This document discusses hepatitis C virus (HCV) genotypes. It begins by introducing HCV and its effects, noting there are 6 major genotypes. Genotype 1 is most common in the US while genotypes 1, 2, and 3 are found worldwide. Genotype helps determine treatment response, as genotypes 1 and 3 are associated with more aggressive disease. The document then explores molecular genotyping as the "gold standard" method and alternative methods. It concludes by examining how HCV genotype predicts response to interferon-alpha therapy and newer direct-acting antiviral drugs, with genotypes 2 and 3 typically responding better to treatment.
This document provides information on HIV/AIDS, including:
1. HIV was discovered in 1983-1984 and is the cause of AIDS. It is a retrovirus that infects CD4 cells and progressively destroys the immune system.
2. HIV has three main genes - Gag, Env, and Pol - which code for structural proteins. The virus attaches to and enters CD4 cells via the Env protein, then uses the Pol protein to integrate its genetic material into the host cell DNA.
3. As the virus destroys CD4 cells over many years, it leaves the infected person vulnerable to opportunistic infections. AIDS is diagnosed when the CD4 count drops below 200. Common infections include PCP
Susceptibility testing is used to determine which antimicrobials will inhibit the growth of the bacteria or fungi causing a specific infection. The results from this test will help a healthcare practitioner determine which drugs are likely to be most effective in treating a person's infection.
Herd immunity occurs when a high percentage of a population is vaccinated, providing indirect protection to unvaccinated individuals. When enough people are vaccinated against a contagious disease, its spread is halted, thereby protecting even those who are not vaccinated such as newborns or the immunocompromised. The threshold for herd immunity varies by disease, depending on its transmissibility. Maintaining high vaccination rates is important for protecting vulnerable groups who cannot receive vaccines and eliminating diseases.
This document discusses antifungal susceptibility testing. It provides background on the history of antifungal susceptibility testing and why it is needed. It describes different methods for testing including broth dilution and disk diffusion. It discusses various antifungal agents and their mechanisms of action. The document outlines the procedures for broth microdilution and macrodilution testing according to CLSI guidelines, including preparation of inoculum, drug solutions, reading results, and testing of filamentous fungi.
This document summarizes information about Human T-Lymphotropic Viruses Type 1 and 2 (HTLV-1 and HTLV-2). It describes their taxonomy as retroviruses, morphology and composition, replication and pathogenesis. HTLV-1 can cause Adult T-cell leukemia/lymphoma and Tropical Spastic Paraparesis, while HTLV-2 is rarely associated with disease. Transmission occurs through blood, sexual contact, and mother-to-child. While no treatment exists for the viruses, some therapies may help related diseases. Diagnosis involves blood tests and DNA detection by PCR.
Methods of Laboratory diagnosis (genotypic detection) of HIVdrakmane
1. Genotypic methods of HIV detection involve detecting mutations in the viral genome that are associated with drug resistance. This is done by sequencing parts of the HIV genome, like the reverse transcriptase and protease genes.
2. There are two main approaches - phenotypic testing directly measures viral replication in the presence of drugs, while genotypic testing detects known resistance-conferring mutations. Genotypic is recommended due to being faster and less expensive.
3. Genotypic testing involves extracting HIV RNA from plasma, amplifying genes with PCR, and then sequencing the genes to identify resistance mutations compared to wild type sequences. This allows detection of resistant strains present at 25% of the total viral population.
Hepatitis C is a global problem caused by the hepatitis C virus (HCV). HCV is a blood-borne virus that infects approximately 200 million people worldwide. Laboratory testing plays an important role in diagnosing HCV, evaluating patients for treatment, monitoring patients during treatment, and following up after treatment. There are 6 major genotypes of HCV with genotypes 1 and 4 being more difficult to treat and less responsive to interferon-based therapy.
This document provides information on HIV/AIDS, including:
1. HIV was discovered in 1983-1984 and is the cause of AIDS. It is a retrovirus that infects CD4 cells and progressively destroys the immune system.
2. HIV has three main genes - Gag, Env, and Pol - which code for structural proteins. The virus attaches to and enters CD4 cells via the Env protein, then uses the Pol protein to integrate its genetic material into the host cell DNA.
3. As the virus destroys CD4 cells over many years, it leaves the infected person vulnerable to opportunistic infections. AIDS is diagnosed when the CD4 count drops below 200. Common infections include PCP
Susceptibility testing is used to determine which antimicrobials will inhibit the growth of the bacteria or fungi causing a specific infection. The results from this test will help a healthcare practitioner determine which drugs are likely to be most effective in treating a person's infection.
Herd immunity occurs when a high percentage of a population is vaccinated, providing indirect protection to unvaccinated individuals. When enough people are vaccinated against a contagious disease, its spread is halted, thereby protecting even those who are not vaccinated such as newborns or the immunocompromised. The threshold for herd immunity varies by disease, depending on its transmissibility. Maintaining high vaccination rates is important for protecting vulnerable groups who cannot receive vaccines and eliminating diseases.
This document discusses antifungal susceptibility testing. It provides background on the history of antifungal susceptibility testing and why it is needed. It describes different methods for testing including broth dilution and disk diffusion. It discusses various antifungal agents and their mechanisms of action. The document outlines the procedures for broth microdilution and macrodilution testing according to CLSI guidelines, including preparation of inoculum, drug solutions, reading results, and testing of filamentous fungi.
This document summarizes information about Human T-Lymphotropic Viruses Type 1 and 2 (HTLV-1 and HTLV-2). It describes their taxonomy as retroviruses, morphology and composition, replication and pathogenesis. HTLV-1 can cause Adult T-cell leukemia/lymphoma and Tropical Spastic Paraparesis, while HTLV-2 is rarely associated with disease. Transmission occurs through blood, sexual contact, and mother-to-child. While no treatment exists for the viruses, some therapies may help related diseases. Diagnosis involves blood tests and DNA detection by PCR.
