Parasitology and Virology: Hepatitis Viruses
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Questions and Answers

What is the significance of prolonged presence of HBsAg in a patient's blood?

  • It indicates the patient has recovered from the disease
  • It indicates the patient is a chronic carrier and is at risk of chronic hepatitis and hepatic carcinoma (correct)
  • It indicates the patient is in the prodrome phase of the disease
  • It indicates the patient is in the acute phase of the disease

    • What is the window phase in Hepatitis B infection?

  • The period when HBsAg is absent but HBsAb is present
  • The period when HBcAb is present but HBsAg is absent
  • The period when HBsAg is present but HBsAb is not yet detectable (correct)
  • The period when HBeAg is present but HBsAb is absent

    • What is the significance of HBcAb in the diagnosis of Hepatitis B?

  • It is always negative during the acute phase
  • It is an indicator of transmissibility
  • It is an indicator of chronic carrier state
  • It is always positive during the window phase and can be used to make the diagnosis (correct)

    • What is the significance of HBeAg in Hepatitis B infection?

    <p>It is an indicator of high transmissibility (B)</p> Signup and view all the answers

    During which phase of Hepatitis B infection is HBsAg detectable in most patients?

    <p>Prodrome and acute disease (B)</p> Signup and view all the answers

    Why is HBsAb not detectable in the acute or chronic carrier state of Hepatitis B infection?

    <p>It is bound to the large amount of HBsAg present in the blood (D)</p> Signup and view all the answers

    What is a unique characteristic of Hepatitis D Virus (HDV)?

    <p>It can only replicate in cells infected with HBV (B)</p> Signup and view all the answers

    How is Hepatitis D diagnosed?

    <p>By detecting delta antigen or IgM antibody to delta antigen (B)</p> Signup and view all the answers

    What is the mean incubation period of Hepatitis C virus?

    <p>8 weeks (A)</p> Signup and view all the answers

    What is a complication of Hepatitis D infection?

    <p>Chronic liver disease is a common complication (C)</p> Signup and view all the answers

    What is the diagnosis for Hepatitis C?

    <p>Detecting antibodies to HCV by ELISA (D)</p> Signup and view all the answers

    What is the confirmatory test for Hepatitis C?

    <p>RIBA (C)</p> Signup and view all the answers

    What is a characteristic of Hepatitis E?

    <p>It is a non-enveloped, positive ssRNA virus (B)</p> Signup and view all the answers

    What is a feature of Hepatitis G?

    <p>It causes chronic liver disease (D)</p> Signup and view all the answers

    What is the characteristic of a chronic Hepatitis C infection?

    <p>Elevated transaminase levels, a positive RIBA, and detectable viral RNA for at least 6 months (D)</p> Signup and view all the answers

    What is a mode of transmission of HDV?

    <p>Through sexual contact (B)</p> Signup and view all the answers

    What is the treatment of choice for chronic Hepatitis C?

    <p>Combination of alpha interferon and ribavirin (B)</p> Signup and view all the answers

    What is the type of genome of the Hepatitis D virus?

    <p>Negative ssRNA (D)</p> Signup and view all the answers

    What is a characteristic of Hepatitis D infection?

    <p>It is often co-infected with HBV (A)</p> Signup and view all the answers

    What is a treatment option for Hepatitis D?

    <p>Alpha interferon (C)</p> Signup and view all the answers

    What is the number of serotypes of Hepatitis D virus?

    <p>1 (C)</p> Signup and view all the answers

    Is there a vaccine available for Hepatitis C?

    <p>No (A)</p> Signup and view all the answers

    What is the interpretation of a serological test result with HBsAg + HBeAg + HBcAb (IgM)?

    <p>Active case (acute) (B)</p> Signup and view all the answers

    What is the interpretation of a serological test result with HBsAb + HBeAb + HBcAb (IgG)?

    <p>Recovered (immune) (C)</p> Signup and view all the answers

    What is the purpose of administering alpha interferon to patients with chronic Hepatitis B infections?

    <p>To reduce hepatic inflammation and lower the levels of HBV (D)</p> Signup and view all the answers

    Who is indicated to receive the Hepatitis B vaccine?

    <p>People who are frequently exposed to blood or blood products (A)</p> Signup and view all the answers

    What is the role of HBcAb (IgM) in the interpretation of serological test results?

