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57 Cards in this Set

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  • Back
What is the one less common herpes virus that affects <5% of general population?
Structural characteristics of herpes viruses
LARGE dsDNA genomes within enveloped icosohedral capsid
What is the MOST important characteristic of herpes viruses
Ability to establish latency
3 subfamilies of herpes
alpha, beta, gamma
Characteristics of alpha herpes viruses
Neurotropic; Broad host range; Rapid reproductive cycle, latent infection of sensory ganglia
Characteristics of beta herpes viruses
Restricted host range (only humans); Slow reproductive cycle, cytomegalic, latent infection of secretory glands, lymphoreticular cells, kidneys, lymphoid tissue
Characteristics of gamma herpes viruses
Restricted host range, lyphotrophic, latent infection of B-lymphocytes, oncogenic
What are the alpha herpes viruses?
During latency, how is the EBV genome maintained?
Genome maintained as a large circular plasmid (episome) by host replication machinery (EBV)
What are the beta herpes viruses?
Cytomegalovirus (CMV); Human herpes virus 6 and 7 (HHV6 and HHV7)
What are the gamma herpes viruses?
Epstein-Barr virus (EBV), Kaposi's sarcoma-associated herpes virus (KSHV, aka HHV8)
To what cells is CMV trophic?
Myeloid lineage
To what cells is HHV6 and HHV7 trophic?
T cells
Primary infections of CMV may result in ___________
cold like symptoms, or mononucleosis (only 15% of mononucleosis)
What kind of reactivations occur in CMV?When?
Probably a few times a year but there aren't any symptoms
How to detect a prior/current CMV infection?
anti-CMV IgG
Seroprevalence of CMV in US
50% but approaches 100% in elderly
How is CMV transmitted?
Shed in saliva, breast milk, urine, cervical secretions, semen
How does CMV affect developing fetus?
Only human herpesvirus that is efficiently transmitted transplacentally to developing fetus.

If seronegative mother gets infected, there can be serious birth defects.
What special risks of CMV do transplant patients experience?
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.
What are transplant patients treated with to prevent CMV complications?
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.
What special risks of CMV do AIDS patients experience?
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
Multi-organ system infection
How are AIDS-related reactivations/infections with CMV treated?
Usually resolves with effective antiretroviral treatment (immune reconstitution). Antivirals can be given.
_ is the major infectious cause of birth defects
7 diseases caused by CMV
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)
Closely related ubiquitious herpes viruses infecting T cells
HHV6 and HHV7
Causative agent of roseola, relatively benign syndrome characterized by higher fever and severe rash
elatively benign syndrome characterized by higher fever and severe rash in infants, caused by HHV6
Roseola infantum
Which herpesvirus subfamily is associated with oncogenesis?
Gamma (EBV, KSHV)
Which cells do EPV and KSHV infect?
B cells.
Immortal B cells lines infected with _____ can be cultured from the blood
Primary EBV infection results in _______
Mononucleosis can be caused by ___ and ____
EBV(70%) and CMV (15%)
Clinical signs and sx of mononucleosis
fever, sore throat, swollen tonsils and cervical lymph nodes, enlarged spleen, mild hepatitis.

Peripheral blood smear reveals atypical lymphocytes
Dx of EBV-induced mononucleosis
“atypical” mononuclear lymphocytes
Heterophile antibody positive
IgM cross-reactive to Paul Bunnell antigen on SRBCs (Monospot assay)
What is heterophile antibody?
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
T/F Presence of IgG reactive with EBV antigens is indicative of current EBV infection
F, only a prior infection. Use heterophile antibody with confirmatory IgM reactivity test
How is EBV genome maintained in infected cells?
As circular episome in the nucleus. NOT integrated into host DNA.
T/F During latent period no infectious virus is produced.
Replication of the episome requires what?
1) One viral protein : EBV nuclear antigen 1 (EBNA-1)

2) Host replication factors
T/F latently infected B cells with EBV are immortal
What malignancies are associated with EBV? (non immunocompromised)
1) African Burkitt's lymphoma

2) Asian nasopharyngeal carcinoma

3) Hodgkins lymphoma
What malignancies or neoplasias are associated with EBV? (immunocompromised)
Lymphoproliferative disorders/lymphomas
uncontrolled growth of EBV+ B cells
Oral hairy leukoplakia
white “hairy” patches on the lateral tongue
Oral hairy leukoplakia is associated with what infection?
What virus is commonly associated with B cell lymphoproliferative disorders in AIDS patients?
How is Kaposi's sarcoma different from the other herpes viruses?
Its prevalence in the population is very low (2%)
KSHV: Where does it replicate initially? Where does it latently infect?
replicates initially in the oral epithelium
latently infects & immortalizes B cells
Who gets KS primarily?
AIDS & transplant patients, older men from Mediterranean regions
What isthe primarily disease caused by KSHV?
Primary effusion lymphoma
B cell lymphomas in AIDS patients
latent KSHV
Multicentric Castelman’s disease : associated with what?
benign growth of lymphoid tissues, expanded germinal centers
may be associated with lytic KSHV replication
KSHV aka
T/F Multinucleated giant cells and intranuclear inclusion are common in herpes viruses
How does CMV infection differ in
A) AIDS patients
B) Patients who've had bone marrow transplant
A) CMV retinitis and colitis
B) CMV pneumonitis (severe pneumonia)
T/F CMV antigen is only present when virus is actively replicating in blood
What is the nucleic acid like in ALL herpes viruses?
ds linear DNA
T/F All herpes viruses are enveloped
Monospot test is used for
Detecting heterophile antibody, antibody against EBV that cross reacts with and agglutinates sheep RBCs.

Rapid screening test for mono.