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Unit 4: Diagnostic Virology and Bacterial Serology > Section 2: Viral Hepatitis > Flashcards

Section 2: Viral Hepatitis Flashcards

(37 cards)

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1
Q

Hepatitis

A

-inflammation of the liver
-the specific cause can vary (viruses, alcohol, drugs, toxins, autoimmunity)

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2
Q

Hepatitis symptoms (physical)

A

-nausea
-abdominal pain
-fever
-malaise
-anorexia
-dark urine
-clay colored stool
-jaundice

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3
Q

jaundice

A

-yellowing of skin and whites of eyes

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4
Q

hepatitis with jaundice is called?

A

-icteric

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5
Q

hepatitis without jaundice is called?

A

-anicteric

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6
Q

Hepatitis lab results

A

-you have elevated levels of ALT, AST, Bilirubin, and PT (clotting time increased)
-can test for the presence of a variety of viruses that infect or affect the liver

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7
Q

hepatotropic viruses

A

-viruses that specifically seek out cells of the liver (tissue tropism)
-Hepatitis A, B, C, D, and E (similar names, but different viruses)

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8
Q

Nonhepatotropic viruses

A

-viruses that primarily infect other cells but can infect cells of the liver

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9
Q

Herpesviridae

A
  • Epstein-Barr Virus (EBV-Mono), varicella zoster (chicken pox), cytomegalovirus (CMV)
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10
Q

Tropism

A

-cells that express specific surface receptors, which make them permissive to infection by a particular virus or bacteria

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11
Q

Hepatotrophic viruses are spread through?

A
  1. Fecal-oral: A and E
  2. Blood-borne: B, C, and D
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12
Q

Hepatitis A (HAV): Family, Genome, and Transmission

A

Family: picornaviridae
Genome: ss(+) RNA- single-stranded positive-sense RNA
-Baltimore Classification IV
Transmission: fecal-oral

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13
Q

Risk groups: Hepatitis A

A

-men who have sex with men
-International travelers
-illegal drug users

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14
Q

HAV Infection

A

-acute hepatitis after an incubation of 28 days
-does not become chronic
-people cannot be re-infected
-35% of infected are hospitalized, with only an 0.8% mortality
-high levels of virus in the stool: 2 weeks prior to symptoms and 1 week post symptoms

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14
Q

HAV Infection

A

-acute hepatitis after an incubation of 28 days
-does not become chronic
-people cannot be re-infected
-35% of infected are hospitalized, with only an 0.8% mortality
-high levels of virus in the stool: 2 weeks prior to symptoms and 1 week post symptoms

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15
Q

HAV Clinical testing

Study These Flashcards
A

-Hepatitis A is a reportable infection to the state health department making an accurate detection is important
-diagnosis usually involves anti-HAV IgM
-Total anti-HAV can be used to assess immune status

16
Q

List the immunoassays that exist for testing HAV

Study These Flashcards
A
  1. Indirect enzyme immunoassays
  2. Competitive direct enzyme immunoassays
  3. Capture immunoassays
17
Q

Hepatitis E (HEV): Family, Genome, Transmission

Study These Flashcards
A

Family: Hepeviridae
Genome: ss(+)RNA / BC IV
Transmission: Fecal-oral
-not spread person to person or sexually
-rare in the US usually associated with travel

18
Q

HEV Infection

Study These Flashcards
A

-causes acute hepatitis 2 weeks to 2 months after infection
-40% of infected actual become ill
-does not become chronic
-1% of cases of the disease are fatal
-pregnant women infected in their third trimester have a nearly 30% mortality
-if a previous liver damage is present mortality can be up to 70% in infected people

19
Q

HEV clinical testing

Study These Flashcards
A

-rarely performed in the US
- immunoassays to detect IgM and IgG
-RT-PCR (reverse transcriptase polymerase chain reaction for detection of viral genome)
-no vaccine or treatment is currently available

20
Q

Hepatitis B (HBV) : Family, Transmission, Genome

Study These Flashcards
A

Family: hepadnaviridae
Genome: partial dsDNA/ BC VII
Transmission: blood borne/ body fluids
-1.5 cases per 100,000 US population- greatly reduced by vaccination program started in 1991
-2 billion people infected worldwide
-350 million develop chronic infection
-HBV tenth major cause of worldwide mortality

