Microbiology Unit 5

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Author:
Sandrayang
ID:
47042
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Microbiology Unit 5
Updated:
2010-11-03 13:35:07
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Hepatitis
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Hepatitis
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  1. Hepatitis A
    General Info
    • most common viral infection
    • aka HAV or infectious hepatitis
    • HAV is very resistant to surface disinfection, can remain on fomite up to 3 weeks
    • No carrier state as there is a complete recovery
  2. HAV transmission
    fecal-oral route often from eating contaminated food or water, raw oysters or food service workers with poor hygiene
  3. HAV Symptoms
    • jaundice, RUQ pain, liver function impairment
    • incubation is 2-4 weeks (shortest)
  4. HAV Diagnosis
    • liver function tests includes AST and ALT (which indicates liver damage)
    • Hepatitis A antibodies (IgM-acute and IgG persist indefinitely)
  5. HAV Treatment and Prevention
    • vaccines available for babies
    • vaccines available for adult, 2 doses, lasts 10 years
    • give Hepatitis Immune globulin if there is a known exposure
    • HAV is very resistant to surface disinfection, can remain on fomite up to 3 weeks.
    • No carrier state as there is a complete recovery
  6. Hepatitis B
    General Info
    • aka serum hepatitis or HBV
    • about 10% will complicate as Chronic Active Hepatitis B
  7. HBV Transmission
    • Heterosexual sex is most common
    • IV, percutaneous (tattoos, body piercing, dialysis)
    • homosexual sex especially in males
    • IV drug using (sharing males)
    • perinatal - babies can get this via vaginal birth
    • blood transfusion - small risk if donor is in the window period because the virus is circulating early in infection; blood test are negative as there is not enough antibody to detect
  8. HBV Symptoms
    • jaundice, RUQ pain, liver function impairment
    • about 10% will complicate to Chronic Active Hepatitis B -- which will continuously destroy liver cells and often death; liver cancer is also common as DNA is altered
    • chronic infection is very common in babies born with HBV
    • can persist for years - carrier state
  9. HBV Diagnosis
    • Blood tests: HbsAg, HbcAg, and HBsAb
    • HbsAg is Hepatitis B Surface antigen that detects the outter shell of the virus; for acute HBV, the results will be positive
    • HbcAg is the Hepatitis B Core antigen that detects the core of the virus; this is positive after 4-6 weeks after the surface is positive
    • HBsAb is the Hepatitis B antibody
  10. HBV Treatment
    • for chronic cases - alpha interferon (Intron A) and Lamivudine (base analog inhibitor)
    • these are used to control viral replication but liver function will still decrease
  11. Hepatitis C
    General Info
    • aka HCV or non-A, non-B hepatitis or post-transfusion hepatitis
    • 4 millions Americans infected
    • at least 35,000 new cases every year
  12. HCV Transmission
    • blood and body fluid transmission
    • IV drug use
    • tattoos
    • body piercing most common means of transmission now
    • occasional perinatal, sexual, health care associated infections
    • transfusion is minimal risk
  13. HCV Symptoms
    • "silent epidemic" as most cases are asymptomatic or mild (80% have no symptom)
    • chronic infection in 75-85% of the population
    • destroys liver function
    • most common reason for liver transplant
  14. HCV Diagnosis
    • lab testing available since 1994
    • home testing is available
    • minimal risk from blood transfusions
  15. HCV Prevention and Treatment
    • treatment: interferon + ribavirin for chronic infection
    • no effective treatment for acute infection
    • prevention: no vaccine available, screen blood supply and only use licensed US tattoo parlors
  16. Hepatitis D
    General Info
    • aka HDV or Delta hepatitis
    • viral fragments - consists of RNA fragments and delta antigen, not whole virus
    • "piggy back" virus with HBV
  17. HDV Transmission
    • coinfects with HBV
    • blood and body fluid transmission
  18. HDV Symptoms
    • double infection is more severe than HBV alone
    • chronic infection may occur
  19. HDV Diagnosis
    test for HDV antibodies (IgM, IgG) since 1995
  20. HDV Prevention
    Vaccine with HBV
  21. Hepatitis E
    • aka HEV
    • outbreaks in China due eating pig
  22. Hepatitis E Transmission
    • fecal-oral route
    • waterborne epidemics in developing countries
    • found in pigs also
  23. HEV Symptoms
    • seen mostly in children and young adults
    • mild disease if not pregnant
    • if pregnant, can cause liver failure with 30% mortality rate and with fetal demise
    • no carrier state or chronic liver disease
  24. HEV Diagnosis
    made by symptoms, travel history to endemic areas, and exclusion of other Hepatitis
  25. Hepatitis G, GBV (GBV-A, GBV-B, and GBV-C)
    • aka non A-E hepatitis
    • in serum, 2% of US blood donors as blood supply is not tested
    • Transmission: spreads via blood and body fluids, contaminated blood products, IV drug use, sexual contact with partners
    • Symptoms: may be acute or chronic, liver failure, aplastic anemia, fatal liver disease
  26. Remember about Hepatitis
    • Liver cancer is B, C, D, G, GBV
    • Fecal Oral route in A and E
    • Vaccines available in A,B
  27. Which types of hepatitis have blood borne transmission
    B, C, D, G, GBV
  28. Most strongly associated with IV drug abuse
    C
  29. vaccines available for babies
    A and B
  30. vaccines for recommend for traveling
    A
  31. Incubation periods
    • A - is short, 2-4 weeks
    • B - is long, 4 weeks - 6 months
    • C - is variable, 2 weeks - 6 months
  32. Most common hepatitis
    A
  33. most endemic in developing countries
    E
  34. Which virus piggybacks with Hepatitis B
    Describe structure and complications
    • Hepatitis D coinfects with Hepatitis B
    • it is a viral fragment, consist of RNA fragments and delta antigen
    • Symptoms are double infections, more severe than HBV
    • chronic infection is more likely
  35. Which hepatitis is associated with a high mortality rate in pregnant women
    E
  36. Which hepatitis seen in the US that is not detected in blood supply
    G and GBV

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