Viral Hepatitis Overview

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Questions and Answers

What is the primary method of transmission for Hepatitis A virus (HAV)?

Airborne transmission

Vector-borne transmission

Fecal-oral transmission (correct)

Bloodborne transmission

What percentage of infected individuals typically develop clinical symptoms from HAV?

50-60%

40-50% (correct)

30-40%

60-70%

How long can HAV fecal excretion last in children and immunocompromised hosts?

Up to 8 weeks (correct)

Up to 2 weeks

Up to 12 weeks

Up to 4 weeks

Which group is NOT considered to be at high risk for HAV infection?

Individuals with chronic liver disease Signup and view all the answers

Where does HAV first replicate after being ingested?

In the oropharynx and salivary glands Signup and view all the answers

What kind of immunity is developed after HAV infection?

Lifetime immunity Signup and view all the answers

What is true about maternal-fetal transmission of HAV?

It is unproven and rare Signup and view all the answers

What happens to HAV during its lifecycle that differentiates it from other viruses?

It lacks a cytopathic effect Signup and view all the answers

What is a characteristic feature of the immunologic response in intrahepatic replication of the virus?

Involvement of NK cells and cytotoxic T cells Signup and view all the answers

How long do IgM antibodies typically remain as markers for current or recent hepatitis A infection?

6 months Signup and view all the answers

Which metabolic process is NOT typically affected by hepatic injury due to hepatitis A virus?

Bone metabolism Signup and view all the answers

What is the average incubation period of hepatitis A virus infection?

21 days Signup and view all the answers

During which period do systemic and non-specific symptoms generally peak before jaundice appears?

Prodromal period Signup and view all the answers

Which of the following symptoms is NOT typically associated with the onset of acute viral hepatitis A?

Night sweats Signup and view all the answers

Which demographic is more likely to experience anicteric forms of hepatitis A infection?

Children Signup and view all the answers

What type of metabolic change is expected regarding cholesterol levels in patients with hepatic injury from hepatitis A?

Decrease in cholesterol levels Signup and view all the answers

Which syndrome is characterized by an increase in transaminases (AST, ALT) during the prodromal period of hepatitis?

Hepatocytolysis syndrome Signup and view all the answers

What level of bilirubinemia is generally associated with obvious jaundice?

4-5 mg/dl Signup and view all the answers

What is a common indicator of a severe prognosis in liver conditions?

Increase in international normalized ratio (INR) Signup and view all the answers

In which syndrome would you expect elevated levels of GGT, alkaline phosphatase, and cholesterol?

Cholestatic syndrome Signup and view all the answers

Which laboratory finding is NOT typically associated with hepatocytolysis syndrome?

High bilirubin levels Signup and view all the answers

What hematological condition can be seen in complicated forms of hepatitis?

Thrombocytopenia Signup and view all the answers

What physiological process indicates the liver's inability to effectively detoxify substances?

Increase in serum ammonium levels Signup and view all the answers

Which type of hepatitis typically shows lower average values of serum bilirubin compared to others?

Acute hepatitis A Signup and view all the answers

What indicates the presence of acute or recent hepatitis A virus infection?

Presence of IgM anti-HAV antibodies Signup and view all the answers

Which of the following is NOT a common differential diagnosis for acute viral hepatitis during its prodromal period?

Obstructive jaundice Signup and view all the answers

In the differentiation of hepatocellular jaundice, which of the following infections is NOT deemed infectious?

Carbon tetrachloride exposure Signup and view all the answers

What laboratory finding indicates a chronic liver injury?

Hypoalbuminemia and hypergammaglobulinemia Signup and view all the answers

Which of the following statements is true regarding HAV diagnostic methods?

RT-PCR can detect HAV RNA in serum. Signup and view all the answers

Which condition is characterized by the accumulation of copper in various organs including the liver?

Wilson's disease Signup and view all the answers

What is a sign of an acute phase of hepatitis A based on serological data?

Increase in serum IgM Signup and view all the answers

Which type of jaundice is associated with hemolytic disorders?

Hemolytic jaundice Signup and view all the answers

What is the duration of the replicative stage with immune tolerance during HBV infection?

2-4 weeks Signup and view all the answers

Which immune cells are primarily responsible for mediating cytolysis during HBV infection?

Natural killer (NK) cells Signup and view all the answers

In which stage of HBV infection can HBsAg become undetectable in the serum?

Integrative stage Signup and view all the answers

What occurs during the replicative stage with immunological clearance?

Disappearance of viral replication markers Signup and view all the answers

Secondary extrahepatic sites of HBV replication include which of the following?

