Theme No. J 12: Clinical virology I (hepatitis, HIV)

To study: Repeat your notes from  J10 and J11

To all tasks

Read always results of examination, do not forget to read controls, try to make a conclusion, if
possible.

In ELISA tests, refer about patients in form „C2, D4, E5“ etc.

Task No. 1: Diagnostics of hepatitis A virus (HAV)

a) assessment of IgM:

Cut off = (C1 + D1) /2.

Cut off = (             +           )/2 = __________

b) assessment of total antibodies:

Cut off = (C1 + D1) /2

Cut off = (             +           )/2 = __________

90 % cut off

110 % cut off

90 % cut off

110 % cut off






Positive patients:


Negative(!) patients:


Borderline patients:


Borderline patients:


Final conclusion (synthesis of both parts):




Task No. 2: Diagnostics of hepatitis B virus (HBV)

a) assessment of HBsAg

a) assessment of HBsAg:

Cut off = (C1 + D1) /2.

Cut off = (             +           )/2 = __________

Controls q OK q not OK

b) assessment of HBeAg:

Cut off = (C1 + D1) /2

Cut off = (             +           )/2 = __________

Controls q OK q not OK

90 % cut off

110 % cut off

90 % cut off

110 % cut off






Positive patients:


Positive patients:


Borderline patients:


Borderline patients:


c) assessment of anti-HBs:

Cut off = (C1 + D1) /2.

Cut off = (             +           )/2 = __________

Controls q OK q not OK

d) assessment of anti-HBe:

Cut off = (C1 + D1) /2

Cut off = (             +           )/2 = __________

Controls q OK q not OK

90 % cut off

110 % cut off

90 % cut off

110 % cut off






Positive patients:


Positive patients:


Borderline patients:


Borderline patients:


Notes to individual hepatatis B markers:













Task No. 3 Diagnostics of hepatitis C virus (HCV)

a)Polymerase Chain Reaction in HCV diagnostics

Evaluate the picture of PCR result (gel electroforesis), draw it and evaluate the results.

Picture:

        1 = positive control q OK (positive) q not OK (negative or inhibition)

        2 = patient A result:


        3 = patient B result:


        4 = patient C result:


        5 = negative control q OK (negative) q not OK (positive or inhibition)

b) anti-HCV detection using ELISA reaction

Cut off = (B1 + C1 + D1)/3 + 0.050

Cut off = (             +            +           )/3 + 0.050 = __________

Controls q OK q not OK

                                                                         Conclusion:

90 % cut off

            110 % cut off



Positive patients:


Borderline patients:


Task No. 4 Diagnostics of human immunodeficiency virus (HIV)

Sera borderline or positive should be confirmed (= sent to reference laboratory in Prague for
ensuring)

Cut off = (C1 + D1) /2                    Cut off = (             +           )/2 = __________

Controls q OK q not OK

90 % cut off

110 % cut off



Patients that should be confirmation (positive, borderline):



In the Czech Republic, we register _____HIV-positive patients (to date of ___.  ___. 200___,
including foreigners).

Check-up questions:

1. What is an importance of total antibodies to HAV? When could we consider hepatitis A?




2. What does the expression “confirmation” mean in serology?  Which infections must be confirmed
and why?





3. Explain importance of HBeAg diagnostics.





4. What group of people is extremely exposed to HCV?




5. After how long period after a risky situation (e.g. a contact with blood or a sexual intercourse
without a condom etc.) is it reasonable to assess antibodies against HIV?