Methods of Laboratory diagnosis (genotypic detection) of HIVdrakmane
1. Genotypic methods of HIV detection involve detecting mutations in the viral genome that are associated with drug resistance. This is done by sequencing parts of the HIV genome, like the reverse transcriptase and protease genes.
2. There are two main approaches - phenotypic testing directly measures viral replication in the presence of drugs, while genotypic testing detects known resistance-conferring mutations. Genotypic is recommended due to being faster and less expensive.
3. Genotypic testing involves extracting HIV RNA from plasma, amplifying genes with PCR, and then sequencing the genes to identify resistance mutations compared to wild type sequences. This allows detection of resistant strains present at 25% of the total viral population.
Hepatitis C is a global problem caused by the hepatitis C virus (HCV). HCV is a blood-borne virus that infects approximately 200 million people worldwide. Laboratory testing plays an important role in diagnosing HCV, evaluating patients for treatment, monitoring patients during treatment, and following up after treatment. There are 6 major genotypes of HCV with genotypes 1 and 4 being more difficult to treat and less responsive to interferon-based therapy.
The lecture was presented to the students of Saudi board of Community Medicine to help them know about the various serological methods applicable in the diagnosis of infectious diseases in general with attention upon the specificity and sensitivity of various diagnostic modalities. The lecture covers the basic principles of each test and the clinical applications with the advantages and disadvantages of each.
Pathogenic mechanisms of microbes of medical importanceJoyce Mwatonoka
The document summarizes the pathogenic mechanisms of microbes that are medically important. It discusses key terms and outlines various mechanisms including adherence, invasion, evasion of host defenses, and toxigenesis. Specifically, it describes how bacteria adhere to host cells using adhesins and receptors. It also explains how they invade tissues using invasins like hyaluronidase and collagenase. Bacteria can evade host defenses by inhibiting phagocytosis and surviving inside phagocytes. Some vary antigens to avoid immune responses. Toxins including exotoxins and endotoxins are also discussed.
This document provides information about hepatitis C virus (HCV) including its structure, genome, genotypes, epidemiology, transmission, pathogenesis, diagnosis, and management. It discusses:
- HCV has a single-stranded RNA genome within the Flaviviridae family. It exists as different genotypes that determine treatment response.
- HCV is a major cause of liver disease worldwide, with transmission primarily through blood exposure. Diagnosis involves antibody and RNA testing.
- Treatment aims to eradicate HCV and involves pegylated interferon and ribavirin combinations. Response is monitored via viral load decline. Adverse effects require monitoring and management. New direct-acting antivirals are improving treatment outcomes.
Antimicrobial susceptibility testing – disk diffusion methodsAnn Sam
This document provides information on antimicrobial susceptibility testing using disk diffusion methods. It discusses the importance of AST for treating infectious diseases and monitoring antimicrobial resistance. The Kirby-Bauer disk diffusion method is described in detail, including media preparation, inoculum standardization, disk and antibiotic solution preparation, quality control strains, incubation, reading zones of inhibition, and interpreting results according to CLSI guidelines. Special considerations are given to organisms like MRSA, VISA, and inducible clindamycin resistance in Staphylococci.
The document summarizes evasion mechanisms used by viruses to avoid the host immune system. It discusses two main mechanisms used by influenza viruses: antigenic drift which involves point mutations in surface proteins, and antigenic shift which involves reassortment of RNA segments between animal and human influenza viruses. It also describes how herpes simplex viruses prevent the transport of viral peptides to the ER through the protein ICP-47, inhibiting antigen presentation through MHC class I molecules on infected cells.
Hepatitis C is a major global public health problem, infecting around 180 million people worldwide. It is a leading cause of liver disease and liver transplants. The hepatitis C virus is a RNA virus that primarily infects liver cells. Around 70-85% of infections become chronic, and 20-40% of chronic infections can lead to severe liver disease like cirrhosis or liver cancer over time. The most common modes of transmission are through blood exposure, though sexual transmission risk is low. There is no vaccine, but effective antiviral treatment exists.
The document discusses viral pathogenesis and genetics. It describes the cycle of viral infection as entry into host cells, primary replication at the infection site, spread within the host, and shedding/transmission. It also discusses the effects of viruses on cells and the host organism. The genetic principles of viruses are explained as mutation, selection, and recombination, which impact viral evolution, management, and experimental study.
This document discusses orthomyxoviruses, which include influenza viruses A, B, and C. It provides details on their structure, including being linear, segmented RNA viruses with negative-sense and enveloped. It also describes the influenza virus life cycle, pathogenesis in humans, clinical symptoms of influenza infection, and methods for prevention and control including inactivated viral vaccines and live attenuated influenza vaccines.
The Epsilometer test, also known as the E-test, is a quantitative method for determining the minimum inhibitory concentration (MIC) of antibiotics against bacteria. It uses plastic strips containing a continuous gradient of an antibiotic immobilized on one side to establish an antibiotic gradient when placed on an agar plate inoculated with bacteria. Elliptical zones of inhibition form where the antibiotic has inhibited bacterial growth, and the MIC is read as the intersection of this zone with the scale on the other side of the strip. The E-test allows for simple and rapid MIC testing of bacteria against various antibiotics.
