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54 Cards in this Set
- Front
- Back
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What family does HBV belong to? |
Hepadnaviridae |
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WHat virus has dsDNA, has an eveloped and belongs to the family hepadnaviridae |
HBV |
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What is so different about the genome of HBV? |
It uses RT and RNA intermediate to generate multiple copies |
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What does the HBV virion include? |
1. RT 2. Core antigen 3. HBAg Specific hepatitis B glycoproteins |
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What is another name for the virus |
Dane particle |
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WHat is the virus core surrounded by? |
Core antigens C and E |
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What is the immunogenic factor in HBV enveloped? |
HBsAg |
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What is so special about HBsAG? |
In serum it outnumbers virion it can block the action of Ab. limiting its abiltiy to fight infections |
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WHat are other names for HBV cause hepatitis? |
1. Blood borne 2.Serum 3.long incubation |
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How many serotypes are there? |
ONE |
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In an acute HBV infection with an effective cell-mediated immune response leads to? |
1. Resolution or 2. Jaundice |
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In a Chronic HBV infection with weak T cell response leads to |
1. Permanent liver damage 2. Cirrhosis 3. Jaundice 4. Fever 5. Rash 6. Anorexia |
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What are the prodromal symptoms of HBV? |
Fever, malaise, anorexia. nausea, vomit, abdominal, dicomfort and chills |
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What are the icteric symptoms? |
Jaundice=too much bilirubin circulating in the blood
degree of yellowing depends on level of bilirrubin |
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How does Jaundive progess? |
First it appears in the face and moves down towards feet |
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In addition to skin, eye whites, stool and urine discoloration, the symptom associated most frequently with jaundice is..... |
Itching-Pruritus |
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How is the diagnosis made for HBV |
1. Symptoms 2.Elevated liver enzymes 3.Serological profile (abs. HBsAG and HB core Ag) 4.Histologival landmark (Ground glass hepatocyte Chronic HBV) |
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What are the 3 hepatitis test? |
1.HBsAG (Hepatitis B surface antigen) 2.anti HBcAG (Ab. vs the hepatitis core Ag) : IgM/IgG 3.anti HBsAG |
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Which serological marker is detected in High levels in serum during acute or chronic HBV infection? |
HBsAG- HB surface antigen |
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Which serological marker indicates recovery and immunity from HBV infection or successful vaccination? |
Anti-HBs- HB surface antibody NOTE: Immuno and you are not contagious |
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Which serological marker will appear at the onset of symptoms in acute HBV and persist for life? |
anti-HBc (Total Hepatitis B core antibody) NOTE: Also indicates previous or ongoing infection |
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Which serological marker indicates recent infection/acute infection with HBV? |
IgM anti HBc IgM antibody to Hepatitis B core antigen |
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Which serological marker is a secreted product of the nucleocapsid gene of HBV, it is also found in serum during acute and chronic HBV? |
HBeAG Hepatitis B e antigen NOTE: Also indicates virus is replicating and has high levels of HBV |
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Which serological marker is produced temporarily during acute HBV infection or consitently during or after a burst in viral replication? |
anti-HBe Hepatitis B e antibody
NOTE: Seroconversion of e antigen to e antibody is a predictor of long term clearance in pt. undergoing antiviral therapy and indicates low levels of HBV |
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IF patient is HBsAg positive for more than 6 months it is considered... |
Chronic |
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Can the virus be spread to baby in utero? |
Yes. via blood |
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What are the the three most common modes of transmission? |
1.Sex 2.IVDU 3.Unknow |
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What are two ways to inactivate the virus? |
Acids and lipid solvents |
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Can the virus survive in dried blood and other biological fluids for several days? |
Yes. The virus is very heat stable |
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What are the two single antigen vaccines available in the US? |
Engerix and RecombivaxHB |
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what are the three combination vaccines available in the US? |
Comvax, Pediarix and Twinrix |
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What is Comvax? |
HBV and Hib vaccines |
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What is Pediarix? |
HBV and DTaP and IPV(inactivated polio) |
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What is twinrix? |
HAV and HBV vaccines |
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WHo do we recommend vaccination to? |
1. infants, children and people in high risk group
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How many doses for a succesful vaccination? |
Series of 3 injections IM; HBsAG subunit vaccine |
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What ensures succesful immunization? |
Single serotype and limited host range |
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What is the goal of treatment in patients with chronic HBV? |
1. reduce risk of progression 2.prevent transmission 3. prevent long term complications (cirrhosis and hepatocellular carcinoma)
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Hepatitis B vaccine is the first... |
Anticancer vaccine |
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Do Hepatitis B vaccines worsen or cause MS or other demyelinating diseasease? |
NO |
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What is the therapy for Chronic infections? |
1. INF-a and PEG-INF 2.Nucleoside analog RT inhibitors 3.Nucleotide analog RT inhibitos |
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Nucleoside analog RT inhibitors |
LAmivudine, Adenofovir dipivoxil, entecavir, telbivudine
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Compared to Adenofovir, lamivudine.... |
has more rapid and more potent suppresion of Hep B |
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Which drugs are superior in suppresing viral replication? |
Entecavir, telbivudine and tenofovir |
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what is the main disadvantage of lamivudine? |
HIGH RATE OF DRUG RESISTANCE |
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What is the most important role of adefovir? |
Treatment of patients with lamivudine resistant |
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What drug is considered the most potent oral antiviral drug for chronic hepatitis B? |
ENTECAVIR |
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What is the main advantage of entecavir? |
Potent antiviral activity and low rate of drug resistance |
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What does a "cure" generally mean for Hep B? |
loses Hep B and develops protective surface antibodies |
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Is there post exposure prophylaxis for HBV? |
YES. Hep B immuno globulin. Must be given within 6 days
Hepatitis B vaccine (within 24hours) 3 IM doses subunit of HBsAg
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What is the goal of treatment? |
HBeAG seroconversion |
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How much longer a person that has seroconverted has to be treated? |
12 more months after HBeAg seroconversion confirmation. Testing on two occasion at least two months apart |
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What can viral relapse lead to? |
Hepatitis flares and hepatic decompensation |
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How long does it take to seroconvert> |
It takes years. 50% of pt. seroconvert in 5 years |
