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MIP > RNA Viruses > Flashcards

RNA Viruses Flashcards

1
Q

what is the smallest RNA virus

A

picornavirus

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2
Q

What is the structure of picornavirus

A

Naked, + icosahedral ssRNA

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3
Q

Where does picornavirus replicate?

A

cytoplasm

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4
Q

what is the picornavirus capsid made of?

A

60 copies of NON-GLYCOSYLATED proteins

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5
Q

how does picornavirus enter the cell?

A

receptor-mediated endocytosis

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6
Q

What does a + genome mean?

A

the genome acts as mRNA

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7
Q

What does a - genome mean?

A

the genome is complementary to the mRNA that will eventually be made

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8
Q

What are picornaviruses released from the cell?

A

cell lysis

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9
Q

What does poliovirus use as a receptor?

A

PVR/CD155

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10
Q

What do most other picornaviruses use as a receptor?

A

ICAM-1

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11
Q

What part of the picornavirus capsid binds to the receptor?

A

canyon region

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12
Q

What else can bind to the picornavirus canyon regions?

A

Antibodies to neutralize virus

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13
Q

What is unique about the protein made by picornavirus?

A

It is translated as 1 protein, and cleaved by a VIRAL PROTEASE

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14
Q

What are (-) copies made by picornaviruses?

A

complementary template used to make more copies of the viral genome

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15
Q

What is found at the 5’ end of picornavirus RNA?

A

VPg

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16
Q

What is cleaved terminally in picornavirus replication? what is made?

A

VP0 –> VP2 and 4 mature particles

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17
Q

What is VPg?

A

virally encoded protein that acts as a 5’ cap; guides translation and packaging of proteins

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18
Q

How is picornavirus transmitted?

A

Fecal-oral

Respiratory droplets

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19
Q

What is unique about rhinoviruses?

A

They are LABILE at acidic pH; like the upper airway

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20
Q

What is unique about the other enteroviruses?

A

STABLE at acidic pH, like the GI tract

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21
Q

What are the examples of the picornavirus family?

A 
Poliovirus
Enterovirus
Rhinovirus
Coxsackie A and B
Hepatitis A
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22
Q

What is the most common cause of the common cold ?

A

Rhinovirus

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23
Q

Where do enteroviruses replicate?

A

mucosa and lymphoid tissue of tonsils and pharynx

M cells and lymphocytes of Peyer’s patches

Enterocytes of intestinal mucosa

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24
Q

What causes the spread of virus to secondary tissues?

A

Primary viremia

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25
Q

What determines the degree of paralysis in paralytic polio?

A

the type of neurons affected and degree of damage

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26
Q

Who is more severely affected by paralytic polio?

A

the young and elderly

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27
Q

What are the effects of spinal cord involvement in paralytic polio?

A

paralysis of limbs or complete flaccid paralysis

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28
Q

What is affected in bulbar paralysis?

A

cranial nerves and the respiratory center in the medulla

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29
Q

Where is replication of poliovirus restricted to?

A

GI tract

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30
Q

What are the symptoms of poliovirus?

A

Could be asymptomatic

Could range from mild fever w/ diarrhea to FLACCID PARALYSIS

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31
Q

What does poliovirus infect?

A

ANTERIOR horn cells of the spinal cord and the MOTOR cortex

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32
Q

What are the vaccines for polio?

A

Salk -Inactivated vaccine (intramuscular)

Sabin- Live attenuated (oral) [CAN REVERT]

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33
Q

How many doses of polio vaccine are given?

A

4

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34
Q

What does coxsackie A cause?

A

herpangina

Hand, foot, and mouth disease

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35
Q

What is herpangina?

A

painful ulcers found in the mouths of young children

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36
Q

What is hand, foot, and mouth disease?

A

vesicular lesions of the hand, feet, and mouth

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37
Q

What does echovirus cause?

A

aseptic meningitis

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38
Q

What does parechovirus cause?

A

GI and respiratory infection

encephalitis, myocarditis

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39
Q

What does kobuvirus cause?

A

GI infections

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40
Q

What does coxsackie B cause?

A

myocardial and pericardial infections

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41
Q

When does enterovirus aseptic meningitis normally occur?

A

Summer and early fall

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42
Q

What is the most common cause of viral meningitis?

