12_STDs caused by Viruses Flashcards

1
Q

STD: define

A
  • sexually transmitted diseases (aka STIs and Venereal disease)
  • illnesses that ahve a significant probability of transmission b/w humans through sexual behavior, incl:
    • vaginal intercourse
    • anal sex
    • oral sex
  • ~20M new cases of STIs every year
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2
Q

other ways STIs can be contracted

(other than sexually transmitted)

A

can be contracted by using IV drug needles as well as through incident involving the contact of a wound w/ contaminated blood or through childbirth or breast feeding

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3
Q

named the major viral STDs

A
  • Herpes simplex virus
  • Human papilloma virus
  • Zika virus
  • Hepatitis
  • Human immunodeficiency
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4
Q

Herpes simplex virus (HSV)

  1. family
  2. infects
  3. structure
  4. symptoms
A
  1. herpesvirus family (Herpesviridae) - HSV-1 and HSV-2
  2. infects humans; ubiquitous and contagious
  3. core of ds-DNA surrounded by protein coat in icosahedral symmetry; nucleocapsid surrounded by an envelope
  4. symptoms
    1. HSV-1 –> causes oral herpes (cold sores)
    2. HSV-2 –> genital herpes
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5
Q

what is the most prevalent STD in the US?

A

genital herpes (HSV-2)

(45 M cases; 1M new genital herpes infxns per year)

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6
Q

epidemiology:

oral herpes and genital herpes

A
  • >100 M Americans have oral herpes;
  • > 45 M Americans have genital herpes
  • annually, 776,000 people in the US get new herpes infxns
  • genital herpes infxn is common; 16% of persons 14-49 y/o have HSV-2 infxn
  • inc. # of genital herpes infxns are caused by HSV-1
  • increases genital HSV-1 infxn have been found in patient population worldwide
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7
Q

how do people get genital herpes?

(through contact w/ what?)

can it be caught from skin that looks normal?

A
  • thru contact w/ lesions, mucosal surfaces, genital secretions, or oral secretions
  • HSV-1 and HSV-2 can both be shed from skin that looks normal;
    • in pts w/ asymptomatic HSV-2 infxns, genital HSV shedding occurs on 10% of days
  • generally a person can only get HSV-2 infxn during sexual contact w/ someone who has genital HSV-2 infxn
  • herpesviruses are highly contagious
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8
Q

symptomology of herpes simplex?

A
  • typically a blister or multiple blisters around infected areas –
    • usually the mouth, genitals, or rectum
  • blisters break –> leaving tender sores
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9
Q

describe the recurrence of herpes infection:

  1. what is the process?
  2. what triggers this?
  3. how do sxs differ from primary episodes?
A
  1. after lesions heal –> virus retreats up nerve fibers and remains dormant in nerve cells of spinal column
    • flare-ups: when virus moves down along fibers to genitals/lips
  2. triggers:
    • stress, anxiety, depression
    • acidic food, UV light, fever, poor nutrition, fatigue
    • general illness (mild to serious conditions)
    • immunosuppression due to AIDS or such medications as chemotherapy or steroids
  3. sxs are generally milder than primary episode and heal more quickly
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10
Q

how to reduce risk of transmission of genital herpes?

A
  • Use condoms – virus can’t pass thru latex condoms
    • During outbreak, avoid sexual contact w/ lesion area (even w/ condom - can become infected)
    • B/w outbreaks - use condoms still bc there can be asymptomatic viral shedding
  • medications are availabel to reduce asymptomatic viral shedding b/w outbreaks –> reduces risk of transmission
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11
Q

herpes complications for:

  1. women, and
  2. both sexes?
A
  1. women:
    • inc. incidence of cervical cancer - women w/ herpes should get pap smears every 6-12 months
    • newborn baby can be infected by passage through birth canal – can cause severe damage or death
      • C-section recommended for women w/ active symptomatic disease
  2. both sexes: ocular herpes infection can occur if virus is transferred from a sore to the eye
    • must be treated quickly to avoid eye damage
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12
Q

how to prevent and treat herpes?

A
  • prevent: reduce frequency of outbreaks
    • suppressive therapy: daily med taken to prevent recurrent outbreaks; reduces asymptomatic viral shedding b/w outbreaks
  • treat symptoms of outbreaks, and speed healing
    • episodic therapy: medication taken to tx outbreaks when they occur
  • using antiviral drugs –> reduce viral shedding & duration/severity of outbreaks
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13
Q

3 antiviral drugs used to tx herpes?

A
  • acyclovir
  • valacyclovir
  • famiclovir
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14
Q

human papilloma virus:

  1. family
  2. infect what?
  3. symptomology
A
  1. papillomavirus family; DNA virus
  2. establish productive infections only in keratinocytes of the skin or mucous membranes
  3. symptoms
    • most HPV infxns are subclinical and cause no physical symptoms
    • some subclinical pts –> can become clinical and cause benign papillomas or cancers of the cervix, vulva, vagina, penis, oropharynx, and anus
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15
Q

clinical symptoms (if present) of HPV

A
  • cause benign papillomas (such as warts [veruccae] or squamous cells papilloma)
  • cancers of the cervix, vulva, vagina, penis, oropharynx, and anus
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16
Q

Low-risk HPV types, and their effects

A
  • HPV 6, 11, among others
  • Leads to benign cervical changes, and/or genital warts
17
Q

HIGH-risk HPV types, and their effects

A
  • HPV 16, 18
  • lead to:
    • precancerous cervical changes,
    • cervical cancer,
    • anal and other cancers
18
Q

What about the HPV genome allows the virus to be associated w/ cancer?