This document discusses apoptosis in cardiovascular disorders. It provides an overview of apoptotic pathways and diseases in the cardiovascular system where apoptosis plays a role. It discusses imaging techniques to study apoptosis and potential therapeutic options to modulate apoptosis. It defines key terms related to apoptosis and describes the intrinsic and extrinsic apoptotic pathways. It also compares necrosis and apoptosis and discusses the role of apoptosis in cardiac development and heart failure.
The document summarizes key information about HIV/AIDS, including:
1) HIV is a lentivirus that causes AIDS by progressively destroying the immune system, allowing other infections to thrive. Once infected, the body cannot rid itself of HIV.
2) Scientists believe HIV originated from chimpanzees in West Africa and was transmitted to humans through contact with their blood.
3) HIV is classified as a retrovirus and exists as two types, HIV-1 and HIV-2. HIV-1 is more widespread and virulent.
4) There is no cure for HIV, but treatment with antiretroviral drugs can control the virus and prevent transmission.
The document describes procedures for the haemagglutination (HA) test and haemagglutination inhibition (HI) test. The HA test detects viruses that can agglutinate or clump red blood cells by binding viral proteins to receptors on RBCs. It is used to measure virus titers. The HI test detects antibodies that inhibit HA by binding to viral antigens and blocking receptor binding. It is used to measure antibody titers and evaluate vaccines. Both tests involve making serial dilutions of virus or serum samples in microtiter plates, then adding RBCs to detect agglutination or its inhibition.
Reverse vaccinology uses genomics and bioinformatics to identify antigens that could be used in vaccines, rather than relying on culturing pathogens. It sequences the genome of a pathogen and predicts potential antigens, allowing development of vaccines for pathogens that cannot be grown in culture. This approach was used to develop a vaccine for Neisseria meningitidis serogroup B, the first reverse vaccinology vaccine approved for use. Traditional vaccinology is limited by only being able to use antigens that are abundant during infection and that the pathogen can be cultured, whereas reverse vaccinology makes all antigens available for vaccine development.
Viruses can interact with host cells and organisms at the cellular, individual, and community levels. At the cellular level, viruses may cause a variety of effects from no effect to cell death. Some viruses like poliovirus cause cell lysis, while others cause cellular proliferation or malignant transformation. Host injury at the cellular level can be caused by viral proteins, accumulation of viral macromolecules, altered plasma membrane permeability, damage to chromosomes, and formation of inclusion bodies within cells. The host response is a complex interplay between the host and virus.
polio virus lecture for MBBS
The picornaviruses are small (22 to 30 nm) nonenveloped, single-stranded RNA viruses with cubic symmetry. The virus capsid is composed of 60 protein subunits, each consisting of four poly-peptides VP1–VP4. Because they contain no essential lipids, they are ether resistant. They replicate in the cytoplasm.
Antimicrobial peptides a novel therapeutic agentkarimbscdu
This document discusses antimicrobial peptides (AMPs), which are small proteins that have broad-spectrum antimicrobial activity against bacteria, viruses, fungi and cancer cells. AMPs are part of the innate immune system and are produced by all multicellular organisms as a first line of defense. There are several classes of human AMPs including defensins, cathelicidins and histatins. AMPs kill microbes through mechanisms such as disrupting microbial membranes and interfering with intracellular processes. Due to their ability to rapidly kill pathogens, broad activity and modularity, AMPs show promise as alternatives to conventional antibiotics.
This document summarizes various laboratory tests used in the diagnosis of HIV infection. It describes the purpose and types of HIV tests, including specific tests like antigen detection, antibody detection using ELISA, rapid tests, and confirmatory tests like Western Blot. It also discusses viral load tests, CD4 counts, and the use of PCR in diagnosis. The temporal sequence of biomarkers in HIV infection is outlined.
This document provides information on antiviral drugs and their classification and mechanisms of action. It discusses different types of antiviral drugs used to treat HIV/AIDS including nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, protease inhibitors, entry inhibitors, and integrase inhibitors. It also discusses antiviral drugs for other viruses like viral DNA polymerase inhibitors, neuraminidase inhibitors, and immunomodulators. Specific drugs are discussed in detail including their mechanisms of action, pharmacokinetics, clinical uses, and adverse effects.
The document discusses HIV testing procedures for adults and children. It outlines the objectives of HIV testing, general principles, types of diagnostic tests, and strategies for testing. It also covers tests for diagnosing HIV in children under 18 months, including DNA PCR. Guidelines for monitoring disease progression and ART response via CD4 count and viral load testing are presented. The key aims of HIV testing are diagnosis, monitoring, and surveillance to help control the HIV epidemic.
Hepatitis C virus (HCV) was identified in the 1970s and can lead to chronic liver disease. Globally, an estimated 71 million people have chronic HCV infection. In India, the prevalence is estimated between 0.5-1.5% with genotype 3 being most common. HCV is transmitted through blood and blood products, unsafe medical injections, and from mother to child. Most infections become chronic, potentially leading to cirrhosis or liver cancer over time. Screening and treatment have advanced significantly in recent decades to help eliminate HCV transmission through blood and cure chronic infections.
Assessment of serum lipid profile in patients with chronic hepatitis cTanveer00786
1. The document discusses a study that assessed the serum lipid profiles of 100 patients diagnosed with chronic hepatitis C.
2. It found that 63% of patients had normal lipid levels, 3% were hyperlipidemic, and 34% were hypolipidemic.
3. The study indicates that progression of hepatitis C viral infection can lead to decreased levels of lipids.
The lecture was presented to the students of Saudi board of Community Medicine to help them know about the various serological methods applicable in the diagnosis of infectious diseases in general with attention upon the specificity and sensitivity of various diagnostic modalities. The lecture covers the basic principles of each test and the clinical applications with the advantages and disadvantages of each.