A

Enteroviruses

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43
Q

Most common culprits of viral conjunctivitis?

A

Coxsackie A24

Enterovirus 70

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44
Q

Most common culprits of hand,foot,and mouth disease?

A

Coxsackie A16

Enterovirus 71

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45
Q

How are enteroviruses diagnosed?

A

Antibodies(IgG or IgM) or viral RNA through RT-PCR

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46
Q

What do rhinoviruses attach to on the cell?

A

ICAM-1

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47
Q

Where is a rhinovirus infection most commonly found?

A

UPPER Respiratory tract

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48
Q

What mediates rhinovirus immunity?

A

IgA (can have re-infection)

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49
Q

How many Hep A serotypes are there?

A

ONE

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50
Q

How is Hep A transmitted?

A

Fecal-oral

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51
Q

Where does Hep A replicate?

A

enteric mucosa

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52
Q

When do Hep A symptoms arise?

A

AFTER excretion

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53
Q

What is a prodrome?

A

set of early symptoms that may indicate a disease is present before specific symptoms arise

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54
Q

What is part of the prodrome of Hep A?

A

Dark urine, clay colored stool

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55
Q

What are symptoms of the icteric stage of Hep A?

A

jaundice, pruritis, tender hepatomegaly

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56
Q

What is unique about Hep A infections?

A

Most will be ASYMPTOMATIC

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57
Q

What labs can diagnose acute Hep A infections?

A

Increased ALT

+ IgM anti Hep A test

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58
Q

Needed for Hep A diagnosis?

A

Hep viral serologies, liver ultrasound

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59
Q

Where is Hep A primarily found?

A

Developing countries

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60
Q

What is the vaccine for Hep A?

A

Inactivated whole virus vaccine

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61
Q

What viruses cause Gastroenteritis?

A

Caliciviruses
Astroviruses
Rotaviruses
Adenoviruses

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62
Q

What is the structure of the calicivirus

A

Naked, + icosahedral ssRNA

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63
Q

What is the primary agent responsible for most acute dirrheal diseases in adults and children?

A

Norovirus

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64
Q

Where is calicivirus commonly found?

A

Cruise ships and day care (causing DIARRHEA)

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65
Q

How is norovirus transmitted?

A

person to person
Fecal-oral
aerosol transmission from vomiting

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66
Q

What is unique about the virus particles of noroviruses?

A

Not many are needed to infect!

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67
Q

What is the pathogenesis of noroviruses?

A

infection of epithelial cells in the stomach/intestine leads to maldigestion

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68
Q

What is unique about astroviruses?

A

it cannot be grown on cell culture

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69
Q

What is the structure of reoviruses?

A

Naked, + icosahedral dsRNA

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70
Q

What are the 2 types of reovirus?

A

Rotavirus

Colorado tick fever

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71
Q

What is the leading cause of severe acute gastroenteritis in children worldwide?

A

Rotavirus

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72
Q

How many rotavirus serotypes are there?

A

5 (G1, G2, G3, G4, G9)

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73
Q

How is rotavirus transmitted?

A

Fecal-oral (VERY STABLE)

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74
Q

What does rotavirus replicate?

A

villous epithelium of the small intestine

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75
Q

What is an important treamtent for rotaviruses

A

REHYDRATION THERAPY

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76
Q

How is rotavirus diagnosed?

A

detection of virus particles or viral antigens in stool

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77
Q

What are vaccines for rotavirus?

A

RotaTeq and Rotarix (both oral live virus vaccine)

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78
Q

Antibodies to what are important for rotavirus protection?

A

VP7 and VP4

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79
Q

What has rotavirus vaccines been associated with?

A

intussusception

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80
Q

What are the symptoms of Colorado tick fever?

A

fever, headache, sever myalgia

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81
Q

How many segments does Colorado tick fever have?

A

12 dsRNA segments

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82
Q

What is the structure of Hep E?

A

Naked, + icosahedral ssRNA

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83
Q

How is Hep E transmitted?

A

fecal-oral

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84
Q

What is a major cause of acute hepatitis worldwide?

A

HEV

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85
Q

What is Hep E primarily associated with?

A

poor sanitation

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86
Q

What kind of disease is Hep E?

