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hepatitis viruses Flashcards

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1
Q

Hep A viral type?

A

picornavirus

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2
Q

Hep A genome

A

ssRNA

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3
Q

Hep A capsid

A

naked icosahedral

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4
Q

is Hep A environmentally rugged

A

yes

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5
Q

Hep A serotypes

A

single

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6
Q

Hep A vaccine?

A

yes

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7
Q

how is Hep A transmitted

A

fecal-oral, infects hepatocytes

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8
Q

what is the usual l symptoms

A

asymptomatic. if there are symptoms then it is usually acute hepatitis. this is mostly immunogenic. the virus is often cleared with no chronic infevtion

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9
Q

what is the worst complication of Hep A

A

fulminant hepatitis. mortality 40%

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10
Q

what to look for on history for Hep A

A

vaccination, foreign travel, shell fish, daycare

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11
Q

what to look for on exam for Hep A

A

fever, jaundice, gastroenteritis, tenderness around the liver, dark urine, pale feces.

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12
Q

what is an IgM positive EIA for Hep A indicative of?

A

acute infection

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13
Q

what is an IgG positive EIA for Hep A indicative of>

A

resolution or vaccination

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14
Q

what determines liver damage on labs for Hep A

A

serum ALT

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15
Q

how do we treat Hep A

A

rest, fluids, monitoring, discontinue alcohol use and contraindicated medications.

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16
Q

prevention of Hep A

A

hand-washing, sanitation, vaccine (IgG long term protection), immune serum prophylaxis.

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17
Q

hep E capsid

A

small naked, icosahedral.

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18
Q

hep E genome

A

positive sense, single strand RNA

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19
Q

hep E serotypes

A

single

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20
Q

hep E transmission

A

fecal-oral, similar to A, acute usually resolves.

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21
Q

what is more deadly hep E or A

A

E is 10X more deadly. mortality in pregnant women is 15-20%

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22
Q

what to look for exam for hep E

A

fever, jaundice, gastroenteritis, tenderness around the liver, dark urine, pale feces. same as A

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23
Q

lab work for hep E

A

serum ALT, serodiagnostics

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24
Q

treatment for hep E

A

rest, fluids, monitoring, discontinue alcohol use and contraindicated medications. same as A

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25
prevention for hep E
HEV239 vaccine
26
Hep B type
hepadnavirus
27
Hep B genome
small, enveloped DNA genome that is partly double stranded
28
what is the pathogenesis of Hep B
replication in hepatocytes is partial and leaves behind many decoys. also integrates into host DNA to establish chronic infection.
29
serotype for Hep B
single. with no reinfection.
30
is there a Hep B vaccine?
yes.
31
how is Hep B transmitted
blood, sex, birthing.
32
what is the infectious process of Hep B
90% are acute hepatitis then clear. others fulminant or chronic.
33
what are the complications of Hep B
cirrhosis via immunogenic. there is kidney damage and arthritis due to complex formation. hepatocellular carcinoma due to integrated viral DNA and ongoing hepatocyte regeneration.
34
what to look for on exam for Hep B
hepatitis and history of vaccine?
35
labs for Hep B
serology for time course of infection. look for surface antigen, antibody, core antibody or E antigen. there is also optional PCR.
36
what lab for incubation period? Hep B
HBsAg -surface antigen
37
what to look for in Hep B prodrome or acute disease
HBsAg, anti-HBc
38
what to look for on labs for Hep B convalescence early phase
anti-HBc
39
what to look for on labs for Hep B convalescence late phase
anti-HBs (anti-HBc)
40
treatment for Hep B acute infection
supportive
41
treatment for Hep B quiescent chronic
monitor
42
treatment for Hep B damaging chronic
discuss interferon therapy -1 year polymerase inhibitors, 4 months pegylated alpha-interferon.
43
prevention of Hep B
vaccine and immune prophylaxis.
44
what percentage of Hep B have resoluton?
90%
45
what percentage of Hep B go fulminant hepatitis
1%
46
what percentage have persistent surface antigen for >6 months
9%
47
what are the common extrahepatic diseases associated with Hep B
polyarteritis nodosa and glomerulonephritis
48
hep D is what?
viroid parasite of hep b. encodes single delta antigen. all other parts are obtained from coinfection with hep B.
49
is hep D capable of solo infection
no
50
how can hep D infect?
either coinfection or superinfection with hep b
51
define superinfection for hep D
when hepatocytes already are infected with hepb but then become infected with hep D. this is more likely than coinfection
52
how is hep D spread
blood, sex
53
what is the hep D delta antigen
hepatotoxin f
54
what is likely to happen with hep D infection
fulminant hepatitis
55
how do we diagnose hep D
hepatitis with hep B + history,. EIA for delta or antibodies against it. follow up with PCR.
56
what is the treatment for hep D
none that are effective. liver transplant if criteria.
57
prevention of hep D
hep b vaccine and prophylaxis. stop IVDU
58
hep C type
flavivirus
59
is hep C enveloped
yes
60
hep C genome
positive-sense RNA genome
61
is there a vaccine for hep C
no
62
how is hep C transmitted
blood, sex.
63
what percentage of hep C is chronic
85%. maybe latent for many years. can proceed to liver failure
64
what to look for when diagnosing hep C
mild acute hepatitis. EIA followed by RIBA and genotyping.
65
how do we assess therapy for hep C
RT-PCR. judge severity by biopsy
66
2nd generation treatment for acute hep C
pegylateed interferon to reduce risk of chronic
67
2nd generation treatment for chronic hep C
attempt to sustain viral response by combination. 1. ) ribavirin -viral chain terminator and immune modulant 2. ) pegylated alpha interferon 3. ) HCV protease inhibitors
68
what are the HVC protease inhibitor drugs?
boceprevir or telaprevir
69
which serotypes of hep c respond better to treatment
2 and 3 need only 6 months of therapy to have >50% SVR rate.
70
what are the harder serotypes of hep c to treat
1 and 4. need 1-2 years of therapy for <50% of SVR.
71
which hep c serotype are the 2nd generation protease inhibitors used for?
serotype 1
72
what to monitor when treating hep c
liver, kidney, blood, viral load
73
what is the main problem in treating hep c
the severe side effects usually cause discontinuation of treatment
74
3rd generation treatments?
simeprevir claims cure for 1. sofosbuvir combination with ribavirin active against 2 nd 3

micro unit 6 (7 decks)

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