Mechanisms of Viral Infection and Pathogenesis Flashcards
Sites of microbe entry
Conjunctiva Respiratory Tract Alimentary Tract Urogenital Tract Scratch, injury Skin Anus Arthropod → Capillary
General Pattern of an Acute Viral Infection
Disease symptoms present when the virus is at its highest titre (highest viral load).
This will make you ill, and the immune system responds to the virus by getting rid of it, allowing you to recover.
Generally, you develop long-lasting protective immunity (principle behind vaccines as well).
Examples of acute viral infections
Common cold Measles Ebola Smallpox Influenza
Common cold virus presentation
The common cold is an upper respiratory tract infection and the immune system resolves this.
Measles presentation
Typical spots and ulcerations of the tongue
- patients find it difficult to eat
- serious CNS problems
Ebola presentation
Complete destruction of the endothelia, massive haemorrhaging causing internal bleeding (these people usually bleed to death).
Therefore, the immune system does not always resolve this acute infection
Types of chronic viral infection
Latent, Reactivating Infection
Persistent Infection
General Pattern of Chronic Viral Infection: Latent, Reactivating Infection
At the beginning of infection, there is a burst of viral replication and disease (like acute infection), the immune system brings this under control so you are disease free.
But, throughout life, there are episodic reactivations of the virus, meaning there is a virus reservoir in the host which is controlled by immunity. If the immune system breaks down in any way, you can get reactivation of the virus, with disease symptoms presenting again.
Example of a reactivating latent viral infection
Herpes virus
-dsDNA genome
How many herpes viruses are there?
8
Different herpes viruses and their effects
Once you get infected with herpes viruses you can’t get rid of them, meaning it is a life-long infection, but they are controlled by immunity.
HHV-1 → classic herpes virus
HHV-2 → genital herpes
HHV-3 (VZV) → chicken pox
HHV-4 (EBV)→ mononucleosis (glandular fever)
HHV-5 (CMV)→ mononucleosis (glandular fever)
HHV-8 (KSHV) → Kaposi’s sarcoma
HHV-1 Presentation
Primary Gingivostomatitis is the initial infection with HHV-1, characterised by a spotty rash in kids. Immune system then acts upon this.
Virus Reactivation during immune stress
- cold sores (local)
- no primary rash
HHV-3 Presentation
HHV-3 (VZV) causes a disseminated rash.
If you get this early enough in life it is effectively harmless, but the later you get it the worse it is.
Virus Reactivation during immune stress
-shingles (local)
What do all herpes virus have in common in relation to their effects on the body?
All of the herpes viruses give you specific fevers during their primary infections
Which herpes viruses develop latency in neurones? Which neurones specifically?
Herpes Simplex & VZV
-sensory neurones in dorsal root ganglion
How do Herpes simplex and VZV develop latency?
In both herpes simplex and VZV, the viruses travel up neurones and establish persistent infection in sensory neurones in dorsal root ganglion where the virus is largely switched off and immune system keeps it so.
Later on, a secondary stimulus (e.g. immunosuppression) can cause the virus to activate in the neurone and for the virus to travel back down the peripheral nerve, causing local infections (cold sore/shingles) in much more specifically localised regions where the tissue is innervated by infected neurone.
General Pattern of a Chronic Viral Infection: Persistent Infection
Persistent infections have two separate patterns.
First pattern:
- virus peaks with an initial infection, and then immune system gets rid of it.
- no symptoms present for a very long time and then you get an eruption of the virus, causing disease (e.g. HIV)
Second pattern:
- rubella infection when pregnant
- if this happens early enough in the first trimester, your immune system will not recognise that as foreign and sees it as ‘self’, and so the unborn foetus is immunotolerant of this virus
- virus will tear through the tissues, causing congenital rubella
- hence why vaccinations are so important!
Cytopathic damage of Influenza A
Respiratory epithelial cells are lined with cilia which beat to expel mucus to get rid of any foreign substances.
The influenza infection (red stain in the pic) targets lung epithelia and destroy the cilia, so you can’t clear the virus.
Cytopathic damage of RSV
The RSV infects respiratory epithelia and all the cells fuse together
-loads of nuclei all inside one cell→non-functional cell
Hepatitis C Virus (HCV): Course of illness
HCV causes classical acute infection which is permanently cured by the immune system in ~20% cases.
Acute infection progresses to chronic liver inflammation ~80% cases. This continues to fibrosis and eventually you get severe liver damage (cirrhosis/hepatic cancer).
