Viral Hep/HIV (lec 25)

Question 1

Hepatitis viruses?

Answer 1

Type A: infectious
B: serum
C: transfusion
D: a/w HBV infection
Non A/B

Question 2

Hepatitis subclinical/anicteric presentation recognized how?

Answer 2

seroconversion

Question 3

Acute Icteric Hepatitis presentation?

Answer 3

Incubation dose-dependent (wks - months)

Prodrome: fatigue, malaise, anorexia

Dark urine, jaundice
Hepatomegaly
↑ ALT/AST enzymes

Question 4

Fulminant Hepatitis?????

Answer 4

slide 6

Question 5

Chronic Hepatitis caused by what types?

Answer 5

B, C, D

Question 6

Hep A characteristics?

Epidemiology?

Answer 6

infectious hep
NOT chronic

Food/water transmission (contaminated by feces)
(U) closed populations w/ poor hygiene
CONTACT w/ INFECTED FAMILY MEMBER

Question 7

Hep A presentation?

Diagnostics?

Tx?

Answer 7

(U) mild

ELISA -> IgM

Rest, fluids, Ø alcohol/drugs
Prophy immu globilin
Vaccine

Question 8

Hep B characteristics?

Answer 8

most common chronic hep

causes hepatocellular CA

Question 9

Hep B antigens?

Answer 9

HBsAg (surface)
HBcAg (core)
HBeAg (surface) -> presence = INFECTIOUS

Question 10

Hep B epidemiology?

Answer 10

(U) China, Alaska, Africa
HEALTHCARE WORKERS
In blood, semen
Spread by needle, tattoo, piercing, prenatally

RESERVOIR = Chronic hep pts/shed when asympt

Question 11

Hep B presentation?

Answer 11

Replicates in liver
Insidious onset
Prodrome: fever, rash, symm arthralgias
Self-limiting

Question 12

Hep B diagnostics?

Tx?

Complications?

Answer 12

Antibodies to HB antigens:

New, current infection = IgM antiHBc + HBsAg

Past inf = IgG antiHBc + IgG HBsAb

Chronic inf = IgG antiHBc + HBsAg = chronic

Immune from vaccine = IgG HBsAb

Tx: vaccine

Complication: Liver CA, cirrhosis

Question 13

Hep D characteristics?

Answer 13

viral parasite of other virus
requires Hep B as helper (steals B’s surface antigens)
↑ severity of Hep B

Question 14

Hep D spread?

Diagnostics?

Tx?

Answer 14

Infected people

ELISA

Hep B vaccine

Question 15

Hep C characteristics?

Answer 15

posttransfusion

(U) CHRONIC infection

Question 16

Hep C chronic infection risk factors?

Answer 16

transfusions, needles, transplants
alcohol
> 40 yo male
Hep B infected
HIV infected

Question 17

Hep C diagnostics?

Tx?

Answer 17

ELISA + nucleic acid test (to catch pts w/o antibodies)

Tx not great:
interferon + ribavirin + protease inhibitor

Question 18

HIV caused by?

Characteristic?

Answer 18

Human retro virus

RNA genome
Enveloped
Reverse transcriptase

Question 19

HIV indicator dzs?

Answer 19

Koposi’s sarcoma, pneumocystis PNA, MAC, CMV

Question 20

HIV replication?

Answer 20

TH cells w/ CD4/chemokine receptors infected

Reverse transcription into host chromo

↑↑ TH cell loss - > immunosuppression

Can form “swarms” of mutant virus

Question 21

HIV diagnostics?

Answer 21

CD4 T cell count < 200
EIA screen
Western blot to confirm

Question 22

HIV tx?

Answer 22

Reverse transcriptase inhibitor +
Protease inhibitor +
Fusion-penetration inhibitor