Hepatitis Flashcards
(38 cards)
Hep A
RNA virus. It is not cytopathic to hepatocytes, it just causes liver injury by stimulating both cellular and humoral immune responses.
How is Hep A transmitted?
F/O (assoc. with poor hand washing, inadequate sanitation, day care centers, etc)
How are epidemics of Hep A caused?
via waterborne or food borne…ie someone poops in a field and it spreads
T/F: there is a vaccine for Hep A?
true, it should be given when traveling to endemic areas and a booster is given at 1 year.
What are the symptoms of Hep A?
flu-like complaints–> abdominal pain, diarrhea, fatigue, fever, HA, myalgia, arthralgia), onset and abrupt (may include nausea and vom) usually lasts around 2 weeks. often missed. jaundice in adults self limited. most recover fully.
when does the Hep A antibody appear?
4 weeks after infection (IgM= acute 1-8 weeks, then IgG=past infection,>2 months). virus is in blood briefly and shed in stool.
How can you monitor the Hep A disease?
with liver enzymes and bilirubin. AST, ALT >3ULN. (500-1000). Urine bilirubin will be positive.
What kind of virus is Hep B?
DNA virus. (circulates as several particles called “dane” particles”
Is Hep B serious?
yes, infected patients manifest Hep B in virtually all body fluids. It can cause around 200,000-300,000 thousands death per year.
What body fluids can you find Hep B in?
all of them
How do you get Hep B?
its a blood borne pathogen so, from needles, body peircings, sexually. blood transfusions are screened.
How many doses is the Hep B vaccine?
Active immunization: 3 at 0,1,6 months since first dose. some people never convert. passive immunity can be conferred with HBIG.
Do all people recover from Hep B?
no, some progress to fulminant. chance of chronic is higher if you are younger.
What are the symptoms of Hep B?
onset can last 1.5-6 months. abdominal pain, diarrhea, fatigue, hepatomegaly, n/v, jaundice (30-50% of adults), urine is dark amber color.
What is HBsAg?
surface antigen, most widely used marker for Hep B. appears at 14 days, gone by 4 months.
HBcoreAg
found the core of the intact virus, no lab test for this.
HBcoreAB: 2 tests available
- HBcoreAB-IgM: acute marker, becomes undetectable within 1-2 months. active disease. >6 months = chronic
- HBcoreAB-total: detects IgG and IgM. Indicates a previous infection. This is not a protective antibody.
What is the core window?
occurs when B surface antigen (HBsAg) is negative but the antibody (HBsAB) hasn’t been produced yet. The HBcoreAB-IgM will be positive.
What is the last antibody to appear, indicates clinical recovery form HBV and is the only marker found in those with the vaccine for HB?
HBsAB, it confers lifelong immunity to the HBV infection. “the surface antibody”
which virus requires a co infection with Hep B to replicate?
Hep D. It is an RNA particle virus.
What is the preferred marker for Hep D infection?
HDVAB (not HDVAg because it will only stay elevated a few days.) Does not confer immunity, people can still transmits infection.
T/F: there is a vaccine for Hep D?
FALSE! no vaccine. highly infectious, no immunity. Associated with drug abuse. very poor prognosis.
Which RNA virus has a high rate of mutation in genes of the envelope protein?
Hep c (hep b has a rare mutation rate). It allows the virus to “hide” in the body.
What is the most common cause of chronic hepatitis in NA, Europe, and Japan?
Hep C
