Kshv, Hhv-6, Hhv-7, Cmv, Ebv

Front 1

What is the one less common herpes virus that affects <5% of general population?

Back 1

KSHV

Front 2

Structural characteristics of herpes viruses

Back 2

LARGE dsDNA genomes within enveloped icosohedral capsid

Front 3

What is the MOST important characteristic of herpes viruses

Back 3

Ability to establish latency

Front 4

3 subfamilies of herpes

Back 4

alpha, beta, gamma

Front 5

Characteristics of alpha herpes viruses

Back 5

Neurotropic; Broad host range; Rapid reproductive cycle, latent infection of sensory ganglia

Front 6

Characteristics of beta herpes viruses

Back 6

Restricted host range (only humans); Slow reproductive cycle, cytomegalic, latent infection of secretory glands, lymphoreticular cells, kidneys, lymphoid tissue

Front 7

Characteristics of gamma herpes viruses

Back 7

Restricted host range, lyphotrophic, latent infection of B-lymphocytes, oncogenic

Front 8

What are the alpha herpes viruses?

Back 8

HSV1, HSV2, VZV

Front 9

During latency, how is the EBV genome maintained?

Back 9

Genome maintained as a large circular plasmid (episome) by host replication machinery (EBV)

Front 10

What are the beta herpes viruses?

Back 10

Cytomegalovirus (CMV); Human herpes virus 6 and 7 (HHV6 and HHV7)

Front 11

What are the gamma herpes viruses?

Back 11

Epstein-Barr virus (EBV), Kaposi's sarcoma-associated herpes virus (KSHV, aka HHV8)

Front 12

To what cells is CMV trophic?

Back 12

Myeloid lineage

Front 13

To what cells is HHV6 and HHV7 trophic?

Back 13

T cells

Front 14

Primary infections of CMV may result in ___________

Back 14

cold like symptoms, or mononucleosis (only 15% of mononucleosis)

Front 15

What kind of reactivations occur in CMV?When?

Back 15

Probably a few times a year but there aren't any symptoms

Front 16

How to detect a prior/current CMV infection?

Back 16

anti-CMV IgG

Front 17

Seroprevalence of CMV in US

Back 17

50% but approaches 100% in elderly

Front 18

How is CMV transmitted?

Back 18

Shed in saliva, breast milk, urine, cervical secretions, semen

Front 19

How does CMV affect developing fetus?

Back 19

Only human herpesvirus that is efficiently transmitted transplacentally to developing fetus.

If seronegative mother gets infected, there can be serious birth defects.

Front 20

What special risks of CMV do transplant patients experience?

Back 20

Since they're transiently immune compromised, the latent, endogenous CMV can be reactivated. Or Can acquire CMB from donor organ/tissue.

Can develop CMV pneumonitis or CMV infection of transplanted organ. Associated with organ rejection.

Front 21

What are transplant patients treated with to prevent CMV complications?

Back 21

Prophylactially: ganciclovir or CMV Ig

Or preemptively monitored for evidence of CMV virema, antigenemia, or DNAemia and treated with antivirals at first sign of active viral infection.

Front 22

What special risks of CMV do AIDS patients experience?

Back 22

Most AIDS patients are CMV seropositive and will reactivate latent CMV as their immune system fails
CMV correlates with CD4+ T cell count
< 50-100 cells/cc predictive of CMV
Retinitis progressing to blindness
Oral and GI tract ulceration
Dementia
Multi-organ system infection

Front 23

How are AIDS-related reactivations/infections with CMV treated?

Back 23

Usually resolves with effective antiretroviral treatment (immune reconstitution). Antivirals can be given.

Front 24

_ is the major infectious cause of birth defects

Back 24

CMV

Front 25

7 diseases caused by CMV

Back 25

1) Cytomegalovirus-inclusion disease of newborn (transmitted in utero)

2) GI tract ulcerations

3) mononucleosis

4) Hepatitis (immunosuppressed)

5) Pneumonitis (immunosuppressed)

6) Retinitis (AIDS)

7) Multi-organ system infection (immunosuppressed)

Front 26

Closely related ubiquitious herpes viruses infecting T cells

Back 26

HHV6 and HHV7

Front 27

Causative agent of roseola, relatively benign syndrome characterized by higher fever and severe rash

Back 27

HHV6

Front 28

elatively benign syndrome characterized by higher fever and severe rash in infants, caused by HHV6

Back 28

Roseola infantum

Front 29

Which herpesvirus subfamily is associated with oncogenesis?

