Serological and Molecular Detection of Viral Infections Hepatitis Viruses

Sub microscopic pathogens that consists of a core of DNA or RNA packaged into a capsid. May be surrounded by an outer envelope

Viruses

Life Cycle of a Virus

Attachment

Penetration

Uncoating

Transcription

Translation

Assembly

Budding

Release

Test that help in establishing presumptive diagnosis, monitoring the course of infection, detection of past infections, and assessing immune status

Serologic Test

____ antibodies - indicate current or recent viral infection

____antibodies - indicate current or past viral infection, can also indicate immunity

IgM

IgG

Test that enhances the ability to detect active infection and are essential in guiding antiviral therapy

Molecular tests

Viruses that causes the inflammation of the liver

Hepatitis Viruses

Flu-Like symptoms and Mild to moderate Right-Upper Quadrant pain

Acute Stage Hepatitis

Chronic stage of Hepatitis (5)

Hepatomegaly

Jaundice

Dark Urine

Light Feces

Cirrhosis

Hepatitis A and E - via the _____________ route

Hepatitis B, C, and D - via the ______________ route

Fecal-oral (ingestion) route

Parenteral route

Contact with HBV contaminated blood or other body fluids, sexual contact, blood transfusions, needle stick injury, perinatal

Parenteral Route

Non-enveloped single stranded RNA virus that belongs to the family Picornaviridae. It is transmitted via the fecal-oral route and has an average period of 28 days

Mostly a self-limiting DIsease

Hepatitis A

Hepatitis A Serologic Tests

______________ - Primary marker to detect acute Hepatitis A

Total anti-HAV predominantly detect _____ antibodies

____________ - More Sensitive marker especially in early stages

IgM anti-HAV

IgG

HAV RNA

Hepatitis A uses what type of PCR?

Reverse Transcriptase PCR

Non-enveloped single stranded RNA virus that belongs to the family Hepeviridae, Genus Hepevirus.

It ihas four genotypes and is often silent

Hepatitis E

Hepatitis E

Genotype 1 and 2 - Associated with the consumption of _________________

Genotype 3 and 4 - associated with ___________ infections

HEV3 can cause _____________________

Contaminated Water

Zoonotic Infections

Chronic Hepatitis

Hepatitis E Serologic Tests

________________ - Detectable at the onset of S/S, should be reserved for patients with observable S/S

________________ - Develops four weeks after S/S develops and persist in several years

IgM anti-HEV

IgG anti-HEV

Gold Standard for Acute HEV infections

Real time PCR (qPCR0

The only DNA Hepatitis Virus that belongs to the family Hapadnaviridae. It has Recombinant vaccines available

Hepatitis B

Most Hepatitis B patients recover within _____ months

Chronic HBV is where virus persists for more than _____ months.

Six months

Structure of HBV

The whole virus has a total diameter of about __nm

Contains the:

___________ antigen

___________ antigen

___________ antigen

45nm

Surface antigen (HBsAg)

Core antigen (HBcAg)

Be antigen (HBeAg)

First marker to appear for Hepatitis B (2-10 weeks). It is the most reliable marker for HBV infection, it peaks during the acute stages and declines as Ab production progresses.

It remains elevated in chronic hepatitis cases and is an indicator of an active infection. It is an important marker in detecting initial infection

HBsAg

Marker of HBV that appears shortly after HBsAg and disappears before HBsAg. It is present during active replication of the virus and represents high degree of infectivity.

HBeAg

First antibody to appear for Hepatitis. it indicates current or recent acute infection. It is useful in monitoring before the core window period, neonatal hepatitis, and fulminant hepatitis

IgM anti-HBc

Antibody used to indicate a past HBV infection

Total Anti-HBc

________________ - Antibody that appears after the HBeAg disappears. It indicates that the patient is recovering from infection

________________ - Appear during recovery and persists for years after infection. It is not produced during chronic infections

Anti-HBe

Anti-HBs

HBV DNA is detected ___ days before HBsAg; use traditional or qPCR

21 days

Also known as delta hepatitis. Infection can only occur in the presence of Hepatitis B

Hepatitis D

Hepatitis D

__________________ : Hepatitis B and D

__________________: Chronic HBV Carriers → infected with HDV

Co-infection

Superinfection

Hepatitis D:

____ anti-HBc (+) = co--infection

____ anti-HBc (+): superinfection

IgM anti-HBc

IgG anti-HBc

Enveloped (+) sense, single stranded RNA virus. It belongs to the family Flaviviridae and is transmitted from exposure to blood. Majority of infections are asymptomatic but chronic infections are common

Hepatitis C

Treatment for Hepatitis C

pegylated IFN-y and ribavirin