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Hepatitis Viruses Flashcards

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1
Q

What causes the most chronic viral hepatitis in the US?

A

hepatitis C

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2
Q

Which hepatitis viruses cause acute infection?

A

A, E

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3
Q

what kind of virus family is hepatitis A of

A

picornavirus

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4
Q

Unlike many RNA viruses, what is notable about the serotypes of hepatitis A?

A

has only a single serotype

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5
Q

how is hep a transmitted

A

fecal oral

contaminated food, water, shellfish, poor hygiene

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6
Q

symptoms of hep a virus

A

asymptomatic

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7
Q

can someone who has gotten hep A be infected again?

A

no, its protective antibodies provide lifelong immunity

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8
Q

what is notable about the capsid of picornaviruses

A

stable to acid, drying, detergents

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9
Q

how does hepatitis A enter its site?

A

enters cells through receptor enriched in liver

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10
Q

what is different about hep A from the other picornaviruses

A

it’s not cytolytic– just shed from cells

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11
Q

tissue culture system for hepatitis viruses

A

no good one for A, B

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12
Q

pathology in the liver from hep A is due to

A

most likely immunopathology

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13
Q

incubation time of hep A

A

30 days

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14
Q

symptoms of hep A

A

jaundice in some pts

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15
Q

What comes first, IgM or IgG

A

IgM

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16
Q

prevention for hep A

A

inactivated hep A vaccine used for high risk people: infants, travel, chronic liver disease, ppl working w HAV

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17
Q

frequency of hep A infection in the US in recent years

A

has decreased since 90s, after vaccine licensed

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18
Q

family of Hep E virus

A

calicivirus

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19
Q

genome of HEV

A

+ sense ss RNA

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20
Q

shape of HEV

A

icosahedral

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21
Q

what is HEV known as

A

enteric virus

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22
Q

transmission of HEV

A

fecally contaminated water
minimal person to person

US cases usually from travel

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23
Q

incidence of HEV in the US

A

sporadic, not endemic

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24
Q

prevalance of HBV in US

A

low

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25
what is notable about the outcomes of Hep B virus infections?
they are different depending on age young-chronic infection chance higher, but symptomatic infec lower older children, adults--chronic infec chance lower, symptomatic infec chance higher
26
family of HBV
hepadnavirus, genotypes A-H
27
envelope or not for HBV
enveloped
28
what is the receptor for HBV
sodium bild acid cotransporter
29
genome of HBV
circular DNA that is partly double stranded
30
life cycle of HBV
``` genome enters DNA synthesis to make complete dsDNA then goes to nucleus trnascribed to mRNA mRNA translated in cytoplasm ``` mRNA reverse transcribed to ssDNA, DNA is made partially DS!!!! viral particles are released, as well as sub-viral particles of sAg
31
what is notable about the DNA of HBV?
it can integrate into the chromosome and stay in the cell
32
what do HBV infected cells release?
infectious viruses as well as non infectious HbsAg particles
33
HbsAg
antigen without DNA--not infectious
34
what was the foundation for the HBV vaccine
HbsAg
35
risk factors for acute hep B in US
sex | intravenous drug users
36
transmission of HBV from what?
``` nursing vaginal secretions blood semen saliva ```
37
how can one get a HBV infec
neonates nursing sex IV drug use blood
38
how does HBV spread in the body in infection?
goes to blood Ab develops goes to liver, where it replicates--with cell mediated immunity, you have symptoms and resolution, or it can go back to blood, infect, etc
39
symptoms of HBV
``` RUQ pain nausea anorexia malaise jaundice dark urine ```
40
when do you start shedding HBV after infec?
2 months later
41
timeline of antibody development against HBV
anti HBc first then Anti HBe AntiHBs
42
outcomes of HBV infec in ADULTS
90% have resolution 9% have HbsAg for more than 6 months--which can go on to be resolution, or asymptomatic carrier state, or chronic persistent hepatitis, or chronic active hepatitis (can lead to hepatic cell carcinoma)
43
what influences the outcome of HBV infec?
immune control presence of HDV (delta agent) immune control--if limited cell med response, get chronic disease and mild symptoms, can lead to cirrhosis or primary hepatocellular carcinoma or fulminant hepatitis Delta agent can cause a chronically infected HBV individual to get fulminant hepatitis
44
hep D virus
viroid--can only grow in HBV infected cells
45
genome of Hep D virus
small RNA that is a riboyzme that processes itself
46
What does the genome of hep D encode
1 antigen that is packaged in Hep B sAg
47
what type of infection is hep D?
coinfection that is acute superinfection (after the HBV infec)
48
implications of Hep D for disease
higher risk of severe chronic liver disease
49
why chronic HBV infec leads to high incidenc of hepatocllular carcinoma
injury to liver->proliferation of cells that are usually quiescent--genetic errors can accumulate integration of viral DNA into host chromosome causes genomic instability--can cause changes in host gene expr virally encoded X protein--associated w/ signal transduc cascades that can be oncogenic--X lowers p53 activity HCC in mice is associated w/ surface antigen expr ession and X expression
50
incidence of acute Hep B in the US in recent years
has decreased since 80s and 90s when HBsAg screening of pregnant was recommended, immunization was recommended for infants,
51
prevention of HBV
screen blood vaccination blood/body fluid precautions
52
treatment of HBV
polymerase inhibitors nucleoside analogs IFN alpha
53
family of hep C
flavivirus
54
genome of hep C
+ strand RNA
55
enveloped or not for hep C
enveloped, associated with VLDL
56
what is notable about transcription for Hep C
error prone RNA polymerase leads to many quasi-species, so no vaccine
57
what does genome of hep C encode
multiple immunomodulators enabling its persistance
58
what is liver damage in Hep C a result of
mostly immunopathology
59
what does hep C increase the risk of
hepatocellular carcinoma
60
hep C causes highc incidence of chronic and ___ infections
asymptomatic
61
what mediates translation for hep C
IRES
62
what happens w the protein translated by hep C
protelytic processing
63
which virus has a close relationship w intracellular lipids and membranes
Hep C
64
sources of infection for Hep C
intrav drug use sex transfusion
65
incidence of hep C of late
has gone down since the 90s because of screening of blood
66
outcomes of HCV infec in ADULTS
15% -recovery and clearance 85% - persistent infection applies for immunocompetent
67
what can persistent HCV infec cause
chronic hepatitis--leading possibly to liver failure, or cirrhosis, or hepatocllular carcinoma
68
why does HCV chronic infec lead to high incidence of hepatocellular carcinoma
HCV core protein regulates many cell tumor suppressors (p53, Rb), pathways in proliferation HCV core protein induces steatosis, leading to oxidative stress, increased cell prolif inhibit NK cells enhance cell growth
69
role of miRNA 122
enhances translation and/or replication for HCV by binding and regulating its mRNA
70
most prevalant genotype of HCV
1
71
HCV therapy
direct acting against viral components host targeting
72
when is hep A virus shed?
in feces before symptoms appear

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