Back 29

Gamma (EBV, KSHV)

Front 30

Which cells do EPV and KSHV infect?

Back 30

B cells.

Front 31

Immortal B cells lines infected with _____ can be cultured from the blood

Back 31

EBV

Front 32

Primary EBV infection results in _______

Back 32

mononucleosis

Front 33

Mononucleosis can be caused by ___ and ____

Back 33

EBV(70%) and CMV (15%)

Front 34

Clinical signs and sx of mononucleosis

Back 34

fever, sore throat, swollen tonsils and cervical lymph nodes, enlarged spleen, mild hepatitis.

Peripheral blood smear reveals atypical lymphocytes

Front 35

Dx of EBV-induced mononucleosis

Back 35

“atypical” mononuclear lymphocytes
Heterophile antibody positive
IgM cross-reactive to Paul Bunnell antigen on SRBCs (Monospot assay)

Front 36

What is heterophile antibody?

Back 36

IgM that recognizes the Paul-Bunnell antigen on sheep and bovine erythrocytes, serving as a marker for EBV mononucleosis and can generally be detected by end of first week of illness

Front 37

T/F Presence of IgG reactive with EBV antigens is indicative of current EBV infection

Back 37

F, only a prior infection. Use heterophile antibody with confirmatory IgM reactivity test

Front 38

How is EBV genome maintained in infected cells?

Back 38

As circular episome in the nucleus. NOT integrated into host DNA.

Front 39

T/F During latent period no infectious virus is produced.

Back 39

T

Front 40

Replication of the episome requires what?

Back 40

1) One viral protein : EBV nuclear antigen 1 (EBNA-1)

2) Host replication factors

Front 41

T/F latently infected B cells with EBV are immortal

Back 41

T

Front 42

What malignancies are associated with EBV? (non immunocompromised)

Back 42

1) African Burkitt's lymphoma

2) Asian nasopharyngeal carcinoma

3) Hodgkins lymphoma

Front 43

What malignancies or neoplasias are associated with EBV? (immunocompromised)

Back 43

Lymphoproliferative disorders/lymphomas
uncontrolled growth of EBV+ B cells
Oral hairy leukoplakia
white “hairy” patches on the lateral tongue

Front 44

Oral hairy leukoplakia is associated with what infection?

Back 44

EBV

Front 45

What virus is commonly associated with B cell lymphoproliferative disorders in AIDS patients?

Back 45

EBV

Front 46

How is Kaposi's sarcoma different from the other herpes viruses?

Back 46

Its prevalence in the population is very low (2%)

Front 47

KSHV: Where does it replicate initially? Where does it latently infect?

Back 47

replicates initially in the oral epithelium
latently infects & immortalizes B cells

Front 48

Who gets KS primarily?

Back 48

AIDS & transplant patients, older men from Mediterranean regions

Front 49

What isthe primarily disease caused by KSHV?

Back 49

Primary effusion lymphoma
B cell lymphomas in AIDS patients
latent KSHV

Front 50

Multicentric Castelman’s disease : associated with what?

Back 50

benign growth of lymphoid tissues, expanded germinal centers
may be associated with lytic KSHV replication

Front 51

KSHV aka

Back 51

HHV8

Front 52

T/F Multinucleated giant cells and intranuclear inclusion are common in herpes viruses

Back 52

T

Front 53

How does CMV infection differ in
A) AIDS patients
B) Patients who've had bone marrow transplant

Back 53

A) CMV retinitis and colitis
B) CMV pneumonitis (severe pneumonia)

Front 54

T/F CMV antigen is only present when virus is actively replicating in blood

Back 54

T

Front 55

What is the nucleic acid like in ALL herpes viruses?

Back 55

ds linear DNA

Front 56

T/F All herpes viruses are enveloped

Back 56

T

Front 57

Monospot test is used for

Back 57

Detecting heterophile antibody, antibody against EBV that cross reacts with and agglutinates sheep RBCs.

Rapid screening test for mono.