Pathogenic mechanisms of microbes of medical importanceJoyce Mwatonoka
The document summarizes the pathogenic mechanisms of microbes that are medically important. It discusses key terms and outlines various mechanisms including adherence, invasion, evasion of host defenses, and toxigenesis. Specifically, it describes how bacteria adhere to host cells using adhesins and receptors. It also explains how they invade tissues using invasins like hyaluronidase and collagenase. Bacteria can evade host defenses by inhibiting phagocytosis and surviving inside phagocytes. Some vary antigens to avoid immune responses. Toxins including exotoxins and endotoxins are also discussed.
This document provides information about hepatitis C virus (HCV) including its structure, genome, genotypes, epidemiology, transmission, pathogenesis, diagnosis, and management. It discusses:
- HCV has a single-stranded RNA genome within the Flaviviridae family. It exists as different genotypes that determine treatment response.
- HCV is a major cause of liver disease worldwide, with transmission primarily through blood exposure. Diagnosis involves antibody and RNA testing.
- Treatment aims to eradicate HCV and involves pegylated interferon and ribavirin combinations. Response is monitored via viral load decline. Adverse effects require monitoring and management. New direct-acting antivirals are improving treatment outcomes.
Antimicrobial susceptibility testing – disk diffusion methodsAnn Sam
This document provides information on antimicrobial susceptibility testing using disk diffusion methods. It discusses the importance of AST for treating infectious diseases and monitoring antimicrobial resistance. The Kirby-Bauer disk diffusion method is described in detail, including media preparation, inoculum standardization, disk and antibiotic solution preparation, quality control strains, incubation, reading zones of inhibition, and interpreting results according to CLSI guidelines. Special considerations are given to organisms like MRSA, VISA, and inducible clindamycin resistance in Staphylococci.
The document summarizes evasion mechanisms used by viruses to avoid the host immune system. It discusses two main mechanisms used by influenza viruses: antigenic drift which involves point mutations in surface proteins, and antigenic shift which involves reassortment of RNA segments between animal and human influenza viruses. It also describes how herpes simplex viruses prevent the transport of viral peptides to the ER through the protein ICP-47, inhibiting antigen presentation through MHC class I molecules on infected cells.
Hepatitis C is a major global public health problem, infecting around 180 million people worldwide. It is a leading cause of liver disease and liver transplants. The hepatitis C virus is a RNA virus that primarily infects liver cells. Around 70-85% of infections become chronic, and 20-40% of chronic infections can lead to severe liver disease like cirrhosis or liver cancer over time. The most common modes of transmission are through blood exposure, though sexual transmission risk is low. There is no vaccine, but effective antiviral treatment exists.
The document discusses viral pathogenesis and genetics. It describes the cycle of viral infection as entry into host cells, primary replication at the infection site, spread within the host, and shedding/transmission. It also discusses the effects of viruses on cells and the host organism. The genetic principles of viruses are explained as mutation, selection, and recombination, which impact viral evolution, management, and experimental study.
This document discusses orthomyxoviruses, which include influenza viruses A, B, and C. It provides details on their structure, including being linear, segmented RNA viruses with negative-sense and enveloped. It also describes the influenza virus life cycle, pathogenesis in humans, clinical symptoms of influenza infection, and methods for prevention and control including inactivated viral vaccines and live attenuated influenza vaccines.
The Epsilometer test, also known as the E-test, is a quantitative method for determining the minimum inhibitory concentration (MIC) of antibiotics against bacteria. It uses plastic strips containing a continuous gradient of an antibiotic immobilized on one side to establish an antibiotic gradient when placed on an agar plate inoculated with bacteria. Elliptical zones of inhibition form where the antibiotic has inhibited bacterial growth, and the MIC is read as the intersection of this zone with the scale on the other side of the strip. The E-test allows for simple and rapid MIC testing of bacteria against various antibiotics.
This document discusses apoptosis in cardiovascular disorders. It provides an overview of apoptotic pathways and diseases in the cardiovascular system where apoptosis plays a role. It discusses imaging techniques to study apoptosis and potential therapeutic options to modulate apoptosis. It defines key terms related to apoptosis and describes the intrinsic and extrinsic apoptotic pathways. It also compares necrosis and apoptosis and discusses the role of apoptosis in cardiac development and heart failure.
The document summarizes key information about HIV/AIDS, including:
1) HIV is a lentivirus that causes AIDS by progressively destroying the immune system, allowing other infections to thrive. Once infected, the body cannot rid itself of HIV.
2) Scientists believe HIV originated from chimpanzees in West Africa and was transmitted to humans through contact with their blood.
3) HIV is classified as a retrovirus and exists as two types, HIV-1 and HIV-2. HIV-1 is more widespread and virulent.
4) There is no cure for HIV, but treatment with antiretroviral drugs can control the virus and prevent transmission.
The document describes procedures for the haemagglutination (HA) test and haemagglutination inhibition (HI) test. The HA test detects viruses that can agglutinate or clump red blood cells by binding viral proteins to receptors on RBCs. It is used to measure virus titers. The HI test detects antibodies that inhibit HA by binding to viral antigens and blocking receptor binding. It is used to measure antibody titers and evaluate vaccines. Both tests involve making serial dilutions of virus or serum samples in microtiter plates, then adding RBCs to detect agglutination or its inhibition.
Reverse vaccinology uses genomics and bioinformatics to identify antigens that could be used in vaccines, rather than relying on culturing pathogens. It sequences the genome of a pathogen and predicts potential antigens, allowing development of vaccines for pathogens that cannot be grown in culture. This approach was used to develop a vaccine for Neisseria meningitidis serogroup B, the first reverse vaccinology vaccine approved for use. Traditional vaccinology is limited by only being able to use antigens that are abundant during infection and that the pathogen can be cultured, whereas reverse vaccinology makes all antigens available for vaccine development.
