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Test 4: Virology > Herpesvirus 6 & 8 > Flashcards

Herpesvirus 6 & 8 Flashcards

1
Q

What are all herpesvirus?

A
  • DNA viruses
  • immediate, early, and late replication
  • all enveloped so can be killed by detergents, heat, during, and acids
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2
Q

How is Epstein-Barr Virus (EBV) transmitted?

A
  • through saliva
  • mono= known as “kissing disease”
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3
Q

What are the characteristics of EBV?

A
  • by 35-40 years, almost all people in the US are infected
  • establishes latency in memory B cells
  • shed virus in saliva throughout life after they are infected
  • young adults: 50% of infected will get infectious mononucleosis
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4
Q

What are the characteristics of infectious mononucleosis?

A
  • virus initially divides in oropharynx causing sore throat through lytic infection.. then infects its main target: B cells
  • primary cause of symptoms: massive expansion of cytotoxic T lymphocytes
  • LONG incubation time: 4-6 weeks and virus can shed in saliva before symptoms start
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5
Q

What is the cycle of EBV mononucleosis?

A
  • causes generalized activation of B cells
  • leads to heterophiles antibody production
  • heterophiles antibodies are non-specific antibodies that react with certain animals, horses, sheep RBC’s
  • test via monospot test
  • once acute infection is over, some memory B cells have latent EBV genome without production proteins
  • when B cells divide, they express a viral protein to make sure viral genome goes into both cells
  • EBV can reactivation from memory B cell pool and make new infectious virus
  • virus will go back to oropharynx and infect epithelial cells to now produce virus that can be detected in saliva
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6
Q

What are complications of mononucleosis?

A
  • spleen enlargement (avoid sports for 3-4 weeks)
  • mild hepatitis (avoid alcohol)
  • airway obstruction due to enlarged tonsils
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7
Q

What is oral hairy leukoplakia caused by?

A
  • EBV but increased risk with smoking
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8
Q

What are the characteristics of oral hairy leukoplakia?

A
  • benign, non-painful lesion on lateral border of tongue
  • can NOT be scraped off tongue (unlike oral candidiasis)
  • can be the first sign of someone with an HIV infection or occur in people taking immunosuppressive drugs
  • best tx: antiviral drugs to increase CD4 count
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9
Q

What are the cancers involved with EBV?

A
  • oral hairy leukoplakia
  • nasopharyngeal carcinoma
  • burkitt lymphoma
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10
Q

What are the characteristics of Burkitt Lymphoma?

A
  • very fast growing, aggressive
  • also correlated with malaria infection
  • endemic BL: starts as tumor of face and more likely in young children
  • caused by chromosomal translation of c-myc gene to a chromosome that has immunoglobulin locus that causes unregulated c-myc expression giving uncontrolled cell growth
  • sporadic BL: starts in abdomen and not highly ass
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11
Q

T/F: CMV infections are mostly asymptomatic

A

True!
- except CMV mono-like syndrome, congenital infections, and immunocompromised

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12
Q

How is CMV transmitted?

A
  • saliva, urine, blood, breast milk, semen, cervical secretions
  • spread through sexual contact, infected salvia, urine, and breastfeeding
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13
Q

T/F: CMV infects a wide range of cells. It is not possible to be infected with more than one strain

A

False.
CMV does infect a wide range of cells but it is very much possible to be infected with more than one strain

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14
Q

When is CMV most severe?

A
  • in people with AIDS: retinitis
  • big problem in transplant recipients
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15
Q

Where is latency established in CMV disease?

A
  • myeloid precursors cells in bone marrow
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16
Q

In mononucleosis like syndrome of CMV, what cells do they infect?

A
  • T cells… does NOT infect B cells
  • no activation/production of heterophiles antibodies
  • so it is antibody negative and mono spot negative
17
Q

What is the #1 congenital infection in the US?

A

CMV
- due to primary CMV infection having a high risk of transferring to fetus
- but only 10% of babies are symptomatic

18
Q

What is the difference between asymptomatic and symptomatic CMV diseased in congenital CMV?

A

Asymptomatic:
- only 10% risk of hearing loss which is delayed and progressive

Symptomatic:
- can have motor, cognitive deficits, hearing loss, or vision impairment

19
Q

Why are children a major cause of adult infection of CMV?

A
  • they can secrete CMV in saliva and urine for over a year
  • most infections are asymptomatic
20
Q

Who is HHV6 common in?

A

children
(very common childhood infection)

21
Q

What does HH6 cause?

A
  • roseola
  • febrile seizures
22
Q

Which is Kaposi sarcoma-associated herpesvirus associated with?

A

HH8

23
Q

Who is HHV8 common in?

A

Men who have sex with men

24
Q

What are the symptoms and transmission of HH8?

A
  • usually no symptoms unless co-infected with HIV and/or lower CD4 count
  • symptoms: oral lesions and lesions on other parts of body that often violet
  • transmitted through sex/saliva/kissing
25
Q

What are prions?

A

– proteinaceous infectious particle
- it is only protein nothing else
- normal protein found in the brain
- ** becomes pathogenic when it is a miss folded prion protein**

26
Q

What do the infectious prions (PrPsc) have compared to normal prions (PrPc)?

A
  • PrPsc have a higher number of B sheets
  • PrPsc convert normal PrPc cells into the PrPsc and cause aggregates of amyloid plaque which then cause cell to die and releases the infectious misfolded prion protein: gives the spongiform appearance of parts of the brain (transmissible spongiform encephalopathy)
27
Q

Although miss folded prions cause many different types of disease, which is the most common?

A

spontaneous Creutzfeld-Jacob disease
- no genetic component and no infection
- spontaneous mutation in prion gene (seen in certain families) or spontaneous misfiled protein that becomes infectious (seen in people older than 50)
- 1% of people who got this are due to an infectious cause: an external source like contaminated surgical instruments

28
Q

What is the fatality of spontaneous Creutzfeld-Jacob disease?

A

after symptoms appear, life expectancy is rarely over a year (fatal condition)

29
Q

Are prions easy to kill?

A

No, they are resistant to many disinfectants, proteases, and normal auto clothing making it VERY hard to kill prions

30
Q

What are the infectious causes of transmissible spongiform encephalopathies?

A
  • variant Creutzfeld-Jacob disease (vCJD)
  • iatrogenic Creutzfeld-Jacob disease (iCJD)
31
Q

What is variant Creutzfeld-Jacob disease (vCJD) caused by?

A
  • eating beef contaminated with prion proteins
  • cows that had spongiform encephalitis (mad cow disease) that were consumed
  • incubation time: 5 years. 100% fatal
32
Q

What is iatrogenic Creutzfeld-Jacob disease (iCJD) caused by?

A
  • healthcare settings
  • most cases from material harvested from cadavers (human growth hormone, dura mater graphs)
  • some cases were from using prion-contaminated neurosurgical instruments (including dental instruments)

Test 4: Virology (17 decks)

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