Exam 3 Hepatitis B, D

Question 1

Hepatitis B virus is part of what family _____

Answer 1

Hepadnaviridae

Question 2

Hepatitis B is a ____ virus

Answer 2

HepaDNAvirus

Question 3

Hepatitis B targets what organ?

Answer 3

Liver

Question 4

Hepatitis B causes _____ due to increase of liver enzymes

Answer 4

Icteric (jaundice)

Question 5

350 million are chronically infected by HBV worldwide in what countries?

Answer 5

Africa and Southeast Asia

Question 6

HBV incidence is declining due to:

Answer 6

Routine HBV immunization

Question 7

What are the four HBV infection routes?

Answer 7

• Major source is blood
• Birth (prenatal)
• Sexual contact
• Environmental survival

Question 8

What are the clinical outcomes of HBV?

Answer 8

• Acute infection
• Chronic infection

Question 9

____ of HBV infections are resolved

Answer 9

90%

Question 10

HBV carrier state is signified as:

Answer 10

HBsAg+ > 6 months

Question 11

HBV structure

Answer 11

Enveloped and icosahedral

Question 12

What is the genomic material found in HBV?

Answer 12

• Partial dsDNA
• covalently closed circular DNA (cccDNA)
• part of one strand missing

Question 13

What enzyme does HBV use to replicate?

Answer 13

Reverse transcriptase (RT)

Question 14

HBV replicates via ____ intermediate

Answer 14

RNA

Question 15

HBV virion is termed _____

Answer 15

Dane particle

Question 16

HBV Dane particle contains:

Answer 16

• Protein kinase
• Polymerase (RTase)

Question 17

HBV contains what three antigens?

Answer 17

• HBcAg
• HBeAg
• HBsAg

Question 18

What is HBsAg?

Answer 18

Surface antigen

Question 19

HBsAg is a marker of ____

Answer 19

Infection

Question 20

What is HBcAg?

Answer 20

Core antigen (not found in serum)

Question 21

What is HBeAg?

Answer 21

• Extracted antigen
• Soluble and “extractable” part of HBcAg

Question 22

HBeAg is secreted into serum and is a marker of:

Answer 22

Active HBV replication AND high infectivity

Question 23

HBV presence in serum: “S” means _____

Answer 23

Infectious

Question 24

HBV presence in serum: “S + E” means _____

Answer 24

Highly infectious

Question 25

What are the steps of HBV replication?

Answer 25

- Completion of dsDNA - Viral replication via RNA intermediate using RTase - RTase makes second partial DNA strand to be dsDNA

Question 26

Risk factors associated with HBV

Answer 26

- Medical employee (1%) - Other/unknown is 47%

Question 27

HBV in ____ is a moderate risk

Answer 27

Saliva

Question 28

HBV is an occupational hazard in ____

Answer 28

Dentistry

Question 29

Concentration of HBV in blood is ___

Answer 29

High

Question 30

____ immunity is required to resolve acute HBV infection

Answer 30

Cell-mediated

Question 31

Chronic HBV infection involves _____ response to ____ antigen

Answer 31

T cell; HbcAg

Question 32

Chronic HBV infection is more likely in patients with _____

Answer 32

Weak immune response

Question 33

HBV acute infection - incubation period

Answer 33

2-6 months

Question 34

What are the four clinical periods of HBV acute disease?

Answer 34

- Incubation - Pre-icteric - Icteric - Convalescence

Question 35

Symptoms of acute viral hepatitis

Answer 35

- Dark urine - Jaundice (skin, sclera)

Question 36

In someone with acute viral hepatitis, liver functions tests will be ____

Answer 36

Elevated

Question 37

Elevated ____ leads to jaundice

Answer 37

Bilirubin

Question 38

Symptoms of chronic HBV

Answer 38

- Cirrhosis of liver - Hepatocellular carcinoma

Question 39

____ can build up inside the cell. What does that look like?

Answer 39

HBsAg; filamentous, "ground glass" hepatocytes

Question 40

Serology for acute HBV infection

Answer 40

- illness typically resolves - most antibodies to HBV decrease eventually

Question 41

Serology for chronic HBV infection

Answer 41

- HBsAg remains high (carrier state = more than 6 months) - continued presence of HBeAg

Question 42

HBV-DNA and HBeAg indicate:

Answer 42

Active viral replication

Question 43

Those immunized for HBV have:

Answer 43

Antibodies to HBsAg

Question 44

HBV chronic outcomes are related to:

Answer 44

Age

Question 45

_____ infections have the highest risk of HBV infection becoming chronic

Answer 45

Neonatal/perinatal

Question 46

____% of neonatal infection may become chronic

Answer 46

90

Question 47

What is the most important cause of neonatal hepatitis?

Answer 47

HBV through infected birth canal

Question 48

What three interventions can be used to reduce transmission of HBV?

Answer 48

- HBV vaccine - HBV immunoglobulin - Antiviral drugs

Question 49

Neonatal prevention of HBV involves:

Answer 49

- Vaccine for all neonates - HBV immunoglobulin for HBV+ mothers

Question 50

HBV prevention for healthcare workers

Answer 50

- Vaccination - HBV immunoglobulin if exposed

Question 51

Chronic HBV treatment methods

Answer 51

- Interferons/PEG-Interferon - Antiretrovirals

Question 52

What antiretrovirals are used for chronic HBV treatment?

Answer 52

- nucleoside analogues (NRTI's) - nucleotide analogues

Question 53

Nucleoside analogues have ____ drug resistance, whereas nucleotide analogues have ____ rate of resistance

Answer 53

Rapid; low

Question 54

Hepatitis D infects people who are infected with:

Answer 54

Hepatitis B virus (cannot infect cells by itself, steals HBV envelop protein)

Question 55

What glycoproteins are needed by Hepatitis D?

Answer 55

M, S, L glycoproteins

Question 56

HDV is transmitted like _____ and worsens ____ infections

Answer 56

HBV; HBV

Question 57

HBV vaccine is protective against:

Answer 57

HDV