Podcast
Questions and Answers
What is the primary mode of transmission for Hepatitis E Virus (HEV)?
What is the primary mode of transmission for Hepatitis E Virus (HEV)?
- Sexual contact
- Fecally contaminated drinking water (correct)
- Airborne particles
- Blood transfusions
What is the typical incubation period for Hepatitis E Virus (HEV)?
What is the typical incubation period for Hepatitis E Virus (HEV)?
- 1 to 2 weeks
- 12 to 16 weeks
- 9 to 12 weeks
- 3 to 8 weeks (correct)
Which of the following populations is at higher risk for fulminant hepatitis associated with HEV?
Which of the following populations is at higher risk for fulminant hepatitis associated with HEV?
- Healthy adults
- Elderly men
- Pregnant women (correct)
- Children under 5 years old
Which serological marker indicates an acute HEV infection?
Which serological marker indicates an acute HEV infection?
Which diagnostic method is NOT used for testing HEV infections?
Which diagnostic method is NOT used for testing HEV infections?
What is the estimated number of people globally infected with Hepatitis B Virus (HBV)?
What is the estimated number of people globally infected with Hepatitis B Virus (HBV)?
Which serious condition is commonly associated with HBV?
Which serious condition is commonly associated with HBV?
What is the primary function of virus-specific antibodies in the humoral immune response?
What is the primary function of virus-specific antibodies in the humoral immune response?
Which antibodies are particularly important for neutralizing viruses in mucosal surfaces?
Which antibodies are particularly important for neutralizing viruses in mucosal surfaces?
How do IgG antibodies contribute to the immune response against viruses?
How do IgG antibodies contribute to the immune response against viruses?
What is the role of CD8 cytotoxic T lymphocytes (CTL) in the immune response?
What is the role of CD8 cytotoxic T lymphocytes (CTL) in the immune response?
What is the main component of the hepatitis B vaccine that was licensed in 1982?
What is the main component of the hepatitis B vaccine that was licensed in 1982?
Which of the following is NOT a recommended measure to prevent HBV infection?
Which of the following is NOT a recommended measure to prevent HBV infection?
What must occur for cytotoxic T cells to recognize and eliminate virus-infected cells?
What must occur for cytotoxic T cells to recognize and eliminate virus-infected cells?
What is the function of perforin released by activated cytotoxic T cells?
What is the function of perforin released by activated cytotoxic T cells?
Who is encouraged to receive the hepatitis B vaccine in Saudi Arabia?
Who is encouraged to receive the hepatitis B vaccine in Saudi Arabia?
What role do granzymes play in the immune response?
What role do granzymes play in the immune response?
What is the average incubation period for hepatitis B virus infection?
What is the average incubation period for hepatitis B virus infection?
What structural component of the HBV is found in its outer envelope?
What structural component of the HBV is found in its outer envelope?
What is the primary method for diagnosing acute hepatitis A in symptomatic patients?
What is the primary method for diagnosing acute hepatitis A in symptomatic patients?
What is NOT a mechanism by which antibodies act against viruses?
What is NOT a mechanism by which antibodies act against viruses?
What characterizes the presence of total HAV antibodies in relation to IgM anti-HAV?
What characterizes the presence of total HAV antibodies in relation to IgM anti-HAV?
Which genotypes of HBV have been identified?
Which genotypes of HBV have been identified?
During which periods is HAV antigen shed in feces of infected individuals?
During which periods is HAV antigen shed in feces of infected individuals?
What is the potential outcome for approximately 1% of adults infected with HBV?
What is the potential outcome for approximately 1% of adults infected with HBV?
What is a significant outcome of the hepatitis A vaccination introduced in the mid-1990s?
What is a significant outcome of the hepatitis A vaccination introduced in the mid-1990s?
What does HBIG stand for and what is its purpose?
What does HBIG stand for and what is its purpose?
Which group is now routinely recommended to receive the hepatitis A vaccine?
Which group is now routinely recommended to receive the hepatitis A vaccine?
What type of virus is Hepatitis E Virus (HEV)?
What type of virus is Hepatitis E Virus (HEV)?
In which scenarios is the hepatitis A vaccine recommended for individuals?
In which scenarios is the hepatitis A vaccine recommended for individuals?
What is the most common method for detecting HAV RNA in patients?
What is the most common method for detecting HAV RNA in patients?
What is the consequence of virus-infected B cells becoming polyclonally activated?
What is the consequence of virus-infected B cells becoming polyclonally activated?
Which symptom is NOT typically associated with infectious mononucleosis?
Which symptom is NOT typically associated with infectious mononucleosis?
Which antibodies are primarily involved in the acute phase of infectious mononucleosis?
Which antibodies are primarily involved in the acute phase of infectious mononucleosis?
How long do heterophile antibodies typically last after the onset of symptoms in most patients?
How long do heterophile antibodies typically last after the onset of symptoms in most patients?
What is the significance of IgM antibody to the viral capsid antigen (VCA)?
What is the significance of IgM antibody to the viral capsid antigen (VCA)?
Which statement is true regarding the persistence of EBV in the body?
