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Hematology > Herpes Viruses > Flashcards

Herpes Viruses Flashcards

1
Q

What is the structure of the herpes virus ?

A

Isosahedral capsid surrounded by lipid envelope that contains about a dozen virus encoded glycoproteins.

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2
Q

Describe the genome of the Herpes virus

A

It is a large double stranded DNA. It is replicated and assembled in the nucleus

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3
Q

What are the symptoms of Herpes Virus Infection ?

A

Self-Limiting Infection, Primary is usually asymptomatic. However in the immunocompromised host life threatening infections and cancer can occure

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4
Q

Describe the replication cycle of the Herpes Virus .

A

It displays a Lytic replication in a variety of cell types to propagate the virus.

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5
Q

What are the herpes virus immeidate early genes ?

A

The immediate Early genes are the virus specific transcription factors. They use host RNA Polymerase 2 and stimulate transcription of early virus promoters.

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6
Q

What are the herpes virus early genes ?

A

Nonstructural viral proteins and enzymes. They include the DNA replication machinery ( Viral DNA Polymerase) and Thymidine Kinase

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7
Q

Where does virus assembly take place ?

A

In the Nucleus where nucelocapsids bud first into the perinuclear space. The particles then migrate to the cell surface where they are released.

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8
Q

Describe the latent stage of Herpes Virus replication

A

In the latent phase the entire genome of the virus is maintained extra-chromosomally in the host and no virus particles are made.

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9
Q

What are the three stages of latency ?

A

Establishment
Maintenance
Reactivation

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10
Q

When does reactivation occur ?

A

Reactivation occurs when there is a lapse in immunity and results in the production of virus particles and recurrent infections.

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11
Q

What is the result of the Herpes Latent cycle

A

Anyone who has the virus is infected for life and runs the risk of recurrent infection.

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12
Q

What are the three herpes viruses discussed in Dr Ryans Lecture ?

A

Alpha Herpes Virinae
Beta Herpes Viranae
Gamma Herpes Viranae

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13
Q

Describe Alpha Herpes Virinae ?

A

Neurotropic for latency, agressive lytic growth
Examples are Herpes simplex-1
HSV-2
HHV-7

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14
Q

Describe Betaherpesviranae ?

A

Lymphotorpic for latency, more insidious

  • Cytomegalovirus
  • HumanHerpesVirus-6
  • HHV-7
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15
Q

Describe Gammaherpesviranae

A

Lymphotropic for latency, more insidious

  • Epstein Barr Virus
  • HHV-8
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16
Q

Who does cytomegalovirus infect ?

A

In lower socioeconomic classes the virus infects people from age 1-2 and up to 80 % of the adult population.
In higher socioeconomic classes is is acquired at 16 years of age and affects 50% of the adult population

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17
Q

Where is CMV found ?

A

Saliva, Urine, Saliva, Cervical Secretions, Semen, Blood.

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18
Q

Describe the pathogenesis of CMV ?

A
  1. Infection is through direct contact with secretions
  2. It primarily replicates in the epithelium followed by spread to the lymph tissue.
  3. CMV latency infects B cells, T cells, Monocytes, and Lymphocytes where it causes large puffed up cells.
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19
Q

What are the symptoms of CMV infection ?

A

In utero it can be asymtomatic or result in retardation or deafness.

In adults it is usually asymptomatic but mononucleosis infection with fever can occur.

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20
Q

What demographic of people are at a very high risk to developing an infection associated with CMV ?

A

TRANSPLANT PATIENTS- get CMV with pneumocytis. which represents the most life threatening aspect of the virus

AIDS PATIENTS are prone to CMV Retinitis

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21
Q

What are the similarities of CMV, EBV, KSHV

A

They are all herpes viruses that share a tropism for lymphocytes.

22
Q

What type of viruses are EBV and KSHV ?

A

Oncoviruses.

23
Q

How do you diagnose patients with CMV ?

A

ELISA or PCR detection

Shell Viral Assay can detect early proteins of the virus after 24 hours.

24
Q

What is a treatment of CMV ?

A

Ganciclovir is a guanosine analog similar to acyclovir which is the prototype uwhich is used in HSV VZV and EBV infections

  • Requires phosphorylation for activity by viral kinase
  • The side effects are neutropenia and GI tract bleeding.
25
Q

How do you distinguish between CMV mono and EBV mono ?