Lymph nodes Signup and view all the answers

What is the consequence of an active immune response during HBV infection?

HBs seroconversion occurs Signup and view all the answers

Which statement about HBV's pathogenic mechanism is correct?

The immune response of the host triggers lesions associated with HBV. Signup and view all the answers

Which virus-related protein is recognized by cytotoxic CD8 lymphocytes?

AgHBc Signup and view all the answers

What type of virus is Hepatitis A Virus (HAV)?

Spherical RNA virus Signup and view all the answers

Which of the following is NOT a method for inactivating Hepatitis A Virus?

Freezing at -20°C Signup and view all the answers

What is the main clinical manifestation of acute viral hepatitis type A?

General infectious and digestive phenomena Signup and view all the answers

Which type of infections does Hepatitis B, C, and D viruses primarily lead to?

Chronic infections Signup and view all the answers

Which of the following properties is true for Hepatitis A Virus?

It replicates exclusively in the liver. Signup and view all the answers

What percentage of hepatitis infections are accounted for by the five main viral agents?

Over 90% Signup and view all the answers

What is the unique antigenic property of HAV?

One unique antigenic determinant Signup and view all the answers

Which of the following clinical developments can occur due to hepatitis infections caused by HBV, HCV, and HDV?

Cirrhosis of the liver Signup and view all the answers

Study Notes

Acute Viral Hepatitis

Acute viral hepatitis are systemic infections primarily affecting the liver.
They are a significant public health concern due to high morbidity and mortality.
Five main viruses cause more than 90% of hepatitis cases: HAV, HBV, HCV, HDV, and HEV.
HBV is a DNA virus, others are RNA viruses.
Clinical presentation ranges from asymptomatic to severe.
Chronic infection is a significant concern with HBV, HCV, and HDV.
Chronic infections increase the risk of hepatocellular carcinoma. (HCC).

Viral Hepatitis A

Etiology: HAV is an RNA virus with icosahedral symmetry and lacks an envelope.
Multiple genotypes have been identified, but HAV is antigenically uniform.
HAV does not induce cytopathic effects in liver cells.
HAV replicates in the liver, bile, and feces.
It is thermostable and resistant to acids and organic solvents.
HAV is inactivated by boiling, chlorination, autoclaving, UV exposure, and formaldehyde.
Epidemiology: HAV is transmitted primarily via the fecal-oral route through direct contact or contaminated food/water sources.
Maternal-fetal transmission is not proven.
Fecal excretion occurs for several weeks and persists even longer in children and immunocompromised individuals.

Viral Hepatitis B

Etiology: HBV is a DNA virus belonging to the Hepadnaviridae family.
HBV is a small, enveloped virus with a core and an envelope, also called a Dane particle.
It has several surface antigen forms (HBsAg).
Anti-HBc antibodies usually appear early.
HBV usually replicates in the liver
The DNA polymerase is necessary for replication.
Epidemiology: The virus is transmitted parenterally, through contaminated blood, bodily fluids, or needles.
Also exists vertical transmission from mother to child.
The prevalence differs, but it is a significant global public health issue.

Viral Hepatitis C

Etiology: HCV is a single-stranded RNA virus belonging to the Flaviviridae family.
Varying genotypes and subtypes exist, influencing the severity of the illness and/or response to treatment.
HCV does not have a direct cytopathic effect; the immune response is vital in the disease mechanism.
Epidemiology: HCV is prevalent worldwide.
Transmission occurs primarily through contact with infected blood or bodily fluids.
IV drug users, healthcare workers, individuals with multiple blood transfusions are at higher risk.

Viral Hepatitis D

Etiology: HDV is a small, defective RNA virus that requires HBV for replication.
HDV infection can occur by coinfection (simultaneous infection) or superinfection (infection of the person with chronic HBV).
Epidemiology: HDV is prevalent in areas with high prevalence of HBV infection.
Transmission is largely parenteral.

Viral Hepatitis E

Etiology: HEV is a single-stranded RNA virus belonging to the Hepeviridae family.
The virus is primarily transmitted enterically.
Epidemiology: HEV is prevalent in regions with poor sanitation and contaminated water sources.
HEV infection commonly presents as acute hepatitis, often self-limited.
Pregnant women are at a higher risk of developing severe or fulminant hepatitis E.

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Description

This quiz covers the key aspects of acute viral hepatitis, focusing on the five main viruses: HAV, HBV, HCV, HDV, and HEV. It discusses their etiology, clinical presentation, and the public health implications of hepatitis infections. Test your knowledge about the characteristics, replication, and epidemiology of viral hepatitis.