L76 (Hep C, A, E) Flashcards Preview

Viruses & Parasites > L76 (Hep C, A, E) > Flashcards

Flashcards in L76 (Hep C, A, E) Deck (34):
1

Hep C genome

+ ss RNA
LARGE
Genotypes 1-7

2

What are the 3 Hep C drug targets?

Non-structural proteins - disable these, disable viral fxn
NS -34A = Protease
NS-5B = RNA pol
NS-5A = critical for viral replication

3

Hep C transmission

Blood - IVDU!!!
Sex
Perinatal

4

Hep C receptor on liver cells

CD81
Shows liver tropism

5

Where does Hep C replicate in host cells?

Cytoplasm - ER

6

Can Hep C go chronic?

Yepppp
Cirrhosis or cancer

7

Most common US genotype

1a

8

Diagnose Hep C

1. ELISA for Ab - more a rule out test
Follow up with
2. PCR for RNA (viral load)

9

Which is more likely to resolve in acute on own: Hep C or B?

B more likely to resolve as acute
C - chronic

10

What is the difference between Hep C and B cancer risk?

C chronic more stable
B you're worried about a switch flip to cancer

11

Who do you treat for Hep C

Fibrosis stage 2+
Need to make sure will be treatment compliant

12

Treat Hep C

A CURE!!!
DAAs = direct acting anti-virals = target non-structural genes
2 DAA =
- Harvoni
- Veikira

13

Hep C grade vs stage

Determined by biopsy
Grade = amt liver inflam
Stage = amt of fibrosis

14

Hep C treatment issues

$$$
Resistance
- Fail NS5A regimen, don't have great alternatives

15

What is unique about genotype 3 treatment?

Doesn't respond great to DAAs
Better on IFN, but we don't use this anymore due to toxicities

16

Define Hep C cured

No viral load for 3-6 mos

17

Why can't you cure HIV or Hep B?

B/c genetic elements persist in the nucleus
HIV - integrates into host DNA
HBV - cccDNA

18

What is Harvoni

Ledipasvir + Sofosbuvir
Ledi = X NS5A (critical for rep)
Sofo = X RNA pol

19

What is Veikira

Protease inhibitor +
NS5A inhibitor +
Non-nucleoside NS5B inhibitor

20

Hep A genome

+ssRNA
Picorna - acute viral hepatitis

21

Hep A transmission

Food/water contaminated by feces (Seafood)
Oral --> GI --> blood --> liver
Replicates in liver --> released in bile = infectious feces

22

Can Hep A go chronic?

Nope

23

Treat Hep A

Supportive

24

Hep A vaccine

1. Passive IG - travelers
2. Active vaccine

25

Hep E genome

+ssRNA
Naked

26

Hep E genotypes

1 & 2 = human host
3 & 4 = pig host, human accident

27

Who are you worried about getting a genotype 1 or 2 Hep E infection? Transmission.

Will infect pregnant women!!!
- HIGH mortality :(
Fecal-oral/water transmission

28

Unique characteristics of Hep E genotypes 3 & 4

Food borne (pork)
Neuro complications

29

Treat Hep E

Supportive

30

Which hep strains can cause fulimnant liver failure?

A
B
E in pregnant women

31

Which hep strains can become chronic?

C !!!
B - newborns
E - transplant pts

32

Which hep strains will resolve?

A
E
Most B
Some C - likely not

33

Which hep strains have active and passive vaccines?

A
B

34

Which hep strains do you treat with anti-virals?

B
C