Viruses can interact with host cells and organisms at the cellular, individual, and community levels. At the cellular level, viruses may cause a variety of effects from no effect to cell death. Some viruses like poliovirus cause cell lysis, while others cause cellular proliferation or malignant transformation. Host injury at the cellular level can be caused by viral proteins, accumulation of viral macromolecules, altered plasma membrane permeability, damage to chromosomes, and formation of inclusion bodies within cells. The host response is a complex interplay between the host and virus.
polio virus lecture for MBBS
The picornaviruses are small (22 to 30 nm) nonenveloped, single-stranded RNA viruses with cubic symmetry. The virus capsid is composed of 60 protein subunits, each consisting of four poly-peptides VP1–VP4. Because they contain no essential lipids, they are ether resistant. They replicate in the cytoplasm.
Antimicrobial peptides a novel therapeutic agentkarimbscdu
This document discusses antimicrobial peptides (AMPs), which are small proteins that have broad-spectrum antimicrobial activity against bacteria, viruses, fungi and cancer cells. AMPs are part of the innate immune system and are produced by all multicellular organisms as a first line of defense. There are several classes of human AMPs including defensins, cathelicidins and histatins. AMPs kill microbes through mechanisms such as disrupting microbial membranes and interfering with intracellular processes. Due to their ability to rapidly kill pathogens, broad activity and modularity, AMPs show promise as alternatives to conventional antibiotics.
This document summarizes various laboratory tests used in the diagnosis of HIV infection. It describes the purpose and types of HIV tests, including specific tests like antigen detection, antibody detection using ELISA, rapid tests, and confirmatory tests like Western Blot. It also discusses viral load tests, CD4 counts, and the use of PCR in diagnosis. The temporal sequence of biomarkers in HIV infection is outlined.
This document provides information on antiviral drugs and their classification and mechanisms of action. It discusses different types of antiviral drugs used to treat HIV/AIDS including nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, protease inhibitors, entry inhibitors, and integrase inhibitors. It also discusses antiviral drugs for other viruses like viral DNA polymerase inhibitors, neuraminidase inhibitors, and immunomodulators. Specific drugs are discussed in detail including their mechanisms of action, pharmacokinetics, clinical uses, and adverse effects.
The document discusses HIV testing procedures for adults and children. It outlines the objectives of HIV testing, general principles, types of diagnostic tests, and strategies for testing. It also covers tests for diagnosing HIV in children under 18 months, including DNA PCR. Guidelines for monitoring disease progression and ART response via CD4 count and viral load testing are presented. The key aims of HIV testing are diagnosis, monitoring, and surveillance to help control the HIV epidemic.
Hepatitis C virus (HCV) was identified in the 1970s and can lead to chronic liver disease. Globally, an estimated 71 million people have chronic HCV infection. In India, the prevalence is estimated between 0.5-1.5% with genotype 3 being most common. HCV is transmitted through blood and blood products, unsafe medical injections, and from mother to child. Most infections become chronic, potentially leading to cirrhosis or liver cancer over time. Screening and treatment have advanced significantly in recent decades to help eliminate HCV transmission through blood and cure chronic infections.
Assessment of serum lipid profile in patients with chronic hepatitis cTanveer00786
1. The document discusses a study that assessed the serum lipid profiles of 100 patients diagnosed with chronic hepatitis C.
2. It found that 63% of patients had normal lipid levels, 3% were hyperlipidemic, and 34% were hypolipidemic.
3. The study indicates that progression of hepatitis C viral infection can lead to decreased levels of lipids.
Hepatitis E Virus (HEV) is a leading cause of acute viral hepatitis worldwide. It is transmitted primarily through the fecal-oral route. While usually self-limiting, it can cause severe disease in pregnant women and those with pre-existing liver disease. HEV genotype 3 can also cause chronic infection in immunocompromised patients such as organ transplant recipients. Treatment involves reducing immunosuppression and using ribavirin, which is effective at clearing the virus. Excellent vaccines have been developed but are currently only marketed in China.
The document summarizes information about several hepatitis viruses including HAV, HBV, HCV, HDV, and HEV. It provides details on their geographical distribution, modes of transmission, clinical presentation, natural history, and markers used to diagnose infection. Highlights include that HBV is a major cause of liver cancer and cirrhosis worldwide, with 400 million chronic carriers. Chronic HBV infection progression can lead to complications like liver failure, cancer, and death if left untreated.
This document discusses HIV, HCV and HBV coinfection. It provides epidemiological data on the prevalence of HCV in different populations. HCV/HIV coinfection increases the risk of liver disease progression. Clinical trials showed that PEG-IFN and ribavirin can achieve virologic response in HCV/HIV patients. Novel direct-acting antiviral drugs against HCV also target specific parts of the viral lifecycle. HBV infection and genotypes also impact clinical outcomes. Vaccination and antiviral therapy are important for managing HBV/HIV coinfection.
1) The study analyzed HIV-1 sequences from 37 patients with high numbers (34 or more) of degenerate base codes in their protease/reverse transcriptase sequences, which can indicate either extensive viral evolution or dual infection. 2) Phylogenetic analysis of envelope and gag sequences from these patients found that 16 (43%) had dual HIV-1 infections, representing 1% of all sequences analyzed. 3) Patients with the highest numbers of degenerate base codes were more likely to have dual infections with different HIV-1 subtypes. The study demonstrates that routine HIV genotyping can help detect undiagnosed dual infections.
