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33 Cards in this Set
- Front
- Back
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what two heps have fecal oral tranmission?
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A and E
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which hep has a DNA genome?
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B
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which heps have a potential for chronicity?
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B, C, D
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benign self limited disease
28 day incubation confers long term immunity hep damage due to CD8 T cell response fecal oral |
HAV
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how do you Dx HAV?
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anit HAV IbM (3-6 months)
IgG appears as IgM declines ALT spikes then goes down |
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who is at risk for HAV?
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travelers to endemic regions
sexual contacts house member cargive infected persons drug users people working with primates |
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where do you find HEV?
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mexico asia africa and middel east
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20% mortality in preggers (3rd trimester)
similar to HAV |
HEV
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DNA virus
120 incubation 5% can progress to chronic |
HBV
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high: blood serum wounds
mod: semen vag saliva low: urine feces sweat milk |
HBV
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what happens to infants who get HBV from mom?
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95% devlop chronic infection
high rep: risk of cirr and HCC low rep: takes longer |
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can HBV cause liver cancer before cirrhosis?
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YES
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what happens to adults that get HBV
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95% recover and develop immunity
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what can you see in the window period when HBsAG and HBsAb are not detectable?
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HBeAB
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how does the HBV vaccine work?
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they are to surface antigens
cause development of anti-HBs dont have anti HBe or antiHBc |
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what does persistence of HBeAg indicate?
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continued viral rep and probably progression to cirrhosis
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4 phases of Hep B: Immune tolerant
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acquired since birth
immune sys know virus is there but isnt fighting it high DNA levels AST/ALT normal minimal inflamation and fibrosis |
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4 phases of Hep B: immune clearnace:
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immune system all of a sudden wakes up ans starts clearinf ivurs
viral load drops, ASt/ALT eleveate develop precore mutant: lose HBe Ag and become pos for anti HBe antibody Chronic active inflammation |
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4 phases of Hep B: inactive carrier state
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ALT/AST normal and lov virus in blood
mild hep and min fibrosis |
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4 phases of Hep B: Reactivation
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pt develops cancer then becomes immunosuppressed after chemo, immune syst starts clearing virus again
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Tx for Hep B
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interferon shots onca week for a year
nucleotide analogues: tenofovir: prevent chroinic carriers from developing cirrhosis and HCC; doesnt clear Monoclonal Abs |
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monoclonal Ab to HBsAg
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used in transplant pts
must give w/in 2 weeks confers no protection decrease replication bc it will bind to HBsAg |
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should all diabetics be vaccinated for HBv?
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yeash
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pt w/chronic HBV has a flair up
usually IVDU |
HDV
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interferon for HCV
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that plus new meds can block replication; decrease viral load: immune syst can finish the job
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what is the big problme with HCV in US?
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75% dont know they have it
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what happens when people get Hep C?
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20% clear
80% chronic infection: cirrhosis: then 1/25 HCC |
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what are some risk factors for HCV?
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blood trans befoer 1992
IVDU cocaine dialysis high risk sex tattoing graft from HCV donor |
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HCV RNA viral load positive
mild symptoms Anti HCV Ab is positive ALT fluctuates |
progress to seriou issues in decades
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anti HCV antibody test EIA
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eas
can have some flase positives |
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Viral Load Test: quantitative HCV RNA by PCR
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false negatives can happen rarely
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Chain for needlestik HCV test:
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baseline HCV Ab test
Viral load HCV RNA test 1-2 wks HCV antibody and HCV RNA 4-6wks HCV RNA test 2-3 months HCV Ab and HCV RNA 4-6 |
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Tx timing for needlestick:
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best if you start treat by 12 wks
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