A

contains an oncogene (gene which in certain circumstances can transform a cell into a tumor cell.

also has major viral transforming proteins (E6 and E7)

19
Q

how does productive HPV infxn progress to malignancy?

A
  • productive life-cycle (2-3 weeks)
    • 1-2 years pass
  • persistent infxn (lack of immune clearance)
    • up to 20 years
  • HPV-induced malignancy (oncogene activation +/- integration)
20
Q

genital warts (GW):

  • prevalence
  • transmission
  • sxs
  • treatment
A
  • prev: >15% of Americans/ 6M new US cases/yr
  • transmission: sexual contact
    • condoms don’t prevent infxn in genital areas not covered by condoms
    • HPV is most commonly transmitted by asymptomatic patients
  • sxs: *most are asymptomatic
    • if visible warts appear, incubation for 3-8 wks after contact
      • Women - GW appear in lower vaginal opening, perineum, labia, inner vaginal walls, and cervix
      • In men, usually on glans, foreskin, or shaft of penis
      • BOTH sexes: can occur on anus
    • appear pink/red and soft w/ cauliflower-like appearance in moist areas, OR hard/yellow-gray in dry areas
  • tx: visible warts removed by cryotherapy (freezing) or chemical tx –> larger warts may need minor surgery
21
Q

does cryotherapy and/or surgery prevent recurrence of genital warts?

A
  • removal doesn’t necessarily prevent recurrence
  • warts may disappear on their own
22
Q

what is the underlying cause of cervical cancer?

when was this connection discovered, and by which groups?

A

HPV is the underlying cause

discovered in 1996 by NIH and WHO

23
Q

HPV infxns: Summary

(persistent low-risk –>

persistent high -risk –> )

A
24
Q

how to prevent cercial cancer?

A
  • screening for precancerous changes (and tx if problems found)
  • vaccination against HPV
25
Q

Hx of the conventional pap smear

A
  • by George Papanicolaou in 1940’s
  • most common cancer screening is pap smear
    • key part of annual gynecological exam
  • has greatly reduced cervical cancer mortality in US
26
Q

HPV vaccine:

  • strains it protects against
  • function
  • consists of what?
  • appropriate age and series
A

GARDASIL vaccine

  • protects against: type 16, 18, 6, 11 (high- and low-risk strains)
  • function: prevents HPV infxn, but doesn’t tx existing infxn
    • highly effective
    • very few serious side effects
  • consists of: virus-like particles
  • administered before puberty; requires 3 injections
27
Q

zika virus:

  • family/lineages
  • structure
A
  • genus: Flavivirus, family: Flaviviridae
    • African lineage
    • Asian lineage
  • enveloped icosahedral, single-stranded RNA virus
28
Q

what is Zika virus closely related to?

where have outbreaks occurred?

A
  • closely related to Dengue fever (~43% homology & extensive Ab cross-reactivity)
  • 1st strain isolated from Rhesus monkey in Zika Forest, Uganda
    • Outbreaks in Africa, Asia, and recent outbreaks in Latin/South America
29
Q

how is Zika virus transmitted?

A
  • vector borne or
    • mosquito (from monkey)
  • non-vector borne
    • accidental lab exposure
    • blood trasnfusion
    • organ transplant
    • monkey bite
    • sexual transmission
30
Q

what can Zika virus cause in newborns?

A
  • microcephaly (small head)
31
Q

possible neurological and ophthalmic complications of Zika?

A
  • Ophthalmic:
    • Conjunctivitis
    • Retinal atrophy
  • Neurological:
    • Meningitis, Meningoencephalitis, myleitis
    • Guillain-Barre syndrome (not confirmed)
32
Q

what is Guillain-Barre syndrome?

can Zika cause this?

A

strongly associated w/ Zika, but connection is not confirmed

33
Q

zika virus:

  • testing/diagnosis
  • primary prevention
A
  • test/dx
    • culture for virus
    • acute phate (more than 7 days after onset)
    • chronic phase (more than 4 days, lasts for months)
  • primary prevention
    • no vaccine, so prevent mosquito exposure
    • people w/ active infxn should avoid exposure to mosquitoes to prevent further spread
34
Q

hepatits:

  • cause
  • prevalence
  • transmission
A
  • caused by hepatitis virus (types A, B, C, D, E) –> attacks liver
    • HepC is most
  • prevalence: >170M people have HepC worldwide, 5M in US
  • transmission:
    • HepA - fecal-oral, oral-anal sexual contact; infected food handlers
    • all can be by sexual contact (HepB is more often by sex)
    • HepC - *needle sharing
    • from infected mother –> fetus/infant
35
Q

which types of Hep viruses cause Chronic liver disease?

transmission and sxs of the various Hepatitis strains?

A
  • B, C, D, E all can cause Chronic liver disease
36
Q

Hepatitis:

  • sxs
  • sequelae
  • tx
  • vaccines?
A
  • sxs: vary
    • asymptomatic
    • mild flu-like sxs
    • high fever, vomiting, severe abdominal pain
    • jaundice/yellowing of whites of eyes or skin due to inc. breakdown of RBC
  • sequelae: chronic infxn w/ HepB or HepC –> risk of liver cancer
    • HepC –> severe liver complications such as cirrhosis, liver failure (20-25% of patients)
  • tx:
    • HepA: bed rest, fluid intake
    • HepB: same as A, but since can be chronic –> may be tx w/ antiviral drugs
    • HepC: more serious –> tx w/ antiviral drugs for some strains
  • vaccines?
    • Available for HepA and HepC patients