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MCIM 309 > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

hepatitis virus

A

Oral-fecal or parentally spread liver viruses.

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2
Q

how many?

A
  1. hepatitis A - E + G
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3
Q

Target?

A

Liver

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4
Q

Classics?

A

Hepatits A virus (HAV)

Hepatitis B virus (HBV)

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5
Q

Non-A, non-B hepatitis (NANBH)?

A 
Hepatitis C (HCV)
Hepatitis D (HDV) [the delta agent]
Hepatitis E (HEV)
Hepatitis G (HGV)
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6
Q

HAV structure + features

A 
picornavirus
\+ssRNA
One serotype
very small
oral-fecal
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7
Q

HAV replication

A

replicates in hepatocytes + Kupffer cells (liver). slowly. non-cytolytic, released by exocytosis.

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8
Q

HAV Symptoms

A

occur abruptly 15-50 days post-infection.
initial symptoms: fever, fatigue, nausea, loss of appetite, vomiting, abdominal pain.
Liver damage symptoms: Dark urine, Pale stool, Jaundice, Icterus. (rarely jaundice in children)

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9
Q

HAV recovery

A

Complete recovery in 99%. within 2-4 weeks of start of symptoms. up to 2 months. Lifelong immunity.

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10
Q

HAV diagnosis

A

based on symptoms
anti-HAV IgM ELISA or Radioimmunoassay.
cannot be isolated.

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11
Q

HAV prevention and control

A

water treatment + avoid uncooked shellfish.

prophylaxis or immune serum globulin treatment (80-90% effective)

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12
Q

HAV vaccines

A 
Killed HAV vaccines.
all children after 1 year of age. high risk adults + travellers. 
two doses.
one serotype.
(live vaccine in chine, crazy fuckers)
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13
Q

E-NANBH

A

hep E. E = enteric/epidemic.
similar to HAV but later symptoms and more mortality.
serious in preg women.
poor places.

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14
Q

HBV structure + features

A

hepadnavirus.
Small enveloped DNA virus, very stable.
small circular, partly (?) dsDNA. encodes RT, replicates thru RNA intermediate. Dane particles, filamentous particle, spherical particle

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15
Q

HBV Replication

A

entry into hepatocyte and uncoating of core. DNA is transcribed in the nucleus into mRNA, RT turns RNA into -DNA, then becomes +DNA. DNA filled core becomes associated with HBsAG, exocytosed.

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16
Q

HBV patho + immune response

A

tropism for liver.
replicates in liver, symptoms >45 days.
HBsAG presence causes cytopathology (necrosis)
inflammation and CMI: causes symptoms and also resolution.

17
Q

HBV types of infection. why?

A

Chronic, acute symptomatic, asymptomatic. Depends on immune response.

18
Q

HBV Chronic

A

weak CMI, echausted CD8 T cells. mild disease, when active liver cirrhosis, failure, major source of spread

19
Q

HBV acute symptomatic

A

90% of infections. Strong CMI, after 45 days: nausea, fever, malaise, anorexia. later: jaundice, dark urine, pale stoolsresolution.

20
Q

Fulmitant hepatitis

A

1% of acute symptomatic cases, kills you.

21
Q

HBV diagnosis

A

initially: jaundice and liver enzymes

HBsAg & HBeAg in serum. anti-HBc&HBe&HBs. quantitative viral load by genomic PCR

22
Q

HBV control + treatment.

A

HBV immune globulin: to recently exposed + neonates of + mothers.
Drugs: Iamivudine, entecavir,telbivudine, tenofovir, adefovir dipivoxii, famciclovir.
Vaccination: 1 serotype = yes. yeast recombinant vaccine,: HBsAg Virus like particle. 3 injections.

23
Q

Hepatitis C virus family

A

Flavivirus

24
Q

of genotypes

A

6 (clades), considerable genetic and antigenic diversity.

25
Q

HCV structure + features

A

enveloped +RNA

infects only humans and chimps.

26
Q

HCV pathogenisis

A

-Acute infection:15-25% clear HCV no treatment
-Chronic HCV: Long term, ~70%
-Hepatic steatosis: fatty liver
-Hepatic Fibrosis: scarring of the liver, still reversible by clearing HCV
-Hepatic Cirrhosis: you
fuked now. severe fibrosis(scarring of living), irreversible
-hepatocellular carcinoma: you have cancer now. (1-5% of cirrhosis people)

27
Q

HCV pathogenesis features

A

-inhibit apoptosis
-down regulates IFN-a response
-down regulate dendritic cell maturation
-major surface proteins E1&E2 drift.
CHRONIC INFECTION:
-antibody does nothing, need CMI. but CD8 T cells damage liver and cause cirrhosis.

28
Q

HCV diagnosis

A

ELISA: anti-HCV antibody.
denome detection and quantitation by RT-PCR
mostly cannot be grown in culture.

29
Q

HCV treatment

A 
Recombinant IFN-a 
ribavirin
boceprevir, telaprevir
ledipasvir
sofosbuvir
(combination.)
no vaccine.
30
Q

Hepatits G virus

A

pretty much HCV, almost no symptomatic cases. detectable by RT-PCR

31
Q

Hepatitis D virus HDV

A

requires HBV to replicate, often co-infection occurs. causes fulmitant hepatitis (fatal)

32
Q

HDV structure

A

small -ssRNA

33
Q

HDV diagnosis

A

anti-HDV antibodies; ELISA and radioummunoassay
RT-PCR for virion genome in blood
ELISA to detect delta antigen.

34
Q

HDV treatment & control

A

no treatment,

avoid being infected by HBV

MCIM 309 (9 decks)

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