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Micro (virology) > Hepatitis Virus > Flashcards

Hepatitis Virus Flashcards

1
Q

rules regarding blood borne pathogens are established by which of the following

CDC
ADA
OSHA
PHS
NASA
NWA
A

OSHA

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2
Q

what is hepatitis

A

inflammation of the liver

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3
Q

acute hepatitis

A

associated with fatigue, abdominal pain, loss of appetite, nausea and vomiting, darkening of the urine, followed by jaundice

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4
Q

jaundice

A

yellowing in skin and eyes caused by the build up of bilirubin in the blood

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5
Q

bilirubin

A

a byproduct of hemoglobin metabolism due to liver not lover properly metabolizing and excreting it

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6
Q

chronic hepatitis can lead to

A

fibrosis

cirrhosis

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7
Q

HAV
HBV
HCV
HDV

A

infection hepatitis
serum hepatitis
formerly nonA nonB hep
delta particle

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8
Q

what causes >90% of viral hepatitis

A

A,B,C

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9
Q

what can also cause hepatitis

A

HSV
CMV
EBV
Yellow Fever Virus

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10
Q

what can cause or worsen hepatitis

A 
alcohol abuse
some drugs (acetaminophen)
toxic chemicals (some organic solvents)
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11
Q

HBV family

A

ss/ds DNA
hepadna-
icosohedral
enveloped

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12
Q

HAV family

A

+ssRNA
pircorna
(entero, polio, ring are also in this family)
icosohedral
not enveloped
hard to decontaminate: resists heat and disinfectants
released by exocytosis

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13
Q

HCV familt

A 
\+ss
flavi
(also west nile, dengue, yellow fever, zika)
icosohedral
enveloped
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14
Q

HAV

A

fecal oral transmission
localize outbreaks
contaminated food: vegetables and shellfish

short incubation:15-45 days
shedding virus in stool 2 weeks prior to symptoms

acute infection only
no fulminant hepatitis
lifelong ab protection after infection

symptoms last 8 wks
-fatigue,
-abdominal pain
-loss of appetite
-nausea, vomiting
-dark urine
-jaundice (70-80% of adults)
90% of childhood infections are asymptomatic
<0.5% mortality
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15
Q

HAV pathogenesis

A

there is some lysis but is result of T cell immune response in the liver

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16
Q

testing for HAV

A

IgM and IgG

elevated liver enzymes (Aminotranferases) (general hepatitis)

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17
Q

prevention and treatment of HAV

A

-hygiene- hand washing by food preparers
-Vaccine- inactivated HAV
100% effected and recommended for people traveling to developing nations
life long immunity
-immune serum containing antibodies that can be given pre-exposure.if traveling too soon for a vaccine to become effective
this can also be given post exposure
Vaccine can be given up to 2 weeks post exposure

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18
Q

Hep B

A 
serum hepatitis
long incubation hepatitis
~90days (with 4-25 weeks variation)
symptoms began ~90 days (60-150 days) after exposure
30% of people are asymptomatic
Endemic in many developing countries
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19
Q

stats on Hep B

A

102 million people infected In US
240-350 million have chronic HBV
~25% of people worldwide will be infected with HBV at some point

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20
Q

how is HBV spread

A
  • mother to fetus or childhood where there is endemic

- sexually of blood transmitted disease in the developed world

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21
Q

which virus led to the development of universal precaution recommendations of the ADA and CDC for dentists in the 70s following a series of disease clusters in dental practices

A

HBV

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22
Q

what type of virus is HBV and what is the implication of that

A

it is a DNA virus and therefore it can integrate into cell DNA

we know this because of genome sequencing. it was found in 11000 year old human remain, integrated into the DNA

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23
Q

Hep B infection

A

acute with resolution (90% in adults)
Chronic- can be a carrier or persistent
carrie can continue to spread infection despite the lack of symptoms

24
Q

what is the risk of chronic infection for infants and children?

A

90% and 25-50% respectively

25
Q

what are acute HBV symptoms similar to?

A

HAV but with joint pain

26
Q

how many virions per day are produced by HBV

A

E10-E11 per day
mutates rapidly
like HIB

27
Q

Chronic hepatitis (B)`

A

> 6 months of liver inflammation
detected by Alanin aminotransferase ALT in the blood
eventual death from infection in 15-20% of chronically infected people

28
Q

what is ALT and what is it indicative of

A

a liver-specific enzymes

its presence in blood indicates liver injury

29
Q

what does chronic infection due to Hep B lead to?

