1.3.2 Hepatitis Viruses II Flashcards Preview

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Flashcards in 1.3.2 Hepatitis Viruses II Deck (21)
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  1. Hepatitis B
  2. Hippo Van: cause of hepatitis
  3. Hepadnaviridae family
  4. DNA virus
  5. Enveloped
  6. Undergoes intranuclear and cytoplasmic replication
  7. Partially double stranded DNA
  8. Reverse transcriptase using RNA-dependent DNA polymerase
  9. Transmitted via sex and blood products (sex, drugs, and rock & roll)
  10. Vertical transmission b/t mother and baby during birth, doesn't cross placenta
  11. Part of TORCHeS
  12. 90% of neonatal HBV cases progress to chronic infections
  13. 10% of HBV progress to chronic HBV infections
  14. Can lead to polyarteritis nodosa (PAN)
  15. Rash (purpuric papules)
  16. Arthralgia (knee pain)
  17. Chronic kidney disease
  18. Membranous glomerulopathy
  19. Membranoproliferative glomerulonephritis
  20. ALT rises during acute infection, then falls when systematic phase is over, ALT > AST
  21. ALT levels are often normal in neonatal HBV
  22. HBsAg is 1st serological marker of an active infection
  23. HBeAg is sign of active viral replication and a sign of high infectivity
  24. During symptomatic phase, pts will be positive for HBsAg and HBeAg
  25. Anti- HBc IgM may be only detectable serological marker during window phase of infection
  26. Presence of Anti-HBe is indicative of low transmissibility
  27. Presence of Anti-HBs is indicative of recovery from infection or prior immunization
  28. Immunized patients will have Anti-HBs only
  29. Can lead to cirrhosis
  30. Risk factor for HCC
  31. Hep D only propogates in the presence of Hep B
  32. Hep D = enveloped RNA virus
  33. Hep D: circular, single stranded DNA
  34. Hep D: negative-sense
  35. Hep D: HBsAg to be infectious
  36. Coinfection of Hep B and Hep D has better prognosis than Hep B alone
  37. Superinfection = Contraction of Hep D by a pt with chronic Hep B
  38. Superinfection associated with a worse prognosis
  39. Lamivudine is effective against Hep B
  40. NRTIs are effective against Hep B
  41. Alpha-interferons are effective against Hep B
  42. Give at-risk children anti-HB Ig and HepB Vaccine



What are the virions and particles associated with HBV?

Dane particle is the only infective virion


Describe the nucleic material of HBV

Partially double-stranded DNA


What is different about the production of HBeAg and HBcAg?


What is the process of HBV replication?

Side note: not listed in objectives specifically but is part of the pathogenesis


What is the typical progression of Acute Hep B in adults?


What is the marker of infectivity? Marker of immunity?

Infectivity: HBsAg

Immunity: anti-HBsAg


Interpret these viral panels




Interpret this Hep B Virus panel


What HBV pt state?

Asymptomatic carrier

Liver is more or less normal except for the scattered hepatocytes with "ground glass" cytoplasm. The cytobplasm of these cells contain numerous 


Which HBV pt state?

Chronic persistent hepatitis


Liver cell destruction. Inflammation is confined to the portal tracts


Which HBV pt state?

Chronic active hepatitis


Mononuclear inflammatory cell infiltrate extends from portal areas and disrupts the limiting plate of hepatocytes which are undergoing necrosis, the so-called "piecemeal" necrosis of CAH

CD8+ T cells present


What are the arrows pointing at?

Councilman Bodies - dying hepatocytes


Define the role of HBV in hepatitis D virus (HDV) disease

HDV replication requires co-infection w/ HBV, which provides HBsAg. Thus, HBV is known as a "helper virus"


What is the difference between co-infection and superinfection with HBV and HDV?


What is the typical progession of HBV-HDV Co-infection (line graph)?


What is the typical progression of HBV-HDV superinfection (line graph)?


What was isolated to developed the HBV vaccine?

Gene for HBsAg


How is the HBV vaccine administered? What % of children and adolescents develop adequate Ab to dosage?

Series of 3 IM doses

95% of children and adolescents develop adequate Ab to recommended series of 3 doses


What are three mechanisms by which HBV infection increase a patient's risk for HCC?


Integration into host genome

Viral proteins (HBx)


What are some treatment/management options for patients with chronic HBV infecctions?