Infectious Causes of Hepatitis

Question 1

What hepatitis viruses are most common?

Answer 1

Hepatitis A, B, C

Question 2

This type of test is used to diagnose hepatitis infection by testing for viral antibodies.

Answer 2

ELISA test

Question 3

This hepatitis antigen is secreted and serves as a marker for the level of infection.

Answer 3

HBeAg

Question 4

What are the two most common risk factors for HBV & HCV infection?

Answer 4

Injection drug use and having multiple sex partners

Question 5

A patient previously diagnosed with HBV is tested for the presence of HBsAg antibodies. The test returns negative. What does this indicate?

Answer 5

The patient is still infected with the virus and does not have immunity. If it has been years since the initial diagnosis, the patient is chronically infected.

Question 6

How does co-infection with HBV & HDV differ from superinfection?

Answer 6

Co-infection is infection with both viruses in a patient who was previously hepatitis negative.

Superinfection occurs when a patient with chronic HBV develops HDV.

Question 7

HCV is most common in the USA among millennials and baby boomers. Why is this?

Answer 7

Millennials - injection drug use

Baby boomers - blood transfusions before screening

Question 8

This hepatitis antigen is responsible for forming the capsid.

Answer 8

HBcAg

Question 9

These hepatitis viruses are transmitted via fecal/oral route.

Answer 9

HAV, HEV

Question 10

The patients are at higher risk of severe HEV infection.

Answer 10

Pregnant women in their third trimester, organ transplant recipients

Question 11

What genotype of HEV is responsible for chronic infections?

Answer 11

Genotype 3

Question 12

True/False. HBV HBsAg antibodies do not appear until HBsAg is cleared from the body.

Answer 12

True. Positive HBsAg indicates active infection. Antibodies to HBsAg indicate immunity.

Question 13

A patient with active HBV infection has high levels of HBeAg, no antibodies to HBe, and high liver enzymes. What is the classification of their infection?

Answer 13

HBeAg+ Immune Active HBV

Question 14

This hepatitis virus can spread from them other to the fetus via the placenta.

Answer 14

HBV

Question 15

What is the HBV infection classification of a patient with low HBeAg levels, positive for HBeAg antibodies, and high HBV DNA levels?

Answer 15

HBeAg-Negative Immune Reactive HBV

Question 16

What is the HBV infection classification of a patient with low HBeAg levels, positive for HBeAg antibodies, and normal liver enzyme levels?

Answer 16

Inactive HBV Carrier

Question 17

This hepatitis antigen is present on the surface of all viral particles.

Answer 17

HBsAg

Question 18

In the USA, HAV infections have decreased due to vaccination. In recent years, among what populations are most new infections found?

Answer 18

Injection drug users and people experiencing homelessness

Question 19

This hepatitis virus cannot cause chronic infection.

Answer 19

HAV (& HEV, except in rare cases of organ transplants)

Question 20

This hepatitis virus only infects in the presence of HBV.

Answer 20

HDV

Question 21

The presence of this antibody indicates prior exposure to HAV and protective immunity.

Answer 21

IgG

Question 22

A patient is infected with HBV. They have relatively high viral levels, but normal liver enzymes. What is the classification of their infection?

Answer 22

Immune-Tolerant HBV - generally infected as infants

Question 23

What mechanism of HCV shields the virus from the immune response and contributes to chronic infection?

Answer 23

HCV associated with VLDLs to form a lipoviral particle that shields viral antigens

Question 24

What are the routes of transmission for HBV, HCV, & HDV?

Answer 24

Blood, IV drugs, sexual (except HDV)

Question 25

How can an active HCV infection be identified?

Answer 25

A positive test for HCV antibodies only indicates exposure to the virus. A follow-up test for viral RNA must be completed. A positive test indicates active infection. A negative test in the presence of viral antibodies likely rules out chronic infection, but additional tests may be recommended.

Question 26

What is the window period in HBV infection?

Answer 26

HBsAg antibodies are not present until HBsAg is cleared from the body. The window period is the time between antigen clearance and the development of antibodies.

Question 27

How is the replication of HBV unique compared to other hepatitis viruses?

Answer 27

HBV is a DNA virus, but it replicates via an RNA intermediate using a reverse transcriptase