Which statement is true regarding the persistence of EBV in the body?
Which of the following antibodies persists for life following EBV infection?
Which of the following antibodies persists for life following EBV infection?
What type of activation do heterophile antibodies undergo when produced during infectious mononucleosis?
What type of activation do heterophile antibodies undergo when produced during infectious mononucleosis?
What is considered the 'gold standard' for EBV serology methods?
What is considered the 'gold standard' for EBV serology methods?
Which method is considered more reliable than serology for detecting EBV in immunocompromised patients?
Which method is considered more reliable than serology for detecting EBV in immunocompromised patients?
What is the most common cause of congenital infections?
What is the most common cause of congenital infections?
How is Cytomegalovirus (CMV) primarily spread?
How is Cytomegalovirus (CMV) primarily spread?
Which laboratory method is NOT typically used for diagnosing CMV infection?
Which laboratory method is NOT typically used for diagnosing CMV infection?
What aspect makes ELISA tests preferable for many laboratories despite the higher specificity of IFA?
What aspect makes ELISA tests preferable for many laboratories despite the higher specificity of IFA?
What type of patients might not demonstrate a good humoral response to EBV?
What type of patients might not demonstrate a good humoral response to EBV?
What type of cells does CMV persist in a latent state?
What type of cells does CMV persist in a latent state?
Flashcards
Toll-like Receptor (TLR)
Toll-like Receptor (TLR)
A type of innate immune receptor that recognizes pathogen-associated molecular patterns (PAMPs) and triggers immune responses. Plays a crucial role in detecting viral threats and activating the immune system.
NOD-like Receptor (NLR)
NOD-like Receptor (NLR)
A type of innate immune receptor found in the cytoplasm of cells. Plays a role in detecting intracellular pathogens and activating immune responses, including inflammation.
NK Cells (Natural Killer Cells)
NK Cells (Natural Killer Cells)
Immune cells that play a key role in the innate immune response against viral infections. They can directly kill infected cells and release antiviral cytokines to help control viral replication.
Response of the Immune System to Viral Infection
Response of the Immune System to Viral Infection
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Humoral Immune Response
Humoral Immune Response
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Neutralizing Antibodies
Neutralizing Antibodies
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Cytotoxic T Cells (CTL)
Cytotoxic T Cells (CTL)
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Perforin
Perforin
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Hepatitis A Virus (HAV)
Hepatitis A Virus (HAV)
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IgM anti-HAV Test
IgM anti-HAV Test
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Total anti-HAV Test
Total anti-HAV Test
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Reverse Transcriptase Polymerase Chain Reaction (RT-PCR)
Reverse Transcriptase Polymerase Chain Reaction (RT-PCR)
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Hepatitis A Vaccine
Hepatitis A Vaccine
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Hepatitis E Virus (HEV)
Hepatitis E Virus (HEV)
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Fecal-Oral Route
Fecal-Oral Route
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Non-enveloped RNA Virus
Non-enveloped RNA Virus
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HBV Envelope
HBV Envelope
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HBV Core
HBV Core
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Hepatitis B Surface Antigen (HBsAg)
Hepatitis B Surface Antigen (HBsAg)
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Hepatitis B e Antigen (HBeAg)
Hepatitis B e Antigen (HBeAg)
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Hepatitis B Immune Globulin (HBIG)
Hepatitis B Immune Globulin (HBIG)
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Hepatitis B Incubation Period
Hepatitis B Incubation Period
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HEV Incubation Period
HEV Incubation Period
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Fulminant Hepatitis E
Fulminant Hepatitis E
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Serology for HEV
Serology for HEV
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IgM anti-HEV
IgM anti-HEV
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IgG anti-HEV
IgG anti-HEV
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RT-PCR for HEV RNA
RT-PCR for HEV RNA
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What happens to B cells infected with EBV?
What happens to B cells infected with EBV?
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Late EBV Antigens
Late EBV Antigens
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What are heterophile antibodies?
What are heterophile antibodies?
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How does EBV persist in the body?
How does EBV persist in the body?
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What is an IFA test?
What is an IFA test?
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What is Infectious Mononucleosis (IM)?
What is Infectious Mononucleosis (IM)?
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What are the classic symptoms of IM?
What are the classic symptoms of IM?
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What is an ELISA test?
What is an ELISA test?
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What are heterophile antibodies?
What are heterophile antibodies?
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How is EBV DNA detected?
How is EBV DNA detected?
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What is Cytomegalovirus (CMV)?
What is Cytomegalovirus (CMV)?
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Why are heterophile antibodies important for diagnosing IM?
Why are heterophile antibodies important for diagnosing IM?
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How is CMV spread to newborns?
How is CMV spread to newborns?
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What does IgM antibody to VCA indicate?
What does IgM antibody to VCA indicate?
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What do IgG anti-VCA, anti-EA-D, and anti-EBNA indicate?
What do IgG anti-VCA, anti-EA-D, and anti-EBNA indicate?
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How is CMV infection diagnosed?
How is CMV infection diagnosed?
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Study Notes
Viral Structure and Characteristics
- Viruses are submicroscopic particles measured in nanometers.