A

ACUTE only

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87
Q

Who is most likely to have fulminate symptoms from Hep E?

A

pregnant women

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88
Q

Hep E symptoms are most common among who?

A

adolescents, young adults, and pregnant women

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89
Q

What is IgG associated with?

A

long term immunity

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90
Q

What is IgM associated with?

A

acute infection

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91
Q

What is IgA associated with?

A

mucosal immunity

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92
Q

What are some viruses causing CNS disease and hemorrhagic fever?

A

Togaviruses
Flaviviruses
Bunyaviruses
Arenviruses

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93
Q

What are arboviruses?

A

arthropod-borne viruses

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94
Q

What is the structure of togaviruses?

A

Enveloped, + icosahedral ssRNA

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95
Q

How do togaviruses enter the cell?

A

receptor-mediated endocytosis

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96
Q

What are the genuses of togaviruses?

A

Alphaviruses and Rubiviruses

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97
Q

Where do alphaviruses replicate?

A

cells of arthropod vectors and vertebrae host

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98
Q

What is the natural host of alphaviruses?

A

mammal or bird

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99
Q

How are alphaviruses transmitted?

A

FEMALE mosquitos

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100
Q

Where is the alphavirus transmitted from?

A

salivary gland of mosquito to capillary bed

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101
Q

Types of alphaviral encephalitides

A

Easter, Western, and Venezueland equine encephalitits

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102
Q

How are arboviruses diagnosed?

A

virus specific IgM and neutralizing antibodies in serum or CSF

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103
Q

What is the most severe equine encephalitis?

A

EASTERN

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104
Q

What is the reservoir of VEE? for EEE and WEE?

A

Rodents. Birds

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105
Q

What is Chickungunya Fever virus?

A

debiliating illness with high fever, petechial or maculopapular rash, headache, fatigue, nausea, vomiting, muscle and joint pain

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106
Q

Where does Chickungunya fever virus replicate?

A

fibroblasts, skeletal muscle progenitor cells, myofibers

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107
Q

Most common lab finding of Chikungunya?

A

elevated creatinine, AST, and ALT

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108
Q

What is the treatment for Chikungunya fever virus?

A

There is none.

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109
Q

How is Chikungunya transmitted?

A

mosquitoes (A. aegypti, A albopictus)

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110
Q

How is Chikungunya diagnosed?

A

Serological IgM/IgG

RT-PCR

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111
Q

What is the structure of flaviviruses?

A

Enveloped, + icosahedral ssRNA

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112
Q

What kinds of diseases do flaviviruses cause?

A

encephalitis and hemorrhagic fevers

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113
Q

What flaviviruses cause hemorrhagic fever?

A

Dengue

Yellow fever

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114
Q

How is yellow fever transmitted?

A

mosquitos

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115
Q

What are the symptoms of yellow fever?

A

MOstly asymptomatic

Can have flu-like symptoms with jaundice, GI hemorrhage, and BLACK vomit

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116
Q

What is the vaccine for yellow fever?

A

Live attenuated 17D vaccine

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117
Q

What is the most widespread arbovirus in the world?

A

Dengue fever

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118
Q

How many serotypes of Dengue fever are there?

A
  1. multiple reinfections possible
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119
Q

How is Dengue fever transmitted?

A

mosquitos

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120
Q

What are the symptoms of Dengue fever?

A

severe headache, muscle and joint pain, leukopenia, thrombocytopenia

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121
Q

Where does Dengue fever replicate?

A

mononuclear cells

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122
Q

What is a nickname for Dengue fever?

A

Breakbone fever

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123
Q

What is Dengue Hemorrhagic fever?

A

occurs with re-infection with a different Dengue fever serotype

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124
Q

What is the treatment for Dengue Hemorrhagic fever?

A

Treat the symptoms.

IV fluids, electrolytes, Oxygen, rehydraton

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125
Q

What are some Flaviviruses that cause encephalitis?

A 
Powassan virus
STL encephalitis
West Nile fever
Japanese B encephalitis
Murray valley fever
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126
Q

What is unique about Powassan virus?

A

it is TICK borne

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127
Q

What is POW encephalitis associated with?

A

long-term morbidity

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128
Q

Clinically, West nile virus can be what?