A

The presence of heterophile autoantibodies on the spot test.

26
Q

What will EBV infection usually lead to ?

A

Infectious mononucleosis

27
Q

What percent of the population contains the Ab to EBV ?

A

95 % of the population

28
Q

What cancers is EBV associated with ?

A

Burketts Lymphoma and nasopharyngeal carcinoma

29
Q

What are the symptoms of EBV mononucleosis ?

A

Sore throat, fever, malaise and lymphadenopathy

30
Q

What are the important antigenetic markers for EBV ?

A
  1. EBNA- the EBV nuclear antigen which will be elevated early in the primary infection.
  2. VCA is the viral capsule antigen
  3. EA will be present in cells that do not produce the virus
31
Q

How can you diagnose EBV- Mononucleosis ?

A

Look for heterophile antibodies on the monospot test

32
Q

What neoplasms can EBV lead to ?

A

PTLD- which is an uncontrolled proliferation of B cells due to their transformation by EBV virus.

Burketts Lymphoma-

Nasopharyngeal Carcinoma-

33
Q

What 3 factors is Burketts Lymphoma associated with ?

A

Early EBV infection leading to latency

Activation of C-Myc

Malaria

34
Q

What is nasopharyngeal carcinoma ?

A

Neoplasm of the epithelial cells associated with EBV. In southern China there is a high frequency due to the salt diet.

35
Q

What is Human Herpes Virus-8 ?

A

A B-cell and endothelial latency tropism, these tumors occure in the lining of the lymphatic system. They fill the lymphatics with with blood cells which appears as bluish blued lesions.

36
Q

How is KSHV transmitted ?

A

Through the saliva and is sexualy transmitted… somehow but the notes said they werent sure.

37
Q

What is primary effusion lymphoma ?

A

Primary Effusion Lymphoma- Non Hodgkins Lymphoma commonly found in the body cavities.

38
Q

What causes the disease symptoms in HKV-8 ?

A

The loss of the immune system

39
Q

What B cell abnormalities does HHV-8 cause ?

A

Primary Effusion Lymphoma

Multimeric Castleman’s disease

B Cell and endothelial latency tropism

Kaposi’s Sarcoma

40
Q

What the hell is cattleman’s disease ?

A

Lymph node tumors that are not strictly a cancer

41
Q

What is a primary effusion lymphoma ?

A

Non- Hodgkin’s B cell lymphoma commonly found in body cavities.

42
Q

Is KSHV sexually transmitted in all cases ?

A

No, In mediterranean polulations and sub-saharan africa it is not sexually transmitted.

43
Q

Is there any treatment for the herpes virus ?

A

Acyclovir- this is a prodrug and needs to receive 3 phosphate groups in order to be incorporated into the replicating DNA.

44
Q

How do the phosphates get added to cyclovir ?

A

The viral phosphorylase adds the phosphate groups. Then cytosine kinases add the additional two phosphate groups. It is a low toxin anti-viral because the starting compund is a prodrug that must be phosphorylated by a viral kinase.

45
Q

Can acyclovere be used to cure a herpes infection or treat any cancer caused by the herpes infection ?

A

It only works on actively replicating viruses. This is acute infection. During latency the virus is not replicating and can not be targeted.

46
Q

What is hairy leukplakia ?

A

A productive infection of tongue epithelial cells which has gone latent and come back and caused a reinfection- this will be cleared by Acyclovir. Which is not as effective for treatment.

47
Q

What does the monospot test look for ?

A

Heterophile Ab’s

48
Q

What are the diagnostic markers for EBV Mono ?

A

EB Nuclear Antigens

Viral Capsid Antigen which is produced during the mono lytic infection

49
Q

What does anti-VCA + and anti EBNA - mean for the patient ?

A

Patient is considered to have a primary infection

50
Q

If the patient is Anti-VCA + Anti EBNA+ what will that mean for the patient ?

A

The patient has had a past infection

51
Q

During the lytic cycle of the EBV virus which diagnostic marker is raised first ?

A

Although EBNA is raised first the VCA becomes positive first and then the EBNA will raise.

52
Q

Can you treat mono ?

A

You have to be careful because the spleen will be enlarged. You can only give supportive treatment

Hematology (12 decks)

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