Hep Virus Ii

Front 1

1. virus family Hep A is part of?
2. ss? (RNA or DNA?)
3. enveloped or nonenveloped - importance?

Back 1

1. Picornavirus - Pico + RNA + Virus & P for positive
2. SS + sense (RNA)
3. nonenveloped -> to survive the gut virus must be non enveloped; resistant capsid

Front 2

1. High [ ] of Hep A are found where?
2. is it more severe in the young or old?
3. any chronic infection?

Cxs - fulminant, cholestatic & relapsing hepatitis

Back 2

1. in the stool; shedding begins 1-2 wks b4 Sx
Often a point source for infection
2. elderly
3. no chronic in A and E

Front 3

Hep A: Sx abruptly 2-7 wks post exposure
- simi to HBV w/ fever, pain, N, fatigue, jaundice
- Sx wane in 3-4 weeks
- complete recovery in 99% of cases
- fulminant disease << 1% but 80% death rate

Back 3

Enters GI circulates to liver; infects hepatocytes & Kipffers cells w/o lysis or virus mediated CPE; liver damage due to cytotoxic T cell response & interferon; Abs neutralize EC virus and prevent reinfection

Front 4

1. What is needed for + Hep A Dx?
2. type of vaccination for Hep A?
3. most prominent genotype of Hep C in US?
4. odds of getting a chronic infection from Hep C?

Back 4

1. HAV-IgM; past infection/immunity = HAV-IgG
2. inactivated viral vaccine (similar to polio)
3. type 1a; 1b is high in Europe and Asia
4. pretty high

Front 5

Hep A IG for ppl at risk:
- pre exposure to intermed & high HAV endemic area
- post - w/in 14 days to household & intimate contacts; day care centers, restaurant outbreaks
Hep A vaccination
- travelers to endemic areas; outbreak settings, lab personnel, homosex, chronic liver disease, IV drug users

Back 5

Hep C - produces a single polyprotein that is cleaved into all the other pieces

Front 6

Flavivirus; Hepevirus; Picornavirus; Satellite virus Hepadnavirus;
1. HAV
2. HBV
3. HCV
4. HDV
5. HEV

Back 6

1. Picornavirus - + sense, ss, RNA, nonenveloped
2. Hepdnavirus - ds, DNA, enveloped
3. Flavivirus - ss, + sense RNA genome, nonenvel.
4. satellite - ss, - sense, circ RNA
5. HepEvirus - ss, + sense, RNA, noneveloped

Front 7

1. virus family for Hep C
2. ss or ds? + sense or -; RNA or DNA
3. enveloped or non enveloped
4. 2 proteins in Hep C??

Back 7

1. Flavivirus
2. ss; + sense RNA
3. enveloped - does not go through gut
4. envelope protein- E- and nonstructural protein (NS)

Front 8

1. How is Hep C transmitted
2. common life ending progressions of HCV infection
3. how is Dx of HCV infection made

Back 8

1. blood to blood -> transfusiion,* needles*, occupational exposure, not common by Sex
2. cirrhosis and HCC
3. HCV Ab usu 4 weeks after infeciton; PCR in acute mb used to determine efficacy of Rx

Front 9

Hep C - less severe in acute phase, often assymptomatic than A or B but ^ chronic rate
70% of infections are chronic, not age related; **no protective Ab response**; Ab present but Hep C changes too rapidly

Back 9

Pathogenesis: CMI causes liver damage but fails to clear infection; Ab develops but does not work; acute phase is mild or assymptomatic; chronic phase is w/o Sx untiil late stage; progresses to cirrhosis and HCC

Front 10

1. What r 3 Rx for Hep C infection
Prevent Hep C via screening of blood, organ, tissue donors; reduce high risk behavior, blood and body fluid precautions

Back 10

1. Interferon (50% response rate) &. Ribavirin & Protease inhibitors for genotype 1 && IFN and ribavirin may be better together than alone

Front 11

1. what is teleprevir / boceprevir
2. only protein encoded by Hep D virus?
3. coinfection w/ what is rqrd for hep D virulence
transmission similar to that of HBV - blood and fluids, drug users, sex

Back 11

1. drugs that prev - ent Hep C -> given w/ ribavirin and interferon alpha
2. delta Ag - forms the viral core
3. Hep B; need HBsAg packaing so makes it a satellite virus

Front 12

1. Hep D viral genome is replicated by what?
2. result of Hep D virus coinfection in Sx?
3. what combo causes a superinfection?
Patho: ^ severity of acute disease; exacerbates liver damage in chronic infection

Back 12

1. host RNA polymerase III
2. more severe acute disease; low risk of chronic
3. preexisting hep B then adding hep D on top; usu causes a chronic infection and chronic liver disease

Front 13

Hep D - replication causes cytopathic damage to liver
- makes HBV infection worse; fulminant is more likely w/ this
- Dx via ELISA for anti-delta Ag; RT PCR for viral RNA

Back 13

Rx same as that for Hep B b/c if you don't get B wont have D so vaccine for B or IFN alpha

Front 14

Hep E - associated w/ fecally contaminated drinking water; more common in Asia, Africa, Russia, Mexico
minimal person-person spread

Back 14

Dx is through anti-HEV Ab in serum
no specific therapy or vaccine available

Front 15

1. What is unique about mortality rates in HEV?
2. relationship of severity w/ age?

Back 15

1. 15-25% mortality in pregnant women
2. increases w/ age