A

cirrhosis of the liver
liver cancer= heptocellular carcinoma
chronic inflammatory response which damages DNA in liver cells

30
Q

what exacerbates liver damage

A

alcohol

31
Q

Hep B
acute vs chronic
asymptomatic vs symptomatic

A

outcome determined by the cellular (Tcell) immune response

strong response causes liver disease in the short term but resolution of infection in the mid-term

32
Q

in hep b, acute vs chronic
asymptomatic vs symptomatic
Weak cellular response leads to

A

chronic infection and long term risk of advanced disease: liver scarring, cirrhosis, liver cancer- primary hetpatocellular carcinoma

a person becomes a carrier
carriers do not necessarily display overt symptoms but can spread the virus

infection of infrequntly leads to them become chronically infected carriers

33
Q

Hep B comes in 2 forms

A
  1. infection virion= dane particle
  2. Immune decoy

there is a lipid envelope

34
Q

what is tested for in an active Hep B infection

A

HBsAg

35
Q

prevention and treatment of Hep B

A

safe sex, no iV drug use (needle sharing)

there are no antivirals for acute infection
chronic can be treated with RT inhibitors that is also used for HIV (Lamivudine)
immune serum can be given after exposure and to newborns of HBV positive mothers

36
Q

what is recombivax

A

a subunit vaccine
uses recombinant DNA technology to make HBsAg particles
3 injections and a time test for antibodies to surface antigen

37
Q

what does HBV vaccine do?

A

elicits an antibody response

prevent virus from reaching liver

38
Q

can the HBV vaccine be give to pregnant women

A

yes and also can be given as a post-exposure prophylaxis

39
Q

HCC vs PHC

A

hepatocellular carcinoma= primary heptocellular carcinoma

40
Q

HCC is

A
  • associated with HBV infection 50-70% of the time
  • HCC tumor DNA has HBV DNA sequences integrated in them
  • alcoholism is risk factor
41
Q

what does chronic HBV and HCV infection cause?

A

ongoing inflammatory responses and oxidative damage to chromosomal DNA of hepatocytes

42
Q

how does the integration of HBV DNA occur

A

occurs in breaks in the cellular DNA of hepatocytes

43
Q

HCV acute symptoms

A

similar to other hepatitis virus infections

chronic fatigue is common

44
Q

what happened before a blood screen for HCV was developed?

A

HCV was a risk factor in transfusion and transplants

non-A and non-B hepatitis (NANBH)

45
Q

facts about HCV

A

1989 - a new viral genius was found in hepatocytes but was impossible to grow in lab until recently

2.7-4 million infected inUS, 170 million in world

46
Q

HCV spread

A

most spread through blood contact
IV drugs, tattooing, unsterilized surgical equipment
mother to child during childbirth

47
Q

Hep C statistics

  • acute infection
  • chronic persistent infection
  • rapid disease progression
  • % of patients with liver cancer
  • % of heptocellular carcinomas associated with HCV
A 
~15%
~70%
~15%
~5%
~25%

Of every 100 persons infected with HCV, approximately
• 75–85 will go on to develop chronic infection
• 60–70 will go on to develop chronic liver disease
• 5–20 will go on to develop cirrhosis over a period of 20–30 years
• 1–5 will die from the consequences of chronic infection (liver cancer or cirrhosis)

48
Q

Hep C structure

A

falvivirus
+ssRNA
enveloped

Mutates rapidly because an RNA virus
these is a great diversity in the glycoproteins which are the major antigens

49
Q

how many visions produced per day

A

E10-E11

just live HIV and HBV

50
Q

how many major serotypes/genotypes

A

6 and there is no cross protection

51
Q

what is tissue damage from HCV caused by

A

cell-mediated immune response of infected cells

the virus itself is apparently non-cytopathic

52
Q

HCV prevention and treatment

A

alcohol worsens liver damage

no vaccine- in part due to variability

53
Q

Ribavirin+ pegylated interferon alpha

A

was the standard of care for HCV until sofosbuvir
side effects are severs
cure rate 50%

54
Q

Sofosbuvir- how it works

A

recently approve to treat HepC
it inhibits the viral RNA polymerase- a chain terminator
can cure Hep C in many cases
could lead to complete elimination of HCV

55
Q

chronic infections

HIV and HCV

A 
enveloped
icosahedral
\+strand single- stranded RNA viruses
9kb genomes
transmitted through bodily fluids
mutate rapidly 
causes chronic infection
56
Q

can HCV be spread during medical or dental procedures?

A

As long as Standard Precautions and other infection control practices are used
consistently, medical and dental procedures performed in the United States
generally do not pose a risk for the spread of HCV. However, HCV has been
spread in health care settings when injection equipment, such as syringes, was
shared between patients or when injectable medications or intravenous
solutions were mishandled and became contaminated with blood. Health care
personnel should understand and adhere to Standard Precautions, which
includes Injection Safety practices aimed at reducing bloodborne pathogen
risks for patients and health care personnel. If health care-associated HCV
infection is suspected, this should be reported to state and local public health
authorities.

Micro (virology) (7 decks)

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