L26 BW (viral hep) Flashcards by Rebecca Lea

HBsAg (-)

total anti-HBc (-)

anti-HBs (-)

susceptible

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what makes fulminant (aka super severe) hepatitis more likely

HBV/HDV infection

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what is a big concern about HBV and why

chronic infection b/c 10% will develop cirrhosis and liver failure

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HBsAg

****HBV surface antigen *****

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what is it called when you get HDV after you already have HBV

superinfection

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what is a good test for HCV

OraQuick HCV- a new rapid test to reveal antibody

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HDV prevention

the HBV vaccine

also PEG interferon to tx

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which hep is far more likely to establish chronic infections

HCV

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HBV complications

cirrhosis, liver cancer

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what antibodies and antigens you will see in HBV window

anti HBe (anti- infectious surface fragments)

total anti-HBc

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HAV transmission

food and water borne; virions are excreted in feces

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continued detection of what antigens reveals a probably chronic state of HBV

HBeAg and HBsAg

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acute icteric hepatitis consists of what phases

incubation

prodrome (fatigue, malaise, anorexia)

icteric phase (jaundice, hepatolmegaly, elev liver enzymes)

convalescent phase (disappearnace of sxs)

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what increases the severity of HBV infections

HDV

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what antibodies and antigens are you going to see there is

resolution after the onset of HBV and it

does NOT progress to chronic

antibodies to surface/ surface fragment antigens and totaly anti-HBc

IgG- anti HBs (anti-surface)

anti-HBe (anti- infectious surface fragments)

total anti-HBc

no antigens

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which types are chronic

B, C, D *******

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IgG anti- HBs

(antibody to surface antigen)

indicates

chronic disease

(with previous exposure)

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what % of infants infected with HBV will become chronically infected

90%

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HBsAg (+)

total anti-HBc (+)

IgM anti-HBc (-)

anti-HBs (-)

chronically infected

dont have IgM and anti HBs b/c

IgM anti-HBc would only be there if it were a new infection

anti-HBs doesn’t develop until way late in the game for people w/ chronic infection

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convalescent phase

disappearance of jaundice and other sxs

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what has reduced risk of infection from blood and blood products

serological screening

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how many genotypes of HCV

6 genotypes and 50 subtypes

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D incubation period

1-6 months

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tx for HCV

direct acting antiviral agents that specifically antagonize virus functions

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what is it called when you get HDV and HBV at the same time

coinfection can be more rapid and severe

when is HBV shed

during asymptomatic periods

C incubation period

2-24 weeks (but mostly 6-7 weeks)

HBsAg (-) total anti-HBc (-) anti-HBs (+)

immune due to vaccine

what antibodies and antigens you will see in HBV onset

first HBsAg- surface antigen (initial villain) then HBeAg- surface fragments (infectious particles) IgM- anti HBc (anti-core) (police)

detection of what antigen is best ID an infectious HBV virus

HBeAg

hallmark of HCV

chronic infection

HBV dx

serum showing antibodies and antigens

total anti-HBc indicates

exposure could be current, could be chronic, could be resolved

what do pts with HAV need to avoid

hepatotoxins- alcohol, drugs, anesthesia

what factors promote HCV progression

ETOH, infection after 40, male, HBV co-infection, HIV co-infection

for many cases of HCV, the source of infection is \_\_\_

unknown- many at risk pts don't know they should be tested

Ig M- anti HBc (antibody to core) indicates

new exposure only around for the acute exposure won't be present in chronic or w/ resolution

major risk factor for HAV

contact with infected family member

HCV drug regimens vary by

virus genotype

prodrome, aka what? sxs?

(aka pre-icteric phase) fatigue, malaise, anorexia

HBcAg

\*\*\*\*HBV core antigen\*\*\*\*

what is the infectious cause of primary hepatocellular carcinoma

HBV!!! \*\*\*\*\*\*\* this was mentioned twice! 80% of hepatocellular carcinoma is linked to chronic HBV \*\*\*\*\*

anti-HBs indicates

vaccine or resolved infection \*\*\*immunity\*\*\* you've got nothing SIMMERING

dane particle

infectious form of HBV

what does HBV tx do?

antagonizes viral replication, preventing extensive liver damage... NOT A CURE

how to prevent HAV

**proper hand washing,** PEP early in infection (85% effective in 1st 2 weeks of exposure) inactivated vaccine

why would tx of HBV be contraindicated?

depends on there liver function and virus replication status (viral load)

A incubation period

2-6 weeks

type of HBV vaccine

subunit

what antigens and antibodies are you going to see if you have someone who was vaccinated for HBV

antibodies to surface and surface fragment antigens: IgG- anti HBs (anti-surface) anti-HBe (anti-infectious surface fragments) **no antigens**

what % of people with acute HCV develop chronic

85%

major reservoir for HBV

chronic hepatitis patients

HBsAg (+) total anti-HBc (+) IgM anti-HBc (+) anti-HBs (-)

acutely infected

what equates to a poor prognosis for HCV

long time without detection

what is not a good test for HCV

ELISA because chronic state and viremic pts often escape detection because seroconversion is slowly after 24 weeks

the incubation period of hepatitis represents

a dose dependent range

IgM

anti-HBc antibodies against core antigen indicates new, ongoing HBV infection if present with HBsAg in serum (diagnostic) Mr. Policeman, He's the 1st responder

what can a pt be given for tx of HBV?

polyethylene glycol (PEG) interferon and or agents to inhibit the viral polymerase including nucleoside and nucleotide analogues

HAV dx

IgM antibody by ELISA

HBsAg (-) total anti-HBc (+) anti-HBs (+)

immune due to prior natural infection

HBsAg is present in

active disease S = SIMMERING (acute or chronic)

HBeAg

HBV surface antigen fragment- presence indicates a pt is infectious \*\*\*\*\*\*\*

NANB hepatitis

not A not B 90% of the time this is C

is interferon required for chronic HCV infections

no- there are several tx options

populations at risk of HBV

\*\*\* HEALTHCARE WORKERS and IVDUsers\*\*\*\* also: gays, slutty straights, institutionalized ppl, family contacts of infected

tx for most HBV infections

most resolve spontaneously and do not require anti-viral tx

which populations of HBV pts are at high risk of becoming chronic

perinatal and peds

why is dx of HCV tricky

it often eludes immune mechanisms

most acute HCV infections present

asymptomatic and are therefore not diagnosed in the acute phase

what antibodies and antigens are you going to see if HBV progresses to chronic

HBsAg- surface antigen HBeAg- surface fragments = infectious total anti-HBC (no IgM- anti HBc, he's just around for the acute phase)

risk factors for HCV

CONTACT WITH HEALTHCARE PROVIDERS, IVDU, dialysis, tattoos, transfusions, transplants

in developed countries the peak of transmission of HCV occurred between what years

1960-1980

B incubation period

2-6 months

HDV is what type of virus

a viral parasite of HBV that uses HBsAg for its capsid

type of HAV vaccine

inactivated virus

with HDV often comes

chronic infection

up to __ in ___ people of what age group may be infected with HCV and may begin presenting with cirrhosis and or cancer soon

1 in 33 baby boomers

Type D Hepatitis

delta agent, ONLY in pts with active HBV infection

icteric phase sxs

JAUNDICE, dark urine, hepatomegaly, high ALT and AST

E incubation period

3-9 weeks

HCV dx

ELISA + a confirmatory test (ie western blot or direct nucleic acid test)

what is an EXTRA rapid and severe HDV outcome

when it co-infects with HBV in a previously uninfected individual

L26 BW (viral hep) Flashcards

(82 cards)