Hepatitis A,E,C

Question 1

What are the families of A, E, C, respectively

Answer 1

A = picorna
C = flavi
E = hepe

Question 2

A, C, E: naked or enveloped

Answer 2

A = naked
C = enveloped
E = naked

Question 3

what do each of the viruses do mnemonic:

Answer 3

A= acute
B = blood borne
C = chronic
D = defective
E = enteric

Question 4

Family and genetic material for HAV

Answer 4

Picornavirus family, +ssRNA, Naked

Question 5

How can you kill HAV

Answer 5

heated to 185F for one minute to inactivate. (withstands heating to 140F for 10 hours)

Question 6

What age group gets jaundice with HAV

Answer 6

Infection < 5 yo = no symptoms

Adult infx = jaundice

Question 7

WHat is main transmission route for HAV

Answer 7

Person to person spread, though close personal contact or sex, is main transmission route.

Question 8

Is there chronic HAV? does infx –> immunity?

Answer 8

no chronic infx

infx –> lifelong immunity

Question 9

What is incubation time for HAV

Answer 9

Incubation Mean 4 weeks (2 to 6 weeks)

Question 10

When is a person is very infectious with HAV

Answer 10

2 weeks before symptoms and one week after becoming jaundiced

Question 11

When is someone Most infectious with HAV

Answer 11

MOST infectious 2 weeks before sx start!!!

Question 12

What is the diagnostic test for acute HAV infection

Answer 12

IgM

Question 13

What are the major complications of HAV? (3)

Answer 13

a. Relapsing Hepatitis
b. Prolonged cholestasis or cholestasis hepatitis
c. Fulminant hepatitis

Question 14

Which age group has more serious infx?

Answer 14

over 50

Question 15

What kind of vaccine is the HAV vaccine

Answer 15

whole killed-virus vaccine with alum added

Question 16

How many doses are required for HAV vaccine

Answer 16

2

Question 17

Which groups should get the HAV vaccine. (7)

Answer 17

1. all children between the ages of 12 and 23 months.
2. Travelers to endemic countries-
3. Men who have sex with men
4. IV and non-IV drug users
5. People who have chronic liver disease, HBV or HCV
6. close contacts of adopted children from countries with high or intermediate levels of HAV.
7. People who receive clotting factors

Question 18

Under 12 months or over 40 years what do you do instead of HAV vaccine?

Answer 18

give pooled IG.

Question 19

What do they give you if you are exposed to HAV

Answer 19

vaccine and/or pooled immunoglobulin within 2 weeks of exposure.

Question 20

What do they give you if you are exposed to HAV and are between 12 months to 40?

Answer 20

only vaccine

Question 21

Major source of infection for HEV

Answer 21

sewage infected water = contaminated drinking water

Question 22

in the developed world cases of HEV are from what source?

Answer 22

eating undercooked pig or deer meat

Question 23

What 2 populations have the highest mortality rate in HEV?

Answer 23

1. underlying chronic liver dz

2. pregnant women

Question 24

What populations get chronic infx (2)

Answer 24

solid organ transplant or immunosuppression.

Question 25

Tx fro HEV

Answer 25

Ribavarin works. (Category X teratogen. )

Question 26

How are all the different mutations of HCV classified

Answer 26

Divided in gentoypes and subgenotypes

Question 27

What does vertical transmission of HEV cuase in fetus

Answer 27

Vertical transmission --> fetal hepatitis and death but not birth defects.

Question 28

What is major transmission of HCV

Answer 28

IVDA

Question 29

What age group has 2/3 of all cases of chronic HCV

Answer 29

people born between 1945 and 1965. 55-75 years old

Question 30

HCV cases are on the increase in what population?

Answer 30

the younger 20-29 IVDAs.

Question 31

HCV RNA is only present in what stage of infx

Answer 31

acute, chronic (not cleared)

Question 32

HCV Ab is not present in what stage of infx

Answer 32

acute (is present in current and chronic)

Question 33

What is HCV txx

Answer 33

Peg IFN@2, ribavarin

Question 34

Who is cix in Peg IFN@2 tx? (2)

Answer 34

Decompensated hepatic disease or depression

Question 35

What is the MOA of ribavarin

Answer 35

Inhibits inosine monophosphate dehydrogenase (IMPDH)-

Question 36

ADE of ribavarinq

Answer 36

hemolytic anemia

Question 37

Cix in ribavarin

Answer 37

preganat = category X

Question 38

Protease Inhibitors end in ?

Answer 38

previr

Question 39

NS5B polymerase inhibitors end in ? | NS5A inhibitors ending in?

Answer 39

NS5B = buvir | NS5A = asvir

Question 40

NS5B polymerase inhibitors: MOA?

Answer 40

block replication of viral RNA

Question 41

Protease Inhibitor MOA

Answer 41

prevents viral polyprotein cleavage and blocks replication of RNA because cannot cleave polyprotein to make active viral polymerase

Question 42

Cannot use protease inhibitors in what condition?

Answer 42

decompensated cirrhosis.

Question 43

What is goal of HCV tx?

Answer 43

Sustained Virologic Response (SVR)= absence of HCV RNA

Question 44

Who to treat for HCV

Answer 44

everyone! too$$$$