A

Non-neuroinvasive or neuroinvasive

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129
Q

How can West nile be transmitted from human to human?

A

Blood transfusions
Transplanted organs
Breast milk
Transplacentally

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130
Q

What test is used by blood banks to check for West Nile?

A

Nucleic acid Amplification Test

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131
Q

How can West Nile be diagnosed?

A

testing serum/CSF for WNV specific IgM antibodies

viral cultures and RT-PCR

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132
Q

What is the treatment for West nile?

A

There is no treatment.

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133
Q

What are some arbovirus Bunyaviruses?

A

California encephalitis virus and RIft valley fever

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134
Q

How is California encephalitis transmitted?

A

mosquitoes

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135
Q

How is Rift valley fever transmitted?

A

mosquitoes and sandflies

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136
Q

What does Hantavirus cause?

A

Hemorrhagic fever and pulmonary syndrome

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137
Q

When does California encephalitis peak?

A

summer months

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138
Q

Influenza is a member of what family?

A

Orthomyxovirus

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139
Q

What is the structure of orthomyxoviruses?

A

Enveloped, - HELICAL segmented ssRNA

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140
Q

What are the major types of influenza

A

A, B, C

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141
Q

How many gene segments do Influenza A and B have?

A

8

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142
Q

What proteins are found in the surface of the influenza virus?

A

Hemagglutinin and Neuraminidase

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143
Q

What is significant about the M2 protein?

A

Needed to get the genome OUT

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144
Q

What does hemagglutinin bind?

A

sialic acid

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145
Q

How many HA subtypes are there?

A

18

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146
Q

What is HA1 used for?

A

attachment

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147
Q

What is HA2 used for?

A

fusion

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148
Q

What is neuraminidase used for?

A

cleaving sialic aicd during release of viruses

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149
Q

Hemagglutinin is a…

A

TRIMER

150
Q

Neuraminidase is a…

A

TETRAMER

151
Q

Which part of the orthomyxovirus is a target for drugs?

A

Neuraminidase

Tamiflu, Relenza

152
Q

Where is HA0 protein cleaved?

A

Respiratory epithelium

153
Q

What causes the conformational rearrangement in HA

A

pH drop in the endosome

154
Q

Where are alpha (2,3) linkages cleaved?

A

LOWER Respiratory tract

avian influenza virus

155
Q

Where are alpha(2,6) linkages cleaved?

A

UPPER Respiratory tract (human influenza virus)

156
Q

What is unique about the HA protein?

A

high degree of variability

virus in is NOT the same virus out

157
Q

Where does the HA variability come from?

A

No exonuclease activity in RNA polymerase

158
Q

What is a quasi-species?

A

not a clone, but a mixture that undergoes selection, has a variety of genotypes

159
Q

Where does orthomyxovirus replicate?

A

Nucleus ( in order to use the 5’ caps of host mRNA)

160
Q

How is orthomyxovirus transmitted?

A

large-particle respiratory droplets

161
Q

Where does influenza multiply?

A

ciliated respiratory epithelium cells

162
Q

Where is the influenza virus limited?

A

respiratory tract

163
Q

What is a complication of influenza infection?

A

invasive bacterial superinfection

164
Q

What is unique about the association between bacterial pathogens and influenza?

A

Bacterial pathogens can readily adhere to the surface of influenza-infected cells

165
Q

What does recovery from influenza infection begin with?

A

IFN production

166
Q

When does influenza peak?

A

winter months

167
Q

What is shift?

A

SUDDEN, emergence of NEW subtypes

Little or no herd immunity

168
Q

What is drift?

A

INCREMENTAL, emergence of VARIANT subtypes

Mutations cause evasion of herd immunity

169
Q

What was the most devastating outbreak in human history?

A

Spanish Flu

170
Q

Is drift or shift associated with increasing the world death rate?

A

SHIFT.

171
Q

What percentage of the population gets the flue each year?

A

5-20%

172
Q

What are the influenza vaccines?

A

Inactivated injection

Live attenuated nasal spray

173
Q

Which influenza vaccine is QUADRIVALENT only?

A

Nasal spray

174
Q

Influenza vaccines are normally grown in what?

A

eggs

175
Q

What influenza vaccine is okay for people with egg allergies?

A

Trivalent vaccine grown in cell culture

176
Q

Who is the high dose trivalent vaccine used for?

