Hepatitis is a general term meaning what
Infection of the liver
What distinct disease causes yellow discoloration of the skin due to bile accumulated in the liver
Jaundice
This was termed _____ since hepatitis was so common among military men
Campaign Jaundice
What are the two types of Hepatitis
Acute self-limited and Persistent chronic
Which forms of Hepatitis are classified as Acute self-limited
A and E
Which forms of Hepatitis are classified as Persistent Chronic
B, C, D, F, and G
Approximately ____ of hepatitis infections remain unexplained
15-17%
What is the Australian antigen
IN 1963, they were doing blood screening to detect blood proteins unique to geographical areas using hemophiliac’s serum. The used the blood from an Australian aborigine had a protein that reacted specifically with the serum antibody of an American hemophiliac. Thus receiving its name, since presence of antigen correlated with serum hepatitis
What is the hepatitis B virion’s alternative name
The Dane Particle
What is the etiological agent of Hepatitis
hepadnavirus
Describe the etiological agent of Hepatitis
Spherical, enveloped, icosahedral nucleocapsid, circular double stranded DNA with single strand gap on one strand. Encodes for 7 proteins
What are the distinctive characteristics of the hepadnavirus
usually partly double stranded and partly single stranded, reverse transcriptase generates genome DNA for pregenome RNA within capsid during virus assembly, makes large amt of noninfectious spherical filamentous particles
Double shelled capsid is unique to which form of hepatitis
Hepatitis B
Which antigen is the reverse transcriptase
The P antigen
What are the unique antigens that are used for diagnostic of Hepatitis B
HBsAg, HBcAg, and HBeAg
What is HBsAg
it is the surface antigen also known as the Australian antigen
What is the HBcAg
the core antigen
What is HBeAg
Endogenous DNA polymerase. It correlates with virus replication
What are the other animals know to have been infected with Hepatitis
woodchucks, ground squirrels, and ducks
Which of hepatitis’ hosts are known to develop carrier states (ACS)
Humans, Chimps, Woodchucks, and ducks
Which of hepatitis’ hosts are known to develop hepatocellular carcinoma (HCC)
Humans, Chimps and Woodchucks
Can the hepadnavirus be cultivated in vitro
No
How many people today worldwide are estimated to be infected with Hepatitis B
2 billion
About ___ persons have chronic infection (carrier)
400 million
An estimated ___ persons die each year due to acute or chronic consequences of hepatitis B and approx. ____ people die each min.
1 million; 2
Approx. 25% of adults who became chronically infected during childhood later die from what
Liver cancer or cirrhosis caused by chronic infection
76% of all cases occur where
Asia, Africa, and South America
Today in the US, there are ___ Americans infected with Hepatitis B and rates highest among ____ years of age
12 million; 25-44
___ of all cases are sexually transmitted and ___ persons have chronic hepatitis B virus infection
~23%; 1.4 million
How is Hepatitis B transmitted
Blood route, Sexual activities, Mother to newborn, and Casual contact
What are the clinical courses Hepatitis B can take
Inapparent subclinical, Anicteric, icteric, Chronic, and Fulminant
Which clinical course leads to death
Fulminant
which clinical course has symptoms w/o jaundice
Anicteric
which clinical course is asymptomatic
Inapparent subclinical
Which clinical course has symptoms with Jaundice
Icteric
What is the incubation period for Hepatitis B
range from 45-120 days
How long could the preicteric period last and about when does the icteric phase begins
1 week; within 10 days
What is the mortality rate for Hepatitis B
Overall infection .2-.5% and icteric only .2-1.5%
___ of patients fail to clear virus from blood and become “carriers” of hepatitis B
2-10%
Which two antigens indicates past infection
Surface and Core
Which antigen induces protective neutralizing antibodies
Surface
Which antigen correlates with active virus replication and may indicate chronic/carrier state
HBeAg
What diagnostic can you conclude if IgM and HBc are shown
Most sensitive for acute infection
What diagnostic can you conclude if IgG and HBs are shown
Indicates past infection, neutralizing antibody, and immune protection
What diagnostic can you conclude if IgG and HBc
indicates past infection
What diagnostic can you conclude if IgG and HBe
indicates acute infection, active virus replication, and chronic/carrier state
Hepatitis B is _____ infectious than HIV-1
50-100 X more
Compare concentration in blood of HIV to HBV
10^6-8 ;10^8-10
Compare risk of infection of HIV to HBV
<.5% ; ~18%
Compare survival in clinical specimen in HIV to HBV
90-99% Reduciton in hours ; up to 7 days
What is the treatment for HBV
Prophylaxis: HB immune globlulin (HBIG), anti bodies that are made in someone else and harvested; No antiviral treatment for acute infection; Chronic infection is treated with interferon-alpha (a reverse transcriptase inhibitor)
What is the history of the HBV vaccine
Dr. Maurice Hillemann used carriers of the HBV as a culture system to produce a commercial vaccine over a 14 year period
___ stages need to extract Dane particles prior to animal tested and ____ weeks needed to make one batch of Dane particles.
7 ; 65
Why did the production of Plasma derived vaccine stopped
due to fear of HIV infection
After plasma derived vaccine stopped , how was the vaccine produced
using yeast that in which 3 intramuscular doses are needed
how is Hepatitis A transmitted
Poor hygiene or sanitation, contamination of water or milk, consumption of contaminated raw oysters or clams, and blood transfusions but not associated with any physical contact of infected
what is the incubation period of Hepatitis A
12-50 days avg 28
Transition from feeling well to ill occurs ___ with Hepatitis A with a short preicteric phase
abruptly
The icteric phase begins within ___ of initial clinical symptoms and is identified how
10 days; showing dark, golden urine followed days later with jaundice and pale stool. May have enlarged liver
Covalescent period begins in ___ and is identified how
~7 weeks; symptoms of jaundice subsides
Mortality rate is highest among __ yrs of age at ___ and over 70% of deaths in patients are what age
> 40; 2.1% ; 49
Which antibodies are specific to HAV
IgM anti- HAV which peaks @ ~6 weeks after exposure then drops; IgG anti-HAV which peaks @ ~ 8 weeks after exposure and remains constant
How is HAV treated
Passive administration of HIGB, effective when given up to 6 days prior to illness; two killed vaccines for prevention of HAV infection; no antiviral drugs