Lymphotrophic Herpes Viruses

Question 1

What are the most common B-herpes viruses?

Answer 1

Human Cytomegalovirus - CMV

Human Herpes Virus - 6a/b and 7

Question 2

What are the most common gamma-herpes viruses?

Answer 2

Epstein-Barr Virus

Kaposi Sarcoma Virus

Question 3

What is a unique characteristic of CMV infected cells?

Answer 3

“Owl Eye” and inclusion body

Question 4

What are two of the five leading causes of birth defects?

Answer 4

CMV and Herpes Simplex

Question 5

What is unique about the CMV genome?

Answer 5

It is the largest human pathogen genome encoding over 750 genes. dsDNA

Question 6

How is CMV transferred and who most commonly get the virus?

Answer 6

Direct Contact with any kind of body fluids including saliva, breast milk, and urine. Inoculation occurs in the mucous membranes.
–Most Common in Daycares and children pass on to their parents–

Question 7

What kind of cells are involved with lytic cell cycle and latent cycle of CMV?

Answer 7

Lytic - almost any kind of cell

Latent - CD34+, MONOCYTES

Question 8

What is the most important part of the immune system in battling the CMV infection?

Answer 8

CD8+ Cytotoxic T-cells, kill CMV infected cells.

Humoral response does not control the infection well.

Question 9

What are common symptoms of CMV?

Answer 9

Many people become infected and are asymptomatic, but others have mild symptoms of:
Fever, Fatigue, Lymphadenopathy, Sore Throat, HA - 2-3 weeks

Question 10

How can you determine between CMV Mononucleosis and Epstein-Barr Virus?

Answer 10

CMV would be heterophile antibody NEGATITVE

EBV = heterophile positive

Question 11

What are the common ways of diagnosing CMV?

Answer 11

Serology - IgM and IgG
Owl’s Eye cells in urine/tissue
PCR or NAT detecting CMV DNA

Question 12

What are two common drugs given to treat CMV that are activated by viral kinases?

Answer 12

Ganiciclovir and Cidofovir, both are base analogs inhibiting viral DNA Polymerase

Question 13

What is a non-base analog used to treating CMV and other viral infections, that can cause renal insufficiency?

Answer 13

Foscarnet - pyrophosphate mimic

Question 14

What is the difference between Herpes Simplex and CMV?

Answer 14

CMV does not encode Thymidine Kinase, thus many drugs that work on Herpes do not work for CMV.

Question 15

What are common symptoms of congenital infection of CMV?

Answer 15

Petechiae
Low birth weight
Enlarged Spleen
Jaundice
--High Mortality Rate--

Question 16

What are permanent symptoms of congenital CMV?

Answer 16

Hearing Loss
Vision Loss
Mental Retardation

Question 17

How can you treat a newborn who has tested positive for CMV?

Answer 17

Pretty much no treatment, but if they test positive in the fist 3 weeks of life they can be given Ganiciclovir, but can cause additional developmental problems from the drug.

Question 18

How can you reduce risk of contracting the virus?

Answer 18

Common hygiene of washing hands and cleaning toys and avoid kissing the newborns.

Question 19

What is a common symptom of CMV of patients with HIV?

Answer 19

CMV Retinitis - mostly untreated HIV

“Cotton Wool Spots”

Question 20

What kind of patients is CMV life threatening in?

Answer 20

Immunocompromised
Chemotherapy, HIV, Transplant Patients
-Usually monitored by NAT/PCR and antivirals-

Question 21

What are common symptoms of infection by Human Herpes 6b? –Roseola Virus–

Answer 21

High Fever for several days and rash after the fever breaks.
Unknown long term consequences

Question 22

What is unique about HH6b compared to other herpes viruses?

Answer 22

This virus is able to integrate into host genome, rather than just becoming latent in the nucleus.

Question 23

Where does HH6b replicate and how is it detected?

Answer 23

Replication occurs in the CD4+ cells, detection by viral DNA via PCR and NAT

Question 24

What are diseases caused by Epstein-Barr Virus?

Answer 24

Mononucleosis
Post Transplant Lymphoproliferative Disorder
Lymphomas

Question 25

What kind of EBV infection causes mononucleosis?

Answer 25

Primary Infections ONLY

Question 26

What are unique cellular characteristics of primary infection by EBV?

Answer 26

Mononucleosis.
Expansive B-cell proliferation -
—expressing Heterophile antibodies–

Question 27

What are the common characteristics of Mononucleosis?

Answer 27

Typically in persons between puberty and 25 years old and transferred via saliva
Fever, lymphadenopathy, enlarged spleen, and malaise lasting several weeks

Question 28

The proliferation of what is the cause of mononucleosis?

Answer 28

Atypical T-cells called Downey Cells

Question 29

What are diseases caused by latency type III of EPV in either the host or donor tissue?

Answer 29

B-cells that are proliferating expressing viral virions causing Mononucleosis and Transplant Lymphoproliferation Disorder

Question 30

What kind of latency reactivation can cause various kinds of lymphomas?

Answer 30

Latency I/II - Memory B cells reactivating

Question 31

How can you diagnose EBV?

Answer 31

Primary Infection - heterophile antibodies and Mononucleosis
Secondary/Reactivation = heterophile antibodies and EBV-nuclear antigen (not present in primary)
PCR and NAT

Question 32

What is the common gamma-herpes virus?

Answer 32

Kaposi Sarcoma Herpevirus

Question 33

What are various diseases caused by Kaposi Sarcoma Herpevirus (HHV8)?

Answer 33

Lymphomas
Kaposi Sarcoma
Lymphoma
Castleman Disease