Lecture 3 Viral Hepatitis Flashcards Preview

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Flashcards in Lecture 3 Viral Hepatitis Deck (15):

  • What are the different Hep viruses?
  • Which ones have a chronic carrier state? 
  • Which ones are faecal-oral?
  • Which ones are parenteral/sexual? 

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  • What is the most common form of Hepatits?
  • Is it going down in infection? Up? 
  • What is the biggest concern about those infected with HBV and HCV?


  • Hep C is the most common with 30k new cases and 4 million are chronic carriers 
    • Hep B second most common with 1 M in a chronic state
    • Hep A is third most common
  • The numbers of infected people are going down in general but not for HCV 
  • The problem with chronic carriers is that they're unaware they have the disease 



  • What is a significant stat about the widespread of HAV?
  • What does it mean to be acutely infected? 


  • About 50% of US population showed antibodies for it pre-vaccine
    • High rate of subclinical infections without jaundice 
    • No chronic carrier state 
  •  Acute infection:
    • accesses new host via fecal oral route and then there is a long incubation of 15-50 days 
    • This is when virus is replicating in intestine and the carrier can spread the infection
    • This is prior to clinical symptoms 




  • What is the pre-Icteric phase?
  • What is the Icetric phase? 


  • Both these phases are when clinical symptoms start showing 
  • PreIcteric phase:
    • Begins with fever, lack of energy, anorexia and lack of appetite
    • Leads to vomiting and diarrhoea 
  • Icteric phase 
    • Viremia and liver infection leading to necrosis and inflammation 
    • Bilirubin excreted in the blood leading to jaundice and melanin in urine to produce dark urine 
    • usually lasts 1-2 weeks most patients recover on their own. 



What are the treatments and prevention of HAV? 

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  • What are the major source of infection? 
  • how many of them are asymptomatic? 
  • How long is the immunity developed? 


  • Major source of infection is sexual contact and IV
  • 30-50% are asymptomatic 
  • The antigen appears for 6 months or less followed by the appearance of the Antibody and IgG will last a life time so its life time immunity. 



  • What are the complications of acute hepatitis B infection?

  • Fulminant? 
    • 1-3% of cases Co infection with HEP D virus and has high mortality rate 60-90%
  • Chronic: lasts longer than 6 months 
    • Patient are chronic carriers of HBsAg
    • Chronic active hepitatis CAH
      • Coinfection with Hep D virus and developes hepatic necrosis and hepatocellular carcinoma
      • Poor prognosis 



  • How do you prevent Hep B? 
  • How many vaccines are there? 
  • What is the recommendation? 
  • What are the antiviral treatments? 
  • What is a problem with antivirals? 


  • 3 forms of vaccines:
    • Recombivax HB 
    • Engerix-B
    • Twinrix 
  • Recommended to take 3 doses and 98% protection after complete series 
  • Antivirals:
    • Alpha interferon
    • Lamivuidine (Nucleotide analogue) 
    • Baraculude



  • How is HCV contracted?
  • What are the 5 key points in lecture? 


How is HCV contracted?

  • 40-50% are intravenous drug use
    • Transfusions
  • Renalhemodyalisis 
  • tattooing and high risk behavior 

Key points:

  • The high rate of subclinical cases 60-70%
  • Causes of chronic liver disease and cancer
  • Chronic carrier state 80% 
  • The onset of illness is insidious 




  • How do you diagnose HepC?
  • What is the traditional antiviral therapy?
  • Is there a vaccine? 



  • Diagnosis:
    • Abnormal liver function
    • Elvated HCV antibodies (By Elisa) 
    • VIral RNA in PCR serum
  • Traditional treatment? 
    • Alpha interferon
    • Pegylated Alpha interferon
    • Ribavirin and Pgalpha-Inf combination 
  • No FDA Approved vaccine



  • What is the treatment of HCV?

  • Very effective new antivirals but very expensive 
  • Two are simepervir
    • Its a protease 
  • Sofosbuvir
    • Polymerase used in combination
    • Used with PEG-INF and RIbavirin will cure up to 90% of genome 1 HCV 



What is HDV? 

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What are the clinical aspects of HDV?


  • HDV only present in HBsAg Carriers that may progress to liver cirrhosis or hepatocellular carcinoma (30% mortality)
  • Hemophilliacas and IV drug users are at risk 


USe Anti HDV antibodies to detect 



What is HEV? 

  • Wide spread infection cause Acute hepatitis 
  • 20 M cases/yr 10-30% mortality 
  • Rare in US 
  • No antiviral, no vaccine and no chronic infection