21
Q

HBV Risk groups

Study These Flashcards
A

-having sex with an infected person
-MSM
-people with multiple sex partners
- healthcare workers
- hemodialysis patients
-travelers
-IV drug users
-Newborns from infected mother

22
Q

HBV virion

Study These Flashcards
A

-enveloped virus- viral nucleocapsid surrounded by lipoprotein envelope derived from host cell
-nucleocapsid core protein: HBc/HBcAg
-envelope surface antigen: HBsAg
-structural E antigen: HBeAg
Excess HBsAg is produced and forms particles called Australian antigens

23
Q

HBV Infection

Study These Flashcards
A

-causes acute hepatitis 90 days after infection
-most people are asymptomatic
-symptoms are similar to other hepatitis infections with the addition of rash and joint pain
-40% of reported symptomatic patients need hospitalization with a mortality of 0.5-1.0
-infection can become chronic (-5%)

24
Chronic HBV Infection
-after acute infection is cleared virus persist -patients can be asymptomatic for 20-30 years -chronic infection leads to liver scarring (cirrhosis) -hepatoma (liver cancer) results in 15-25% of chronically infected -both cirrhosis and hepatoma can lead to death
25
HBV Clinical testing
-the levels of antibody are different in acute resolving patients and acute becoming chronic patients -both antigens and antibodies are detected and have distinct clinical outcomes HBsAg -Anti-HBs+ (anti-HBsAg) HBcAg -Anti-HBc+ (anti-HBcAg) HBeAg -Anti-HBe+ (anti-HBeAg)
26
HBV treatment
-no treatment is given for acute HBV infection due to spontaneous recovery -antivirals are given to severely ill patients but little to no evidence they work -chronic infection with active replication is treated with interferon A, reverse transcriptase inhibitors, -severely causes cancerous or cirrhosis can be treated with a liver transplant along with anti-HBV immunoglobulin -five vaccines available in the US
27
Hepatitis D (HDV)
-also called hepatitis delta virus -circular ssRNA (only known animal virus): only codes for two proteins (long and small delta antigens) -required co-infection with HBV: uses HBV surface antigens to make viral envelope, and sub viral satellite -transmission similar to HBV -can be detected by antibody product to HDV antigens and RT-PCR -can prevented with HBV vaccine
28
Hepatitis C (HCV): Family, Genome, Transmission
Family: flavivirdae Genome: ss(+)RNA / BC IV Transmission: blood born/ body fluids -4 million chronically infected in the US
29
Risk group: Hepatitis C
-IV drug use -Blood transfusion prior to implementation of standard testing in 1992 -sexual
30
HCV Infection
-70% of acutely infected patients are asymptomatic -symptoms occur 6-7 weeks after infection -symptomatic patients are less likely to progress to chronic infection (like HBV) chronically infected patients -75 to 85% develop chronic infection - 60-70% will progress to chronic liver disease - 5-20% will progress to liver cirrhosis or hepatoma (20 years)
31
Mixed essential cryoglobulinemia
-HCV infection is the most common cause of this disease (1-2%) -immune complexes form with viruses, antibody, complement, and rheumatoid factor -cause symptoms of type III hypersensitivity (rashes and joint pain) -if exposed to the cold patients can develop Raynaud's phenomena (pain, numbness, and tingling of the fingers and toes)
32
CV Clinical testing
-diagnosed with a group of immunoassays and molecular techniques -immunoassays measure antibody in two different ways: screening test and confirmatory test -molecular testing for HCV RNA are both qualitative and quantitative -after positive molecular test, genotyping is performed because different types respond differently to treatment -liver biopsy is performed to assess cirrhosis and hepatoma
33
screening test
-third generation indirect enzyme immunoassays using a mixture of viral antigens on microbeads -measures structural and nonstructural antigens qualitatively
34
confirmatory test
-after a positive screen recombinant immunoblot assay (RIBA) is performed
35
RIBA
-similar to western blot -uses synthetic antigens placed on nitrocellulose strip: C33c, NS5, 5-1-1, c100, and c22 peptides -indirect immunoassay is performed with enzyme labeled secondary antibodies
36
HCV Treatment
-no postexposure prophylaxis is available -no vaccine is available -PEGylated interferon-a ribavirin is effective in 55% of patients -patients with cirrhosis do not respond to treatment -transplantation can be performed in liver failure `

Unit 4: Diagnostic Virology and Bacterial Serology (2 decks)

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