18-2: Liver Infections Flashcards
What is the alphabetical mnemonic for causes of acute liver faulire?
A - Acetaminophen, HAV, autoimmune B - HBV C - HCV, cryptogenic D - Drugs, HDV E - HEV, esoteric F - Fatty changes
Which hepatitis virus that we care about almost never causes chronic liver disease?
HAV
how does proportion of people exposed to hepatitis A virus change in well developed country?
50% by 50 have been exposed (seropositive) for HAV
What are the four major clinical presentations of HBV
1) acute hepatitis followed by recovery and elimination
2) acute hepatitis w/ massive liver necrosis
3) chronic hepatitis w;w/o progression to cirrhosis
4) asymptomatic carrier
How many people in the US live with chronic HBV infection
2 million
What is the most common vector of HBV world wide for high, medium and low prevalence?
vertical transmission (90%) world wide (high prevalence)
horizontal transmission (intermediate prevalence)
IV drug abuse (low prevalence)
What type of immune response to HBV infection is associated with high and low hepatocyte injury
high hepatocyte injury (CD8+ cytotoxic response)
Low hepatocyte injury (Specific CD8+ CD4+ IFN-y producing cells)
what is the best predictor of chronicity in HBV?
age of infection - inverse
what is the most common cause of chronic viral hepatitis
HCV
How much more likely is a healthcare worker stuck by a needle to contract HCV
10X more likely
What does HDV require to maintain its “living process”
HBV coinfection
how does immunocompromisation affect the course of HCV and HBV infection
immunocompromised people are more likely to progress to severe liver disease. people who are on successful HIV treatment or immunocompetent will have a normal course compared to those who are HIV neg
what is the hallmark of chronic hepatitis
increased portal chronic inflammation
What is the hallmark of progressive chronic liver damage
scarring
what causes ground glass hepatocytes
accumulation of HBsAg
-think pink inclusions on H&E staining
