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Flashcards in Hepatitis Deck (12):
1

The hepatitis viruses are NOT

closely evolutionarily related to each other, but symptoms are similar because they all infect HEPATOCYTES

2

All hepatitis viruses can cause

acute hepatitis, treated with supportive care; A and E usually more severe ACUTE than B and C

3

A and E are _____; B/C/D are

fecal-oral;
sex/birth/blood transmitted

4

A, B, and hopefully now E are controlled by

vaccination

5

A is endemic in; E is endemic in ____ and causes

Mexico and South America;
Asia and Mexico, also causing complications of pregnancy

6

D has high risks for

bad outcomes but is totally dependent on coinfection with B ("helper virus," complementation), so HepB vaccination is PROTECTIVE

7

Diagnosis of hepatitis is by _____:

serology;
for HepA, IgM is acute, IgG is recovered/vaccinated; for HebB, viral surface antigen is acute, IgG against viral surface antigen is recovered/vaccinated; for HepC, EIA is real or false positive, with RIBA serving for confirmation;
for HepD delta antigen means infection

8

B and C can cause

chronic hepatitis leading to cirrhosis and/or cancer; treatment with IFN has many SE's, often ineffective. Second-gen protease inhibitors combined with IFN improves SVR rates for HepC serotype 1. Third-gen inhibitors of HepC protease, polymerase, and Ns5A are exciting but still brand-new

9

B produces a large number of

immune decoys composed of its surface antigen alone; Ag-Ab complex disease may follow (think glomerulonephritis)

10

C once established forms a

huge constellation of point mutant forms, difficult for either immunity or drugs to target effectively

11

Liver transplant alleviates

liver failure caused by chronic B or C, but new liver may become infected from secondary sites (lymph nodes?)

12

Chronic B and C pose particular treatment problems

in the context of HIV