Exam 4 Objectives Flashcards
(121 cards)
Fecal-oral:
Fecal-oral: route of transmission of a disease, when pathogens in fecal particles passing from one host are introduced into the oral cavity of another host.
Parenteral
Parenteral: taken into the body or administered in a manner other than through the digestive tract, as by intravenous or intramuscular injection.
Blood/Body Fluids:
Blood/Body Fluids: liquids originating from inside the bodies of living people. They include fluids that are excreted or secreted from the body as well as body water that normally is not.
HBcAg:
HBcAg: Hepatitis B core antigen that is a protein surrounding viral DNA in the virus core, not detectable in serum
HBeAg
HBeAg: Hepatitis Be antigen that is a protein surrounding viral DNA in virus core, appears shortly after HBsAg and indicates high viral replication and a high degree of infectivity.
HBsAg:
HBsAg: Surface antigen, and the first antigen to appear in serum. It is detectable 2-12 weeks post exposure, and peaks during acute infection. Persistent HBsAg is indicative of a chronic or active infection.
anti-HBc
IgM anti-HBc antibody and the first to appear. It is an isotype antibody against HBcAg and is used as an indicator of current or recent acute infection
IgG anti-HBc antibody appears later and persists for life. It indicates a past infection and usually immunit
anti-HBs:
anti-HBs: patient antibody that appears during recovery and persists for years and provides protective immunity to reinfection.
Identify the main health concern associated with viral hepatitis (acute, chronic, etc.).
Acute: hepatitis, highly infective or asymptomatic, hepatosplenomegaly, tenderness, jaundice, fever, fatigue, GI upset (loss of appetite), muscle pain.
Chronic: Cirrhosis and/or liver cancer, chronic infection
Recognize the significance of IgM isotype antibody, IgG isotype antibody, and viral Ag or nucleic acid (RNA or DNA) in general staging of viral infections by laboratory testing
IgM: indicates a current or recent acute infection due to the fact that IgM falls off as isotype switching occurs and IgG concentrations increase. IgM in newborns will indicate a congenital infection.
IgG: indicates a current or past infection and immunity in most cases. IgG in newborns does not indicate a congenital infection because the antibody can be from passive immunity from the mother indicating that that the baby was infected in utero. If both IgG and IgM are positive, it may indicate a chronic infection.
Viral DNA or RNA: (through molecular diagnostics) indicates a current infection.
Hepatitis A Virus (HAV)
Mode of Transmission:
Mode of Transmission: Fecal-oral route (foodborne), most common cause of viral hepatitis.
HAV incubation period:
28 days until patient develops symptoms.
Most infected adults are symptomatic.
Infected children are usually asymptomatic
HAV acute or chronic?
Acute
Resolves in 1-8 weeks
Rarely fulminant
Virus does not become chronic except in immunocompromised individuals.
HAV antibodies used for diagnoses?
Ig/Ag useful for diagnosis by serology:
IgM anti-HAV in patient serum indicates acute infection
Total anti-HAV indicates immunity and past infection
HAV vaccination available and recommended for travel to endemic areas and is now part of the childhood vaccination program in the United States.
Intramuscular injections of anti-HAV Ig prevents disease in exposed individuals through passive immunity
HEV mode of transmission
Mode of Transmission: Fecal-oral route, contracted from drinking water contaminated with feces, primarily in developing countries.
HEV acute or chronic?
Acute; self-limiting disease
HEV consequences of chronicity?
Consequences of chronicity: Major concern is associated with a high rate of mortality in pregnant women who become infected, especially if they are infected during their 3rd trimester. Pregnant women are considered immunocompromised
HEV antibodies used for diagnosis?
Ig/Ag useful for diagnosis by serology: Serological test for IgM anti-HEV has been developed but is not commercially available in the U.S. due to the rarity of infection here.
HBV mode of transmission
Mode of Transmission: Blood or body fluids (parenteral)
HBV incubation period
Incubation Period: Long incubation period of 60-90 days prior to disease onset
HBV acute or chronic?
Acute or Chronic: Both. Highly variable and depends on the age when infected
Acute:
30-50% of adults, so the majority are asymptomatic
HBV age group that develops chronic infection?
All
HBV consequences of chronicity?
Consequences of chronicity: Severe liver disease, necrosis, fatality, carrier, chronic infection
HBV antibody used for diagnosis?
HBcAg: Hepatitis B core antigen that is a protein surrounding viral DNA in the virus core, not detectable in serum
HBeAg: Hepatitis Be antigen that is a protein surrounding viral DNA in virus core, appears shortly after HBsAg and indicates high viral replication and a high degree of infectivity.
HBsAg: Hepatitis B surface antigen, a protein in the outer virus envelope and in blood particles that allows the virus to dock. It is the first antigen to appear in serum.
It is detectable 2-12 weeks post exposure, and peaks during acute infection.
Persistent HBsAg is indicative of a chronic or active infection. Levels decline as patient Ab increases (detectable 12-20 weeks after symptoms)
HbeAg: appears shortly after HBsAg and indicates high viral replication and high degree of infectivity.
IgM anti-HBc: appears first (IgM isotype antibody against the HBcAg) and used as an indicator of current or recent acute infection
Useful for detecting the core window (time between disappearance of HbsAg and anti-Hbs)
When Ig and Ag are present in equal amounts, Ag is not detected by EIA because it is bound up = core window. You can detect the Ig to the core even though you can’t detect the surface antigen any longer
IgG anti-HBc: appears later and persists for life. Indicates a past infection and usually immunity.
Anti-HBs: appears during recovery and persists for years and provides protective immunity to reinfection
Failure to develop anti-HBs indicates chronic infection and the inability to clear surface antigen. This antibody is produced in response to vaccination.