- Basic viral structure includes a core of DNA or RNA packaged within a protein coat (capsid).
- Some viruses have an outer envelope of glycolipids and proteins derived from the host cell membrane.
- Viruses are obligate intracellular pathogens, relying on host cells for replication and survival.
Viral Infection Mechanisms
- Viruses infect host cells by attaching to specific receptors on the cell surface.
- They penetrate the host cell membrane.
- Viral genetic material (DNA or RNA) is released, directing host cell machinery to produce more viral components.
- New viruses assemble within the cell, either by lysis or budding off the cell's surface, to infect new cells.
- Free virions (complete virus particles) spread the infection.
Immune System Response to Viral Infection
- Innate immune response provides the initial defense against viral pathogens.
- Type I interferons and Natural Killer (NK) cells are crucial nonspecific defenses against viruses.
- Virus-infected cells stimulated to produce IFN-α and IFN-β after recognizing viral RNA or DNA by Toll-like receptors (TLRs).
- Interferons inhibit viral replication and enhance the activity of NK cells which further induce cell death to prevent viral spread.
- Phagocytes, such as macrophages, play a role in pathogen clearance through various PRRs including TLRs and NLRs.
Adaptive Immune Response
- Virus-specific antibodies produced by B cells and plasma cells neutralize free virus particles, preventing infection.
- Antibodies bind to viral components that bind to a host cell receptor thus blocking viral entry into the cell.
- Antibodies can activate complement and promote phagocytosis.
- Cytotoxic T cells (CTLs) target virus-infected host cells.
- Upon activation, CD8+ T cells attack the virus-infected cells through cytotoxicity to prevent virus replication.
- CTLs bind to virus-infected cells via MHC class I complex and deliver cytotoxic proteins (perforin and granzymes) directly to the infected cell which induces apoptosis.
Viral Strategies to Evade the Immune System
- Frequent genetic mutations generating new viral antigens enables viruses to escape immune detection.
- Viruses can disable immune components such as interferons, complement proteins, and lysosomal enzymes preventing efficient immune responses.
- Viruses may suppress the immune system. Infections may reduce MHC molecule expression, making the virus-infected cells harder for the immune system to identify and eliminate them.
- Some viruses can directly alter the function of immune cells, such as B cells or T cells after directly infecting them thus altering normal immune responses.
- Some viruses can establish latency, integrating their nucleic acid into the host cell's genome, hindering immune responses and enabling persistence.
Viral Hepatitis
- Hepatitis is a general term representing liver inflammation often caused by viruses or other agents.
- Several viruses can cause hepatitis, including HAV, HBV, HCV, HDV, and HEV.
- Various factors including the transmission routes, clinical manifestations, diagnostic approaches and treatments.
Hepatitis A (HAV)
- HAV is a non-enveloped, single-stranded RNA virus.
- HAV is transmitted through the fecal-oral route.
- The infection is typically self-limiting with symptoms usually resolving within 2 months.
- Diagnosis involves detecting HAV antigens, IgM antibodies to HAV during acute phase, and total HAV antibodies for confirmation.
Hepatitis E (HEV)
- HEV is a non-enveloped, single-stranded RNA virus.
- HEV is transmitted through the fecal-oral route, mainly related to consumption of fecally contaminated water in regions with poor sanitation, and it causes acute, self-limiting hepatitis.
- Diagnosis typically uses serological testing (IgM and IgG antibodies to HEV) and molecular tests (RT-PCR) detect HEV RNA.
Hepatitis B (HBV)
- HBV is a DNA virus.
- HBV is transmitted primarily via the parenteral route (blood, other body fluids like semen, vaginal secretions, and saliva).
- It can cause both acute and chronic hepatitis, with chronic infections increasing the risk of liver complications.
- Diagnosis primarily relies on detecting HBsAg, HBeAg, and specific antibodies in the blood.
Hepatitis D (HDV)
- HDV is a defective RNA virus that relies on HBV for replication and expression and can only occur in the presence of HBV.
- Transmission routes similar to HBV.
- Diagnosis focuses on detecting HDV RNA through molecular tests (PCR) and specific antibodies via serological assays.
Hepatitis C (HCV)
- HCV is an enveloped virus.
- HCV is transmitted mainly through contact with infected blood, including unsafe injections and intravenous drug use.
- Chronic HCV infection can lead to cirrhosis and liver cancer.
- Diagnosis commonly involves serological testing for HCV antibodies (IgG) and molecular methods for HCV RNA.
Herpes Viruses
- Herpesviruses are a family of DNA viruses that cause latent infections.
- Diagnosis utilizes different virus-specific antigens through serology and/or molecular tests.
- Multiple Herpesviruses exist and have different manifestation, transmission routes and impact.
Epstein-Barr Virus (EBV)
- EBV is a member of the herpesvirus family.
- EBV usually occurs through physical contact with saliva from an infected person.
- It causes infectious mononucleosis and is associated with some cancers.
- Diagnosis often involves serological tests to detect IgM and IgG antibodies to the virus-specific antigens.
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