This document provides an outline for a presentation on HCV genotyping methods. It discusses the morphology and characteristics of HCV, its history and structure. It describes the six genotypes of HCV and their geographical distribution. It also discusses mutants of HCV, clinical importance of genotypes, laboratory diagnosis, and different methods for genotyping including direct sequencing, RFLP typing of the 5'UTR, and line probe assay (LiPA). The advantages of LiPA include it being easy, less time consuming and capable of reliably genotyping HCV RNA directly from clinical samples.
Antiretroviral Resistance in HIV-1 Patients at a Tertiary Medical Institute in Saudi Arabia: a Retrospective Study and Analysis.
Journal Club,
Virology Rotation , 1/5/2019
This study aimed to determine the genotypes of hepatitis C virus (HCV) among Libyan patients using the line probe assay (LiPA) technique. Blood samples were collected from 75 HCV-infected Libyan patients and genotyped using the INNO-LiPA HCV II kit. The results found that genotype 4 was the most prevalent, accounting for 60% of samples, followed by subtype 1a at 26.7%. Less common genotypes identified included 1b, 2a/2c, 1a/1b, and 2. There was no significant difference in genotype distribution between age groups, sexes, or between those with and without HIV co-infection. The distribution of HCV genotypes in Libya is consistent with neighboring countries, with
This document describes a study that aimed to determine the genotypes of Hepatitis C Virus (HCV) among Libyan patients using a Line Immune Probe Assay (LiPA). Blood samples were collected from 75 HCV-infected Libyan patients and genotyped using the LiPA technique. The results found that genotype 4 was the most predominant, comprising 60% of samples, followed by genotype 1a at 26.7%. Some differences in genotype distribution were seen between HIV-infected and non-infected groups. In conclusion, the distribution of HCV genotypes in Libya is consistent with neighboring countries, with genotype 4 being the most common.
This document describes a study examining hepatitis C virus (HCV) core antigen expression in liver tissue samples from liver transplant patients with either severe or mild recurrent HCV infection post-transplant. Liver samples were analyzed from 12 transplant recipients (6 with severe cholestatic hepatitis and 6 with mild recurrence) at three time points: pre-transplant, early post-transplant, and late post-transplant. HCV core antigen staining was stronger in the severe group, especially in explant samples. Serum HCV RNA levels were also higher in the severe group. The results suggest that strong HCV staining in explant samples may predict more severe recurrent disease post-transplant.
The relationship between the molecular epidemiology of hepatitis c and the be...Alexander Decker
This study examined the molecular epidemiology and prevalence of hepatitis C virus (HCV) infection in Jordan. Researchers tested 1929 patients for HCV antibodies between 2010-2011. A total of 149 patients (9%) tested positive, with the infection being twice as common in males compared to females. The most common causes of infection were blood transfusion (68%), kidney dialysis (17%), addiction treatment centers (6%), and unknown causes (9%). HCV RNA detection and genotyping was performed on positive samples. The results suggest blood transfusion is a major route of HCV transmission in Jordan and screening of blood donors has helped reduce prevalence over time.
This study examined risk factors for HCV infection and severity of liver disease in 86 Mexican women reactive for anti-HCV antibodies. Surgery (80%) and blood transfusions before 1993 (58%) were main risk factors, with 52% having both. The most common reasons for surgery and transfusion were obstetric/gynecologic (74% and 68%). 64% were HCV RNA positive. Age and history of transfusion before 1993 predicted cirrhosis. Anti-HCV levels correlated with time since transfusion but not age. HBV co-infection rate was low (5%) and did not influence severity.
Comparison Between Antiviral Combination Therapies Against Hepatitis C Virus ...Mohammed Fathy Zaky
Hepatitis C virus (HCV) is a leading cause of chronic liver disease worldwide. HCV genotype 4 is predominant in the Middle East and Africa, especially Egypt where 90% of HCV cases are genotype 4. The aim of this study is to compare the efficacy and safety of new antiviral combination therapies for treating HCV genotype 4 infection in Egyptian patients.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
This document discusses occupational exposure to bloodborne viruses such as hepatitis B, hepatitis C, and HIV among healthcare workers. Healthcare workers are at risk of contracting serious viral infections through needlestick injuries or contact with infected bodily fluids. Vaccination and proper post-exposure management are important for preventing transmission of bloodborne viruses. Professionals with frequent occupational exposure include emergency room staff, surgeons, dentists, and those working in dialysis units or blood banks.
This document summarizes research presented by Dr. Mohamed El Zowalaty on avian influenza virus surveillance. It describes efforts to isolate avian influenza viruses from polymerase chain reaction-negative waterfowl samples, experiments testing different sample types and virus isolation methods, and identification of various avian influenza virus subtypes isolated including H5 strains. The research aimed to improve avian influenza virus detection and surveillance methods.
This document summarizes key information about HIV/AIDS, including its history, virology, diagnosis, treatment, and prevention. It describes how HIV was first identified in 1981 as the cause of AIDS, belongs to the retrovirus family, and has two types, HIV-1 and HIV-2. Over 30 million people have died of AIDS since 1981, and approximately 2.5 million people are newly infected with HIV each year.
This document provides an overview of Hepatitis C. It begins with an introduction stating that over 71 million people worldwide are chronically infected with HCV. It then covers the virology of HCV including its structure, genome, replication cycle, genotypes/quasispecies. The epidemiology section discusses the global prevalence and incidence. Pathogenesis outlines how HCV evades the immune system to cause chronic infection. Clinical features are separated into acute hepatitis C and chronic hepatitis C. Extrahepatic manifestations associated with HCV are also summarized.
TEST BANK For Community and Public Health Nursing: Evidence for Practice, 3rd...Donc Test
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Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
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2. INTRO TO HEPATITIS C
Hepatitis C virus (HCV) is single-stranded RNA
virus hepacivirus of the Flaviviridae family.
