5. Blood-borne Infections: HIV and HBV

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cornpops
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96298
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5. Blood-borne Infections: HIV and HBV
Updated:
2011-08-11 04:57:11
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PH162A midterm
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public health microbiology midterm 3 lecture 5
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  1. general epidemiology
    • transmission =
    • blood products/ contaminated fomites
    • transplacental and neonatal
    • milk of infected nursing mothers
    • saliva
    • vaginal secretions
    • semen
  2. general prevention
    • standard STD prevention
    • screening of body fluids donated to others
    • universal precautions - new needles, gloves etc.
  3. Hepatitis B Virus
    enveloped DNA virus - gets envelope from host, looks like host's cells
  4. Hepatitis B Virus and Cirrhosis
    virus causes serious inflammation of the liver and can lead to liver cancer or liver failure
  5. Hepatitis B Virus epidemiology
    • global problem - asia accounts for most of the burden
    • many people infected
    • leads to liver cancer
  6. Hepatitis B Virus pathogenesis
    • fusion
    • partial DNA genome repaired into cccDNA
    • stays in nucleus as template for viral proteins
    • reverse transcriptase converts into DNA template for packaging
  7. outcomes of Hepatitis B Virus infection
    develop long-living immunity

    • die of acute infection from liver failure
    • become chronically infected - most die/ill from this, often asymptomatic
  8. Hepatitis B Virus immune response
    • antibodies are important in mounting response for acute infection - anti-HBe
    • chronic infection does not mount response - age at infection matters
  9. Hepatitis B Virus diagnosis
    • Hepatitis B surface antibody test + have immunity
    • Hepatitis B surface antigen test + have hepatitis
  10. Hepatitis B Virus treatment
    • no cure
    • monitor liver regularly
    • if needed, treat with antivirals
  11. Hepatitis B Virus prevention
    • vaccination
    • HBIG and vaccination soon after birth to prevent maternal to child transmission
  12. Human Immunodeficiency Virus
    • retrovirus - RNA as genetic material
    • uses reverse trancriptase
  13. HIV infection
    targets CD4 receptor and coreceptor on CD4 T cells and monocytes
  14. HIV classification
    HIV-1 = includes M(major) - responsible for most infections

    HIV-2 = in West Africa
  15. HIV course of infection
    • exposure:
    • infects CD4 cells
    • replicates rapidly (acute phase)

    • 2-4 weeks:
    • flu like symptoms
    • immune system fights back - symptoms subside (latent phase)

    • 10-12 years:
    • development of Acquired Immunodeficiency Syndrome (AIDS)
    • death due to opportunistic infections
  16. CD4 cell death possible causes
    • budding
    • apoptosis
    • CD8 T cell killing
    • anergy
    • damage to precursor cells
  17. HIV-2
    • found mostly in western africa
    • longer latent period
    • less aggressive AIDS
  18. clinical definition of AIDS
    • CD4 cell count less than 200/uL
    • less than 14% of total
    • AIDS-defining illness
  19. AIDS-defining illnesses
    • would normally only get if immune system compromised
    • pulmonary tuberculosis - most common infectious cause of death
    • Kaposi's Sarcoma
    • CMV retinitis
    • Fungal infections
    • cerebral toxoplasmosis
  20. routes of HIV infection
    • sexual intercourse
    • IV drug use
    • trans-placental
    • breastfeeding
    • transfusion
  21. HIV immune response
    • proper protective response not known
    • probables - neutralizing antibodies, CTLs
    • genetics - delta 32 mutation
  22. HIV Diagnosis
    • centrifuge blood, look at T cell count
    • look for pathogen - protein, nucleic acid detection
    • look for an immune response - ELISA, western blot
  23. HIV treatment
    • entry: CCR5 inhibitors, Fusion inhibitors
    • reverse transcriptase inhibitors
    • integrase inhibitors
    • viral protease inhibitors
  24. HIV prevention
    • no vaccine
    • re-exposure prophylaxis
    • circumcision?
    • maternal to child transmission - given antiretrovirals to breastfeeding women

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