A

the elderly (4x antigen)

177
Q

Who is the nasal spray vaccine recommended for?

A

Healthy people 2 through 49 that are not pregnant

178
Q

How do zanamivir and oseltamivir work?

A

inhibits neuraminidase

179
Q

What is another name for zanamivir?

A

Relenza

180
Q

What is another name for oseltamivir?

A

tamiflu

181
Q

How do amantidine and rimantidine function?

A

target the M2 ion channel and block fusion

182
Q

How is influenza diagnosed?

A

By looking at the viral antigens

183
Q

What are some complications of influenza vaccines?

A

Guilian-Barre syndrome

Reye’s syndrome

184
Q

Which bird flu has never been detected in peopl?

A

H7N9

185
Q

What would cause bird flu to become a Human pandemic virus?

A

Better binding by HA
Better replication
Better processing of viral RNAs and proteins
Person-person transmission

186
Q

What is a necessary precondition for a virus to be pandemic?

A

PERSON TO PERSON TRANSMISSION

187
Q

What is the structure of paramyxoviruses?

A

Enveloped, - helical ssRNA

188
Q

Who is mostly affected by Respiratory syncytial virus?

A

infants and elderly

189
Q

Who is mostly affected by parainfluenza?

A

young children (Croup)

190
Q

What does metapneumovirus cause?

A

acute respiratory disease

191
Q

What is the structure of RSV?

A

enveloped w/ 2 envelope glycoproteins

192
Q

What is the G glycoprotein of RSV for?

A

Attachment

193
Q

What is the F glycoprotein of RSV for?

A

Fusion

194
Q

What is the single most important cause of respiratory diseases in infancies?

A

RSV

195
Q

What does RSV infect?

A

Upper and lower respiratory tract

196
Q

RSV is localized where?

A

Respiratory epithelium

197
Q

What drug is targeted as the F protein of RSV

A

Palivizumab

198
Q

What does Palivizumab target?

A

F protein of RSV

199
Q

How many parainfluenza serotypes are there?

A

4

200
Q

What is unique about each of the 4 parainfluenza serotypes?

A

There are antigenically stable.

201
Q

What are parainfluenza viruses?

A

Enveloped paramyxoviruses with HA and NA on the SAME SPIKE

202
Q

Parainfluenza viruses can cause what kind of illness?

A

Upper and Lower respiratory illnesses

203
Q

Which parainfluenza viruses are most often associated with croup?

A

HPIV-1 and HPIV-2

204
Q

What is HPIV-3 associated with?

A

bronchitis, bronchiolitis, and pneumonia

205
Q

RSV is more associated with what disease?

A

Bronchiolitis

206
Q

Parainfluenza is more associated with what disease

A

Croup

207
Q

How is parainfluenza transmitted?

A

Person to person

208
Q

What is another name for measles?

A

Rubeola

209
Q

What is another name for mumps?

A

epidemic parotitis

210
Q

What type of vaccine is the MMR vaccine?

A

Live attenuated

211
Q

Where does measles replicate?

A

upper respiratory tract

212
Q

Symptoms of measles

A

Cough, Coryza, Conjunctivitis, Koplik’s spots on buccal mucosa

213
Q

How is mumps transmitted?

A

Respiratory transmission

214
Q

Where does mumps initally replicate?

A

Respiratory tract epithelium and local lymph nodes

215
Q

Where does mumps disseminate to?

A

salivary glands and CNS

216
Q

What are some complications of mumps?

A

meningitis, encephalitis, pancreatitis, orchitis, oophoritis

217
Q

What is orchitis?

A

most common complication in postpubertal males. Inflammation of epididymis

218
Q

What is the structure of togaviruses?

A

Enveloped, + icosahedral ssRNA

219
Q

How is Rubella transmitted?

A

respiratory droplets

Transplacentally

220
Q

Where does rubella replicate? Where does it disseminate?

A

Upper respiratory tract

Lymphoid tissue, skin, organs

221
Q

When during pregnancy is fetus at risk for rubella damage?

A

1st trimester

222
Q

What is the treatment for measles, mumps, and rubella?

A

There is no treatment, BUT THERE IS A VACCINE MMR

223
Q

What are some zoonotic paramyxoviruses?

