Hepatitis 2

Question 1

Which hepatitis has a 30-50% perinatal infection rate if untreated?

Answer 1

hepatitis B

Question 2

hepatitis B and C are transmitted mainly how?

Answer 2

sexual and IV drug

Question 3

what are you chances of getting hepatitis C if you are IV user?

Answer 3

50-60%

Question 4

hepatitis is ___ times more prevalant than HIV in Australia

Answer 4

18 times

Question 5

hepatitis is ___ times more prevalant than HIV in Victoria

Answer 5

16 times

Question 6

hepatitis B has how many walls? nonenveloped?

Answer 6

double walled with outer envelope and inner capsid

Question 7

What are HBsAG particles?

Answer 7

Hepatitis B Surface Antigen particles (incomplete viruses)

Question 8

Hep B preGenome has own polymerase?

Answer 8

Yes, pregenomic RNA

Question 9

describe the extracellular Hep B genome? ds? ss? RNA? DNA?

Answer 9

dsDNA

Question 10

4 general different reading frames for Hep B coding

Answer 10

core (c)
surface(s)
polymerase(p)
X

Question 11

Why do you get lots of mutant Hep B viruses?

Answer 11

reverse transcription from RNA to dsDNA has a high error rate

Question 12

Hep B penetration is where?

Answer 12

mucosal epithelia

Question 13

Hep B replication is where?

Answer 13

Liver

Question 14

High concentration of Hep B in body fluids? 3 places

Answer 14

blood
serum
wound exudates

Question 15

Moderate concentration of Hep B in body fluids? 3 places

Answer 15

semen
vaginal fluid
saliva

Question 16

3 Hep B modes of transmission:

Answer 16

Sexual
Parenteral-needle stick
Perinatal

Question 17

Which moms are more likely to transmit Hep B perinatally?

Answer 17

HBeAg positive ‘e antigen’

Question 18

Hep B incubation period?

Answer 18

60-90 days

45-180 day range

Question 19

Hep B jaundice by age? why?

Answer 19

5

dictated by immune response

Question 20

which group has higher chronic infection of Hep B?

Answer 20

<5yr olds 30-90%

Question 21

General trends for outcome of Hep B with age?

Answer 21

the younger you are, the more likely to have chronic Hep B infection but more asymptomatic. The older you are, the more symptomatic but the less chronic infection

Question 22

Natural history of chronic Hep B infection? how long?

Answer 22

acute
chronic hepatitis
cirrhosis
liver cancer
death
30-50 years

Question 23

Hep B recovery serology looks like how?

Answer 23

initial rise in IgM and HBsAg
Then as IgM goes down you have increased and sustained:
Anti-HBs (surface protein)
anti-HBc (core protein)

Question 24

In chronic Hep B serology, what is missing?

Answer 24

Missing Anti-HBs

there is Anti-HBc

Question 25

Why is a missing Anti-HBs bad for chronic Hep B?

Answer 25

the existing Anti-HBc is a poor anti-HBs so it persists

Question 26

Chronic carrier of Hep B has what serology marker?

Answer 26

HBsAg positive

Question 27

what is the most common cause of liver cancer?

Answer 27

Hep B sequelae

Question 28

% of Hep B lifetime mortality?

Answer 28

~30%

Question 29

How long from infection to cancer for Hep B?

Answer 29

10-30years

Question 30

How much more likely are you to get hepatocellular carcinoma with Hep B carriers?

Answer 30

100x yo....

Question 31

HBeAg indicates what?

Answer 31

active replication

Question 32

HBsAg indicates?

Answer 32

general marker for infection

Question 33

What is a marker of acute Hep B infection?

Answer 33

rising anti-HBc IgM

Question 34

What is a marker of past or chronic Hep B infection?

Answer 34

anti-HBc IgG

Question 35

when do you use HBV-DNA testing?

Answer 35

indicates active replication | used for escape mutants

Question 36

3 current treatments for Hep B?

Answer 36

``` interferon alpha pegylated nucleoside/tide analogues new NCTP (sodium co-transporting polypeptide) ```

Question 37

what kind of drugs are adefovir, tenofovir? for what? what do they target?

Answer 37

Hep B nucleotide analogues target polymerase function

Question 38

What is 3TC/Lamivudine?

Answer 38

nucleoside analogue (no phasphate group)

Question 39

Hep B vaccine is now cultured from?

Answer 39

yeast

Question 40

Hep B vaccine protects from what? how many doses?

Answer 40

Hep B Hep D 2-3 doses

Question 41

how is Hep D like Hep B?

Answer 41

ssRNA with a delta antigen and encased in the Hep B surface antigen

Question 42

How can you catch Hep D?

Answer 42

only infects in conjunction with Hep B

Question 43

What happens when you get HBV and HDV coinfection?

Answer 43

severe acute disease | low risk of chronic infection

Question 44

what happens in a HDV superinfection?

Answer 44

HDV after an already HBV+ | get chronic HDV and liver infection