Step I Hepatitis B and C

[Transformers]

I always confuse these two...but between Hep B and C, what is more likely to cause:

a.) Mother-fetal transmission? Is this transplacental OR perinatal (fetus coming of the vaginal canal and getting infected)

b.) IV drug transmission

thanks

 

[Transformers]

Also as far as causing HCC...doesnt hbv do this by an oncogene after viral integration while hcv do this by repeated bouts of liver cell necrosis and regeneration and hence mutation accumulations....at least i thought so but robbins seems to say HBV causes HCC alsoby repeated cycles of necrosis and regeneration

 

[oceanillusion42]

Hepatitis B doesn't cross the placenta, it is transmitted perinatally. Mothers with HBeAg in their blood have an extremely high risk of passing the infection to their child, whereas mothers with no HBeAg have a low rate of infectivity. The WHO says that transplacental trasmission doesn't occur as the virus is too large, however medscape says it can occur in a minority of cases.

Both HCV and HBV are trasmitted thru blood and can therefore effect IVDUs

 

[Phloston]

Also as far as causing HCC...doesnt hbv do this by an oncogene after viral integration while hcv do this by repeated bouts of liver cell necrosis and regeneration and hence mutation accumulations....at least i thought so but robbins seems to say HBV causes HCC alsoby repeated cycles of necrosis and regeneration

Yeah, that's right.

I had encountered a practice question some time ago with an IV-drug user, then they showed you a picture of the hepatic histology. I went with HepC because that's more common among IV-drug users, but the answer was HepB.

As far as I can remember, HepB looks ground-glass-like. HepC forms larger atypical aggregates of apoptotic and necrotic cellular material.

Based on the latter, I'd reckon that's the basis of the HCC with HepC, whereas with HepB, you've gotta be familiar with the viral integration, HBx protein and TP53 down-regulation in the "X-region."

The replication mechanism for HepB is also exceedingly high-yield.

 

[ijn]

I highly doubt they're going to make you diagnose Hep B vs Hep C histologically because not even professional pathologists do that in real life. If they want to go down that route they'll probe your knowledge of the immunological markers.

The pathophysiology behind how each virus can cause cancer sounds like a good Step 1 question.

 

[Phloston]

The histo on the exam is a complete toss-up. We all have ******ed things appear on our Step. That histo question was UWorld btw.