90% genotypes 1+4

Cure rate is dependent on the genotype, treatment history and presence of liver damage

27
Q

Prospects for HCV vaccine

A

11 major genotypes

Reinfection can occur - lack of neutralising antibody

28
Q

Hep E
Type of virus
genotypes
Incubation?

A 
>50% is NOT a, b or c 
RNA virus
4 genotypes 
Faecal-oral spread 
Average incubation - 6 weeks
29
Q

Vaccines available for types…

A

2 - A and B

DEN303 - IHD (58 decks)

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