A

Hendra and Nipah

224
Q

What is the structure of a coronavirus?

A

Enveloped, + ssRNA, w/ spike-like glycoproteins

225
Q

What are some examples of zoonotic coronaviruses?

A

SARS, MERS

226
Q

What are the 2 main virusese of the Rhabdovirus family?

A

Rabies and Vesicular Stomatitis virus

227
Q

What is the structure of a rhabdovirus?

A

Enveloped, - helical ssRNA with a bullet-shaped capsid

228
Q

Where does rabies multiply?

A

brain

229
Q

What are the phases of a rabies infection?

A

Prodrome
Neurologic
Comatose

230
Q

What is the treatment for rabies?

A

THERE IS NO ANTIVIRAL TREATMENT, BUT THERE IS A VACCINE

231
Q

What is the rabies vaccine?

A

Human Diploid Cell Vaccine (inactivated, gives active immunity)

232
Q

When is it best to vaccinate someone for rabies?

A

When they think they have been exposed to it

233
Q

How is rabies transmitted?

A

saliva of infected animals through a bite

234
Q

How is rabies diagnosed?

A

Watching for clinical changes in the animal

Negri bodies in the brain (cytoplasmic inclusions)

235
Q

How is rabies diagnosed in humans?

A

RT-PCR of saliva

anti-rabies Abs in serum/spinal fluid

biopsy of hair follicles from nape of neck

236
Q

What is the Rabies prophylactic treatment?

A

1 dose of immunoglobulins and 4 doses of rabies vaccine over a 14-day period

237
Q

How is Human Diploid Cell Vaccine made?

A

in tissue culture using normal human WI-38 fibroblasts. The rabies virus is then inactivated

238
Q

What is the only non-arboviric Bunyavirus?

A

Hantavirus

239
Q

How many segments does Hantavirus have?

A

3

240
Q

What are the 2 different manifestations of hantavirus?

A

Hemorrhagic fever w/ renal syndrome

Hantavirus pulmonary syndrome

241
Q

What hantavirus type causes Hemorrhagic fever w/ renal syndrome

A

Old world Hantaviruses

242
Q

What hantavirus type causes hantavirus pulmonary syndrome?

A

New World Hantaviruses

243
Q

Where is hantavirus found in infected rodents?

A

urine and feces (rodents are not sick)

244
Q

How is hantavirus transmitted?

A

aerosolized rodent excreta

245
Q

How is Hantavirus pulmonary syndrome caused?

A

an inflammatory response against infected tissues

246
Q

What is the structure of an arenavirus?

A

Enveloped, - helical segmented ssRNA

247
Q

What is unique about arenaviruses?

A

they have TWO separate nucleocapsids surrounding the 2 segments of RNA

248
Q

What are some diseases caused by arenaviruses?

A

Lymphocytic choriomeningitis virus and Hemorrhagic fevers

249
Q

Where are arenaviruses shed?

A

urine and droppings of infected hosts

250
Q

How are arenaviruses transmitted?

A

contact with excretions of infected rodents

some person-person transmission

251
Q

How does LCMV present?

A

aseptic meningitis, encephalitis, or meningioencephalitits

252
Q

A transplacental LCMV infection is associated with what?

A

congenital hydrocephalus
Chorioretinitis
mental retardation

253
Q

What is the primary host of LCMV?

A

Mus musculus (house mouse)

254
Q

What disease does Lassa virus cause?

A

African Hemorrhagic fever (Lassa fever)

255
Q

What disease does junin virus cause?

A

Argentine hemorrhagic fever

256
Q

What disease does Machupo virus cause?

A

Bolivian hemorrhagic fever

257
Q

What disease does Guanarito virus cause?

A

Venezuelan hemorrhagic fever

258
Q

What disease does sabia cause?

A

Brazilian hemorrhagic fever

259
Q

What groups are particularly at risk of death with arenavirus hemorrhagic fevers?

A

Fetuses with transplacental infections and women in the 3rd trimester

260
Q

What are some symptoms of arenavirus hemorrhagic fever?

A 
fever
hemorrhagic manifestations
hepatitis
shock
neurological manifestations
261
Q

What is the last ditch effort against RNA viruses?

A

Ribavarin

262
Q

What is the structure of a fillovirus?