    <p>It is a marker of acute infection (B)</p> Signup and view all the answers

    What is the advantage of using nucleoside analogues, such as lamivudine, in the treatment of chronic Hepatitis B infections?

    <p>They reduce hepatic inflammation and lower the levels of HBV (C)</p> Signup and view all the answers

    What is the component of the Hepatitis B vaccine produced in yeasts by recombinant DNA techniques?

    <p>HBsAg (B)</p> Signup and view all the answers

    What is the interpretation of a serological test result with HBsAg + HBeAb + HBcAb (IgG)?

    <p>Chronic carrier (B)</p> Signup and view all the answers

    Which of the following hepatitis viruses has a transmission route of oral-fecal?

    <p>Hepatitis A (A)</p> Signup and view all the answers

    Which of the following hepatitis viruses is a significant risk for patients with a history of hemophilia?

    <p>Hepatitis B, C, and D (C)</p> Signup and view all the answers

    Which of the following hepatitis viruses has a negative sense single-stranded RNA genome?

    <p>Hepatitis D (D)</p> Signup and view all the answers

    Which of the following hepatitis viruses is associated with carcinoma and cirrhosis?

    <p>Hepatitis C (D)</p> Signup and view all the answers

    Which of the following hepatitis viruses has a diagnostic test involving serum levels of HBsAg?

    <p>Hepatitis B (C)</p> Signup and view all the answers

    Which of the following hepatitis viruses has an incubation period of 2-10 weeks?

    <p>Hepatitis D (D)</p> Signup and view all the answers

    Which of the following hepatitis viruses is not typically associated with a chronic infection?

    <p>Hepatitis A (C)</p> Signup and view all the answers

    Which of the following hepatitis viruses has a transmission route of parenteral, transplacental, and sexual?

    <p>Hepatitis B and D (B)</p> Signup and view all the answers

    Flashcards

    HBsAg

    Hepatitis B surface antigen, present during incubation, prodrome and acute disease. Prolonged presence indicates chronic hepatitis and carrier state.

    HBsAb

    Hepatitis B surface antibody, not detectable in acute or chronic carrier states due to being bound to HBsAg. Appears after recovery.

    Window phase

    Period after recovery from acute hepatitis B where HBsAg disappears but HBsAb is not yet detectable.

    HBeAg

    Hepatitis B e antigen, indicates transmissibility. Presence signals high transmissibility.

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    HBeAb

    Hepatitis B e antibody, indicates lower transmissibility. Presence suggests the immune system is fighting the virus.

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    Hepatitis B Carrier State

    Prolonged presence of HBsAg (at least 6 months) indicating risk of chronic hepatitis and liver cancer.

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    Active Hepatitis B

    Current infection, characterized by presence of HBsAg, HBeAg, and IgM HBcAb.

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    Hepatitis B Recovery

    Successful immune response, characterized by HBsAb, HBeAb, and IgG HBcAb presence.

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    Chronic Hepatitis B Carrier

    Persistent infection despite presence of HBeAb, characterized by HBsAg, HBeAb, and IgG HBcAb.

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    Hepatitis B Vaccination

    Immune protection against hepatitis B, indicated by presence of HBsAb.

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    Alpha interferon

    A treatment option for chronic hepatitis B infection, but not a cure.

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    Nucleoside analogues

    Drugs like lamivudine that reduce inflammation and viral levels in chronic hepatitis B.

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    Hepatitis B Vaccine (Recombivax)

    Contains HBsAg produced in yeast using recombinant DNA technology.

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    Hepatitis C

    Viral infection causing chronic liver disease, cirrhosis, and risk of liver cancer.

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    Hepatitis C Incubation

    Average incubation period of 8 weeks.

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    Hepatitis C Autoimmune Reactions

    Can trigger vasculitis, arthralgias, purpura, and glomerulonephritis.

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    Hepatitis C Diagnosis

    Detected by ELISA test for HCV antibodies, confirmed by PCR for viral RNA.

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    Hepatitis C Treatment

    Combination of alpha interferon and ribavirin, new treatments include Sofosbuvir, Simeprevir, Daclatasvir, Ledipasvir, Velpatasvir, and Glecaprevir.

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    Hepatitis C Prevention

    No vaccine or hyperimmune globulins available.

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    Hepatitis D

    Defective virus requiring HBV co-infection for replication, causing more severe illness.

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    Hepatitis D Transmission

    Spread through sexual contact, blood, and perinatal routes.

