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Bio 3021 Infectious Disease & Society > Hepatitis > Flashcards

Hepatitis Flashcards

(65 cards)

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0
Q

What is the most notable sign of general hepatitis?

A

Jaundice

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1
Q

What is a general term reserved for infections of the liver?

A

Viral hepatitis

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2
Q

What is jaundice?

A

A yellow discoloration of the skin and conjunctiva of the eyes caused by concentration of bile pigments in the blood

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3
Q

Why do bile pigments accumulate in the blood?

A

Because the liver is damaged and fails to remove them from the blood

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4
Q

Liver disease and jaundice are well known to….

A

Babylonians and other ancient civilizations

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5
Q

When were there reports of scattered outbreaks of jaundice affecting populations?

A

17th,18th, 19th centuries

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6
Q

Campaign jaundice is

A

Common among military men

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7
Q

When was the first form of blood transmitted hepatitis reported?

A

1885

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8
Q

When was the transmission of blood serum hepatitis firmly established?

A

Late 1930s

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9
Q

What are two classifications for the hepatitis virus?

A

Acute self limited hepatitis & Persistent chronic hepatitis

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10
Q

What type of hepatitis is hep A classified as?

A

Acute self limited hepatitis

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11
Q

What type of hepatitis is hep B classified as?

A

Persistent chronic hepatitis

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12
Q

Describe the discovery of hep B

A

Blumberg took a serum sample from an Australian aborigine and reacted it with a serum antibody of an American hemophiliac. The protein antigen from AA correlated with the serum hepatitis.

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13
Q

Hep B virion is known as…

A

The Dane particle, researcher who discovered complete virion 1970

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14
Q

Describe key components of hepadnavirus (virion & genome)

A

Virion: abundant smaller spherical/filamentous forms that lack nucleocapsid and are not infectious

Genome: circular double stranded DNA with single stranded gap on one strand

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15
Q

What’s the name of the virus that causes hepatitis? Can it be cultivated in vitro?

A

Hepadnavirus; No

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17
Q

Distinctive characteristics of hepadnavirus (3)

A

Partly double stranded and partly single stranded circular DNA genome
Reverser transcriptase generates genome DNA from pregenome RNA with capsid during virus assembly
Makes large amounts of noninfectious spherical and filamentous particles

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18
Q

What antigens are hepatitis composed of? function?

A

HBsAg (surface antigen)- most important
HBcAg (core antigen)
HBeAg (endogenous DNA polymerase; correlates with virus replication)

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19
Q

How many of the hepadnavindae family cause hepatitis? asymptomatic carrier state? hepatocellular carcinoma?

A

4: HBV, WHV, GSHV, DHBV
4: HBV, WHV, GSHV, DHBV
3: HBV, WHV, GSHV

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20
Q

Worldwide; estimated infected with Hep B?

A

2 billion persons

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21
Q

Worldwide; have chronic Hep B infection (carriers)?

A

400 million persons

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22
Q

Worldwide; die every year due to Hep B? every min?

A

1 million persons; 2 people

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23
Q

Worldwide 76% of all cases of Hep B occur where?

A

Asia, Africa, and South America

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24
Q

United States; in 2011 infected with Hep B?