HCV affects the liver; can lead to: cirrhosis, liver
cancer, and liver failure.
United States alone, nearly 4 million persons
are infected 1
30,000 acute new infections are estimated to
occur annually 1
HCV is responsible for an estimated 8,000 to
10,000 deaths annually in the United States.1
HCV is the leading reason for liver
transplantation in the US.
3. INTRO TO HEPATITIS C
There are two main types of
hepatitis C:
Acute hepatitis C
Short-term- lasting only six
months or less
Chronic hepatitis C
Can last for one's entire life
4. HCV GENOTYPES
The ability of the virus to mutate has resulted in the existence of
different genetic variations of HCV
HCV has six genotypes, labeled 1 through 6.
There are also subtypes labeled with letters.
HCV Genotype HCV Subtypes
Genotype 1 1a, 1b
Genotype 2 2a, 2b, 2c, 2d
Genotype 3 3a, 3b, 3c, 3d, 3e, 3f
Genotype 4 4a, 4b, 4c, 4d, 4e, 4f, 4g, 4h,
4i, 4j
Genotype 5 5a
Genotype 6 6a
5. HCV GENOTYPES
Genotype 1 is the most
common strain in the
United States.
Genotypes 1, 2, and 3 are
found worldwide.
Genotype 4 is found
throughout northern Africa
Genotype 5 commonly is
found in South Africa.
Genotype 6 is common in
Asia.
6. HCV GENOTYPES
Genotype helps to determine treatment
HCV genotypes respond differently to antiviral treatments due to
substantially differences in genetic make-up.
Can help predict the outcome
Genotype 1 and 3 infection are associated with more aggressive
liver disease, with increased risk for cirrhosis. 6
7.
8. “GOLDEN STANDARD”
Molecular Genotyping
1) Genomic amplification
through polymerase chain
reaction
2) Sequencing of a specific
amplified portion of the HCV
genome obtained from the
patient
(NS5, core, E1, and 5’ UTRs
region)
3) Phylogenetic tree analysis
confirmation
9. “GOLDEN STANDARD "LIMITATIONS
1) The amplification of some genomic regions may not be efficient. 2
2) If population template sequencing is employed, the predominant HCV
genotype will be revealed in patients with mixed infection. 2
3) When a large number of isolates are studied, the assignment of some
isolates may not be clear cut. 2
4) Expensive and labor intensive, making it difficult to study HCV
genotypes in a large number of patients.
10. ALTERNATIVE METHODS
1) Amplification with type-specific
primers or type-specific probes. 3
Different HCV types(I to IV)
recognized by the distinct sizes of
their PCR products
11. ALTERNATIVE METHODS
1) Amplification with type-specific
primers or type-specific probes. 3
2) Line probe assay (LiPA)- allows
discrimination of HCV types and
subtypes capable of detecting
single nucleotide differences in 5’
UTR. 4
Different HCV types(I to IV)
recognized by the distinct sizes of
their PCR products
12. ALTERNATIVE METHODS
2) Line probe assay (LiPA)- allows
discrimination of HCV types and
subtypes capable of detecting
single nucleotide differences in 5’
UTR. 4
13. HCV GENOTYPE AND RESPONSE
TO THERAPY
HCV genotype is an important viral
factor that has been identified as a
strong independent predictor of
sustained virological response (SVR) to
therapy.
SVR is defined as an undetectable
level of HCV RNA at 12 weeks
(SVR12) or 24 weeks (SVR24) after
completion of treatment.
HCV genotype has direct clinical
implications for duration and dosage
of combination therapy.
14. HCV GENOTYPE AND RESPONSE
TO THERAPY
An important breakthrough in the treatment of chronic HCV
infection includes standard or pegylated interferon-α (IFN-α)
administered as a monotherapy or in combination with ribavirin.7
Response to IFN-α therapy differs among HCV genotypes
Response rates among patients with genotypes 2 and 3 observed
to be two- to threefold higher than in individuals infected with
genotype 1. 8
The limited efficacy of IFN-α to block viral replication and the
reduced rate of sustained HCV clearance observed in patients
infected with HCV genotype 1. 9
Therapy for patients with infected with genotypes 2 or 3 has been
optimized for a duration of 24 weeks rather than the 48 weeks
10
15. HCV GENOTYPE AND RESPONSE
TO THERAPY
New treatment option - Direct acting antivirals (DAA)- high efficacy
and well-tolerated medications with high cure rates
DAAs are molecules that target specific nonstructural proteins of the virus and
results in disruption of viral replication and infection.
The first approved DAAs, telaprevir and boceprevir, were
introduced in 2011 for the treatment of HCV genotype 1 infection.
Use of telaprevir and boceprevir in combination with pegylated
IFN-α and ribavirin led to achievement of SVR rates in 65%–75%
of patients with HCV genotype 1. 11
16. Treatment durations are adapted from the 2015 guidelines of the American Association for the
Study of Liver Diseases (AASLD) (50) and European Association for the Study of the Liver (EASL)
(51).
18. REFERENCES
1. National Institutes of Health Consensus Development Conference Panel. 1997. National Institutes of Health Consensus Development
Conference Panel statement: management of hepatitis C. Hepatology 26(Suppl. 1):2S–10S.
2. Zeuzem S, Franke A, Lee JH, Herrmann G, Ruster B, Roth WK. Phylogenetic analysis of hepatitis C virus isolates and their correlation to
viremia, liver function tests and histology. Hepatology 1996.
