Hep A-E

Question 1

What does each hep A-E stand for?

Answer 1

A- acute
B- blood borne
C- chronic
D- defective
E- enteric, expecting
* all cause liver damage*

Question 2

What type of virus is Hep A?

Answer 2

• piconoravirus
• +ssRNA, naked
• stable in stomach acid
• mostly fecal/oral transmission
• to stop: must be heated to 185F

Question 3

When does virus spread the most in HAV?

Answer 3

• virus shed in feces 1-2 weeks before symptoms and during symptoms (prodrome symptoms and jaundice sometimes)

Question 4

What is the vaccine for HAV?

Answer 4

inactivated virus vaccine

Question 5

T/F: post-exposure prophylaxis (vaccination within 2 weeks of exposure) in HAV can be successful

Answer 5

True!
- 86% effective
- can also get pooled immunoglobulin Ig (90% effective) but doesn’t last lifelong like the vaccine would

Question 6

What type of virus is Hep E?

Answer 6

• own family hepesvirus
• +ssRNA, naked
• mostly transmitted through contaminated drinking water but also done fecal/orally

Question 7

What is the mortality rate of a pregnant patient with HEV?

Answer 7

• 20%. worse in the 3rd trimester
• 34% fetal mortality

Question 8

What is the vaccine for HEV?

Answer 8

no vaccine

Question 9

What type of virus is Hep C?

Answer 9

• flavivirus
• ++ssRNA, enveloped
• NOT transmitted fecal oral but is a blood borne infection via shared needles

Question 10

What are transmission routes of HCV?

Answer 10

• mostly shared needles
• vertical: pregnant person to baby
• sexual: rare

Question 11

What is the chance of getting HCV from sharing a needle with someone who has it?

Answer 11

0.2%

Question 12

What is causing liver damage in HCV?

Answer 12

• CD8+ CTL killing infected cells

Question 13

How common is vertical transmission in HCV?

Answer 13

6% (spread from pregnant mother to child)

Question 14

What is the incubation time for HCV?

Answer 14

• long! ~45 days

Question 15

What are the 3 tx for HCV?

Answer 15

• viral protease: stop replication after translation of +ssRNA so protease can’t cleave polyprotein and no viral polymerase is made so no viral replication takes place
• viral polymerase: stop virus from replicating viral genome
• viral protein NS5A: interfere with genome replication and assembly/release of viral particles
  NO VACCINE OR POST-EXPOSURE TX TO PREVENT INFECTION so use direct acting antivirals that can help cure by 90% but can be re-exposed

Question 16

What type of virus is Hep B?

Answer 16

• hepadnavirus
• -ss/dsDNA, enveloped
• has a reverse transcriptase
• transmitted via blood borne

Question 17

How common is a chronic infection if baby is infected with HBV at birth?

Answer 17

90%
- baby will get vaccine in one arm and hep B immune globulin in the other to be 85-95% effective

Question 18

What are the major routes of HBV?

Answer 18

• IV drug use, sex, perinatal

Question 19

T/F: HBV is not stable because it is enveloped.

Answer 19

False!
Although, it is enveloped it is very stable and can live up to 7 days on surfaces

Question 20

What is vaccine for HBV?

Answer 20

subunit vaccine that contains only HBsAg (Hep B surface antigen) for babies and healthcare personnel

Question 21

What is the tx for HBV?

Answer 21

• INFalpha
• nucleoside reverse transcriptase inhibitors because has reverse transcriptase
• no cure for chronic HBV infections, tx is for life

Question 22

What type of virus is Hep D?

Answer 22

• deltavirus
• negative strand circular RNA virus, enveloped
• can only infect a cell that is already infected with HBV

Question 23

What are the 2 ways to get infected with HDV?

Answer 23

• confection: HBV and HDV at the same time. only 2% go onto chronic with HDV and HBV. can use post-exposure prophylaxis
• superinfection: already have HBV and then get HDV. 80-90% go onto chronic infection with HDV. can NOT use post-exposure prophylaxis

Question 24

Can HDV be prevented by a vaccine?

Answer 24

Yes, but it uses HBV vaccine. Does not have it’s own vaccine