A

~12 million Americans

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25
United States; new cases of Hep B in 2011?
~18,800 cases
26
United States; highest rates of Hep B among?
adult males 25-44 years of age
27
United States; have chronic Hep B (carriers)?
Up to 1.4 million persons
28
How can Hep B transmitted?
Blood Sexual Mother to newborn Casual contact
29
Where is Hep B present in high quantities and detected frequently?
High in the blood serum; detected in high frequencies of the saliva, semen, & cervical secretions
30
Clinical Disease: inapparent subclinical
asymptomatic
31
Clinical Disease: anicteric hepatitis
symptoms w/o jaundice
32
Clinical Disease: icteric hepatitis
symptoms + jaundice
33
Clinical Disease: chronic hepatitis
carrier state
34
Clinical Disease: Fulminant hepatitis
leads to death
35
(4) Characteristics of Hep B clinical disease?
incubation 45-120 days (long incubation) icteric phase begins within 10 days after onset dark urine, stools pale, liver enlarged & tender transition from feeling well to ill is slow (insidious)
36
``` Predicted Outcomes of Subclinical ? Anicteric hepatitis? Icteric hepatitis? Complete recovery? Chronic disease? ```
65-80% 20-35% 90-98% 2-10%
37
The likelihood of becoming a carrier of Hep B in comparison to age?
Varies inversely with age at which initial infection occurs
38
Which antigens indicate past infection?
HBsAg & HBcAg
39
What is the function of HBeAg?
correlates to virus replication & may indicate chronic/ carrier state
40
Diagnostic Value for IgM Anti-HBc?
most sensitive for acute infection
41
Diagnostic Value for IgG Anti-HBc?
indicate past infection
42
Diagnostic Value for IgG Anti-HBs?
indicate past infection indicate neutralizing antibody indicates immune protection
43
Diagnostic Value for IgG Anti-HBe?
indicates acute infection indicates active virus replication indicates chronic carrier state
44
Hep B virus is _____ more infectious than HIV?
50x-100x
45
Hep B vs. HIV (concentration in blood)?
HIV 10^6 to 10^8 | Hep B 10^8 to 10^10
46
Hep B vs. HIV (risk of infection)?
HIV <.5% | Hep B ~18%
47
Treatment & Control of Hep B virus?
``` prophylaxis (Hep B immune globulin) acute infection (no antivirals) chronic infection (interferon alpha; Epivir) ```
48
An active homosexual was _____ more likely to contract Hep B than an active male heterosexual?
10-15x
49
Development of Hep B Virus Vaccine?
Dr.Hillemann 65 weeks needed to make one batch of Dane particle 7 stages needed to extract Dane particles prior to animal tested
50
How was the Dane particle extracted from volunteers who were carriers for Hep B?
plasmaphoresis
51
Describe the process of plasmaphoresis?
1. Serum containing Dane particle are centrifuged to purify 2. Dane particle inactivated with formaldehyde 3. Each batch tested for inactivation
52
When was Phase 1 code broken?
June 1980
53
Details for the plasma-derived vaccine?
prepared of inactivated Dane particles purified | no longer produced due to fears of HIV infection
54
Details of recombinant vaccine?
produced in yeast that contains the HBsAg killed vaccine HBsAg purified from yeast 3 intramuscular doses induce antibody response
55
Name who should receive the Hep B vaccine?
health care workers, prisoners, sexually active homosexual males, morticians, hemodialysis pts
56
Along with Hep A, who is a member of the picornavirus?
pilovirus
57
United States: new cases of Hep A in 2011?
~2,700
58
Hep A is not....
a sexually transmitted disease & has no chronic infections (no carriers)
59
Hep A transmission is associated with?
``` poor hygiene poor sanitation contamination of water or milk consumption of contaminated raw oysters blood transfusion ```
60
Hep A transmission is not associated with?
``` sharing of utensils sharing of cigarettes kissing sexual activities transmission by insects ```
61
(4) Characteristics of Hep A clinical disease?
incubation 12-50 days (short) pts remain asymptomatic despite active replication in gut transition from feeling well to ill occurs abruptly icteric phase begins 10 days of initial clinical symptoms: dark urine, pale stools, jaundice
62
Predicted Outcomes of Hep A?
children <5 years have milder cases than adults complete recovery is usual chronic disease has not been observed
63
Clinical Diagnosis of Hep A?
not as complex as Hep B Biochemical assessment of liver functions detection of Hep A virus-specific antibodies: IgM anti-Hep A & IgG anti Hep A
64
Treatment of Hep A virus?
no antiviral drug available | vaccination is mainstay for prevention of Hep A
65
Hep A vaccine?
2 killed vaccines available (Vaqta & Havrix)

Bio 3021 Infectious Disease & Society (4 decks)

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