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    Hepatitis D Pathogenesis

    Cytotoxic T cells damage infected hepatocytes, leading to more severe disease.

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    Hepatitis D Diagnosis

    Detected by identifying delta antigen or IgM antibody to it in the blood.

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    Hepatitis D Treatment

    Alpha interferon may reduce symptoms but doesn't eliminate chronic infection.

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    Hepatitis E

    Resembles hepatitis A, but no chronic disease or prolonged carrier state.

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    Hepatitis G (GBV-C)

    A virus associated with chronic liver disease, transmitted through blood and sexual contact.

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    Hepatitis E Prevention

    No vaccine or antiviral treatment available.

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    Study Notes

    Hepatitis B

    • HBsAg appears during the incubation period and is detectable in most patients during the prodrome and acute disease.
    • Prolonged presence of HBsAg (at least 6 months) indicates carrier state and risk of chronic hepatitis and hepatic carcinoma.
    • HBsAb is not detectable in the acute or chronic carrier state because it is bound to the large amount of HBsAg present in the blood.
    • In the acute state, when recovered, there is a period of several weeks when HBsAg has disappeared but HBsAb is not yet detectable, known as the window phase.
    • HBeAg presence indicates transmissibility, and its presence indicates low transmissibility.

    Interpretation of Hepatitis B Serological Test Results

    • HBsAg + HBeAg + HBcAb (IgM): active case (acute)
    • HBeAb+ HBcAb (IgM): window
    • HBsAb + HBeAb + HBcAb (IgG): recovered (immune)
    • HBsAg + HBeAb + HBcAb (IgG): chronic carrier
    • HBsAb: vaccine (immune)

    Treatment and Prevention of Hepatitis B

    • Alpha interferon is clinically useful for the treatment of chronic hepatitis B infections.
    • Nucleoside analogues, such as lamivudine, are effective in reducing hepatic inflammation and lowering HBV levels in chronic carriers.
    • The vaccine (e.g. Recombivax) contains HBsAg produced in yeast by recombinant DNA techniques.
    • Indications for vaccination include healthcare personnel, patients receiving multiple transfusions or dialysis, and patients with frequent sexually transmitted diseases.

    Hepatitis C

    • Leads to chronic liver disease, cirrhosis, and predisposition to hepatocellular carcinoma.
    • Mean incubation period is 8 weeks.
    • Causes significant autoimmune reactions, including vasculitis, arthralgias, purpura, and membranoproliferative glomerulonephritis.

    Laboratory Diagnosis of Hepatitis C

    • Diagnosed by detecting antibodies to HCV by ELISA.
    • Test does not distinguish between IgM and IgG and does not distinguish between an acute, chronic, or resolved infection.
    • Confirmation by PCR to detect viral RNA.

    Treatment and Prevention of Hepatitis C

    • A combination of alpha interferon and ribavirin is the treatment of choice for chronic hepatitis C.
    • New treatments include Sovaldi/Gratisovir (Sofosbuvir), Olysio (Simeprevir), Dactavira (Daclatasvir), Harvoni (Sofosbuvir + Ledipasvir), Epclusa (Sofosbuvir + Velpatasvir), and Mavyret (Pibrentasvir + Glecaprevir).
    • No vaccine is available, and hyperimmune globulins are not available.

    Hepatitis D

    • Defective virus that requires HBV co-infection to replicate.
    • Transmitted sexually, through blood, and perinatally.
    • Pathogenesis involves cytotoxic T cell damage to infected hepatocytes.
    • Disease is more severe in co-infected individuals.

    Laboratory Diagnosis of Hepatitis D

    • Diagnosis made by detecting either delta antigen or IgM antibody to delta antigen in the patient's serum.

    Treatment of Hepatitis D

    • Alpha interferon reduces some effects of chronic hepatitis caused by HDV but does not eradicate the chronic carrier state.
    • Immunization against HBV prevents HDV infection.

    Hepatitis E

    • Clinically resembles hepatitis A, but chronic liver disease does not occur.
    • No prolonged carrier state exists.
    • No antiviral treatment and no vaccine are available.

    Hepatitis G (GBV-C, Human pegivirus)

    • Discovered in the mid-1990s, causing some sort of chronic liver disease.
    • Transmitted by blood and sexual intercourse.

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    Description

    Quiz on Hepatitis viruses, covering pathogenesis of HBV, HCV and HDV, and laboratory diagnosis of Hepatitis B, including HBsAg and chronic hepatitis.

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