3. H. Okamoto, Y. Sugiyama, S. Okada, K.Kurai, Y. Akahane, Y. Sugai, T. Tanaka, K.Sato, F. Tsuda, Y. Miyakawa, et al.Typing hepatitis C
virus by polymerase chain reaction with type-specific primers: application to clinical surveys and tracing infectious sources. J. Gen.
Virol., 73 (Pt 3) (1992), pp. 673-679
4. L. Stuyver, A. Wyseur, W. van Arnhem, F.Hernandez, G. MaertensSecond-generation line probe assay for hepatitis C virus genotyping.
J. Clin. Microbiol., 34 (1996), pp. 2259-2266
5. E.N. Ilina, M.V. Malakhova, E.V.Generozov, E.N. Nikolaev, V.M. GovorunMatrix-assisted laser desorption ionization-time of flight
(mass spectrometry) for hepatitis C virus genotyping. J. Clin. Microbiol., 43 (2005), pp. 2810-2815
6. Chopra S. Characteristics of the hepatitis C virus. Uptodate. Edwards MS, Di Bisceglie AM, Bloom A, eds. Accessed at:
www.uptodate.com. 2014.
7. McHutchison JG & Fried MW. Current therapy for hepatitis C: pegylated interferon and ribavirin. Clinical Liver Disease 2003; 7:149–
161.
8. Poynard T, Marcellin P, Lee SS, Niederau C, Minuk GS, Ideo G, Bain V, Heathcote J, Zeuzem S, Trepo C & Albrecht J. Randomised trial of
interferon alpha2b plus ribavirin for 48 weeks or for 24 weeks versus interferon alpha2b plus placebo for 48 weeks for treatment of
chronic infection with hepatitis C virus. International Hepatitis Interventional Therapy Group (IHIT). Lancet 1998; 352:1426–1432.
9. Hadziyannis SJ, Sette H Jr, Morgan TR, Balan V, Diago M, Marcellin P, Ramadori G, Bodenheimer H Jr, Bernstein D, Rizzetto M, Zeuzem
S, Pockros PJ, Lin A & Ackrill AM. Peginterferon-alpha2a and ribavirin combination therapy in chronic hepatitis C: a randomized study
of treatment duration and ribavirin dose. Annals of Internal Medicine 2004; 140:346–355.
10. Seeff LB & Hoofnagle JH. Appendix: The National Institutes of Health Consensus Development Conference Management of Hepatitis C
2002. Clinical Liver Disease 2003; 7:261–287.
11. European Association for Study of Liver. EASL recommendations on treat- ment of hepatitis C 2015. J Hepatol 2015;63:199–236.
Editor's Notes
There are two main types of hepatitis C• Acute hepatitis C and• Chronic hepatitis CThe length of time you may experience symptoms will depend on the type of infection you have.With acute hepatitis C, the symptoms are more short-term, lasting only six months or less. Acute hepatitis, however, can lead to another type of hepatitis, chronic hepatitis.Chronic hepatitis can last for one's entire life because it's very difficult for the body to get rid of the virus.
The HCV genotype isn’t absolutely related to the rate of liver damage, or the likelihood of eventually developing cirrhosis. However, it can help predict the outcome of treatment.
The genotype can help predict the outcome of anti-HCV therapy with interferon-based treatment regimens. Genotype has also helped to determine treatment. In some formulations, the recommended doses of ribavirin and pegylated interferon (PEG) are for people with specific HCV genotypes.
different genotypes respond differently to medicines that treat and cure HCV.
Genotype assignment helps in disease prognosis and assists in establishing the appropriate duration of treatment. More than 10 types and 70 subtypes of HCV have been described.
The HCV genotype isn’t absolutely related to the rate of liver damage, or the likelihood of eventually developing cirrhosis. However, it can help predict the outcome of treatment.
The genotype can help predict the outcome of anti-HCV therapy with interferon-based treatment regimens. Genotype has also helped to determine treatment. In some formulations, the recommended doses of ribavirin and pegylated interferon (PEG) are for people with specific HCV genotypes.
different genotypes respond differently to medicines that treat and cure HCV.
Genotype assignment helps in disease prognosis and assists in establishing the appropriate duration of treatment. More than 10 types and 70 subtypes of HCV have been described.
Treatment durations are adapted from the 2015 guidelines of the American Association for the Study of Liver Diseases (AASLD) (50) and European Association for the Study of the Liver (EASL) (51).
səˈrōsəs/
The reference standard and most definitive method for determining genotype involves the direct sequencing of a specific polymerase chain reaction (PCR)-amplified portion of the viral genome obtained from a patient sample, followed by phyloge- netic analysis. The NS5, core, E1 and 5′ UTR regions of the HCV genome have been used to determine viral genotype using this method
However, alternative methods that offer rapid and cost-effective genotyping are more suitable for clinical use.
Ryebavirin
Tell-ay-previr
Bose-previr
Hepatitis C Virus: A Review of Treatment Guidelines, Cost-effectiveness, and Access to Therapy
here are four classes of DAAs, which are defined by their mechanism of action and therapeutic target. The four classes are nonstructural proteins 3/4A (NS3/4A) protease inhibitors (PIs), NS5B nucleoside polymerase inhibitors (NPIs), NS5B non-nucleoside polymerase inhibitors (NNPIs), and NS5A inhibitors
Hepatitis C Virus: A Review of Treatment Guidelines, Cost-effectiveness, and Access to Therapy
here are four classes of DAAs, which are defined by their mechanism of action and therapeutic target. The four classes are nonstructural proteins 3/4A (NS3/4A) protease inhibitors (PIs), NS5B nucleoside polymerase inhibitors (NPIs), NS5B non-nucleoside polymerase inhibitors (NNPIs), and NS5A inhibitors