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Hugh's MD1 Abdominal > Viral Hepatitis > Flashcards

Viral Hepatitis Flashcards

(75 cards)

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1
Q

What is the most common mode of transmission of HBV in high prevalence areas?

A

Perinatal

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2
Q

How does HBV and HCV get from the intestinal epithelium to the liver?

A

Via the blood

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3
Q

What are the symptoms of chronic viral hepatitis?

A

General malaise

(Cirrhosis, liver cancer)

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3
Q

Which population gets the most severe acute diseaes from HBV infection?

A

> 5 years old

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4
Q

What are the symptoms of acute viral hepatitis?

A

Non specific, flu-like symptoms

Jaundice

Black urine

Pale faeces

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4
Q

How does HCV make protein?

A

Translates a single large polyprotein which it cleaves into different proteins

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5
Q

How long do symptoms last in Hep A infection?

A

2-3 weeks

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5
Q

What does HBV package with it in its virion?

A

DNA polymerase

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5
Q

Hepatitis B can lead to what type of cancer?

A

Hepatocellular carcinoma

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6
Q

What is a marker of active replication of HBV?

A

HBeAg

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7
Q

What family of virus is Hep E?

A

Hepeviridae

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8
Q

Which is more infectious, Hep A or E?

A

A

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9
Q

What is the incubation period of Hep E?

A

40 days average, 2-10 weeks

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10
Q

What are the symptoms of viral fulminant hepatitis?

A

Acute-like symptoms followed by liver failure and death

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10
Q

What does HCV virion associate with when excreted from cells?

A

Lipid droplets

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11
Q

Which virus particle is more fragile, Hep A or E?

A

E

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11
Q

What is the incubation period of HCV?

A

6-7 weeks average

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12
Q

Name some treatments for Hep E infection

A

Supportive therapy only

No immunoglobulin

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12
Q

What percentage of Intravenous drug users have HCV?

A

50-60%

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13
Q

Which virus family is Hep A from?

A

Picornaviridiae

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13
Q

Do HCV and HBV replicate in the intestinal epithelium?

A

No

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14
Q

What is a limitation of the Hep A vaccine?

A

It’s expensive to produce (requires diploid cells)

Requires 2-3 shots

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15
Q

How does Hep B infection lead to hepatocellular carcinoma?

A

Random integration into the hepatocyte genomes

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16
Q

Hepatitis infection in younger people tend to be what?

A

Less severe

Greater chance of chronic infection

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17
T/F Hepatitis is cytolytic
False, damage is done by the immune response
18
How often does cholestasis occur in Hep E?
50%
19
When do you get Hep D infections?
When you already have HBV because HBD uses HBV surface ag
20
What type of HBV particles are there?
Double walled, infectious virion Incomplete particles containing only surface protein
20
How many Australians are infected with HCV?
200,000
22
What translational technique utilised by HBV limits its ability to mutate?
Translation of the surface protein and the polymerase off the same transcript by using multiple reading frames
23
What are some sequelae of Hep C?
Liver fibrosis Cirrhosis Liver failure Hepatocellular carcinoma
24
What are some complications of hep A infection?
Fulminant hepatitis Cholestatic hepatitis (blockage of bile flow from liver to duodenum)
24
When is virus secreted in faeces in Hep E infection?
2 week before and 1 after symptoms
25
What percentage of infected individuals clear HCV infection?
30%
26
What ELISA results indicates an acute hep infection?
IgM ab Rising IgG titre
26
Which hepatitis virus has the greatest amount of sexual transmission?
Hep B
28
What happens to the RNA progenome during HBV replication?
It acts as a template for reverse transcriptase
29
What percentage of \>14 y.o. get symptoms in Hep A infection?
70-80%
31
What percentage of Hep B infected individuals develop hepatocellular carcinoma?
2-10%
32
What type of virus is Hep E?
Non-enveloped + ssRNA isocosahedral
33
Which group of people is most at risk of death with Hep E infection?
Pregnant women (25-30% case fatality rate)
34
How many Australians develop cirrhosis each year?
5300
36
What anti-virals are available vs HBV?
Interferon-alpha Nucleoside/tide analogues
37
An increase is ALT in the blood during hepatitis indicates what viral behaviour?
The virus is replicating
38
How many serotypes of Hep A are there?
1
40
What do the new antivirals for Hep C target?
Non-structural proteins
41
Why is it so difficult to develop a vaccine for Hep C?
It induces a weak immune response
42
Where does Hep A virus replicate in the body?
Intestinal epithelia Hepatocytes
43
What viral proteins does the HBV genome encode?
Core Polymerase Surface "X"
45
What type of genome does HBV have?
dsDNA
47
What type of virus of Hep A?
Non-enveloped +sense ssRNA 30nm
49
Which ab's are detectable in chronic HBV infection?
anti-HBcAb IgG
51
What type of vaccine is the hep A vaccine?
Inactivated
52
Which is more prevalent in Australia, HBV or HCV?
HCV
54
What type of virus is Hep C?
+ sense, ssRNA Flavivirus
55
What is the problem with IFN-alpha treatment for Hepatitis?
It gives flu-like side effects Only 30-40% response rate
57
What is the serological sign of a chronic HBV carrier?
Positive serum HBsAg
58
What is the incubation period of HBV?
60-90 days average
59
In which fluids is HBV most concentrated?
Blood Serum Wound exudates
60
How can the HCV polymerase be described?
Highly error prone
61
What is the incubation period of hep A infection?
Average 30 days, 15-50 days
62
Which hepatitis virus has the greatest perinatal transmission?
Hep B
63
What is the lifetime mortality of HCV infection?
~5%
64
How many carriers of are there of HBV worldwide?
350 million
65
What ag are detectable in chronic HBV infection?
HBeAg HBsAg
66
What is the best diagnostic test to diagnose hepatitis?
Serology - ELISA
67
What is marker for acute HBV infection?
Anti-HBc IgM
68
What is a marker for recovery/immunity/vaccination against Hep B?
Anti-HBs Ig
69
What is the problem with the new HCV antivirals?
They're extremely expensive
70
Which type of hepatitis is the most common is Australia?
Hep A
71
What occurs inside the host nucleus during HBV replication?
The epigenome is closed by covalent bonding and transcribed into a RNA progenome which is exported out of the nucleus
72
What is the rate of premature mortality from chronic liver disease?
15-25%
73
What treatment options are available for Hep A infection?
Immunoglobulin - only within 2 weeks of infection though
74
What is the difference between nucleotides and nucleoside analogues?
Nucleotide analogues have a phosphate group added
75
What percentage of HCV infections are due to intravenous drug use in Australia?
80%

Hugh's MD1 Abdominal (21 decks)

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