A

Enveloped, - helical ssRNA

263
Q

What are some examples of filoviruses?

A

Ebola, Marburg

264
Q

What is the most likely reservoir of ebola?

A

fruit bats

265
Q

Most likely source of zoonotic ebola infection

A

bushmeat

266
Q

What are the first symptoms of filovirus infection?

A

sudden onset of flu-like symptoms

267
Q

What cells are infected by filovirus infection?

A

lymphoid and endothelial cells

268
Q

What causes death in a filovirus infection?

A

hypovolumic shock, multi-organ failure

269
Q

What is the pathogenicity of RNA viruses associated with?

A

cross species jump

270
Q

What is the most likely reason for virus spread?

A

increased, rapid, international travel

271
Q

What is the structure of a flavivirus?

A

Enveloped, +icosahedral ssRNA

272
Q

What family is Hep C a part of?

A

Flavivirus

273
Q

What does HCV exist as?

A

A quasispecies

274
Q

Where is antigenic variation predominnat in HCV

A

envelope glycoprotein E2

enables escapes and persistant infection

275
Q

What is the most common chronic blood-borne infection in the US?

A

HCV infection

276
Q

Who is Hep C screening recommended for?

A

People born between 1945-1965

History of IV drug use

277
Q

How is HCV transmitted?

A

Percutaneous exposures to infectious blood sex(infrequent)

Trans-placentally

278
Q

What are some symptoms of an acute HCV infection?

A

fever, fatigue, dark urine, clay-colored stool, abdominal pain, loss of appetite, nausea, vomiting, joint pain, and jaundice

279
Q

Where does the initial replication of HCV occur?

A

monocytes, B ant T cells

280
Q

What is unique about HCV disease?

A

Infection is usually mild and anicteric, but results in a chronic carrier state in a majority of people

281
Q

How long is IgG anti HCV found in an infected individual?

A

For life.

282
Q

What is a host factor that may improve clearance of HCV?

A

IL-28B gene plymorphisms

283
Q

Chronic HCV disease has what kind of disease progression?

A

Insidious

284
Q

What are some complication of chronic HCV disease?

A

Cirrhosis

Hepatocellular carcinoma

285
Q

What is the leading cause of liver transplants in the US?

A

Chronic HCV Disease

286
Q

HCV is mainly an ______-mediated dissease

A

Immune (cytokine storm)

287
Q

What allows HCV to escape the immune system?

A

Viral mutations from its quasispecies nature

288
Q

How does HCV target the immune response?

A

HCV core binds host’s TNF receptor

289
Q

Are Hep C antigens for in the blood?

A

NO. antibodies are

290
Q

How is HCV diagnosed?

A

Anti- HCV using ELISA

HCV RNA using Nucleic Acid Test

291
Q

What are some treatments for HCV?

A

protease inhibitors (telaprevir, boceprevir, simeprevir)

nucleotide inhibitors (sofosbuvir)

292
Q

What are the 4 families of retroviruses?

A 
LOSE:
Lentiviruses
Oncoviruese
Spumaviruses
Endogenous retroviruses
293
Q

What are human endogenous retroviruses (HERVs)?

A

retrovirus sequences that have been integrated into the human genome

294
Q

Do HERVs produce infectious particles?

A

No. but can encode some functional proteins

295
Q

What is HERV-W?

A

functional envelope protein expressed in human placenta (syncytin protein); needed for creation and maintainence of syncytiotrophoblast

296
Q

How do retroviruses work?

A

they beome part of the host DNA

297
Q

What does reverse transcriptase do?

A

converts ssRNA into ssDNA, and then into dsDNA

allows for integration of viral genome into host DNA

298
Q

What is the structure of a retrovirus?

A

Enveloped, + icosahedral with 2 IDENTICAL COPIES of ssRNA

299
Q

What is unique about retroviruses?

A

They do not directly code for protein, they will be reverse transcribed into DNA

300
Q

What is gag for in the retroviral genome?

A

encodes capsid, nucleocapsid, and matrix proteins

301
Q

What is pol for in the retroviral genome?

A

encodes the reverse transcriptase, protease, and intergrase

302
Q

What is env for in the retroviral genome?

A

encodes surface and transmembrance proteins

303
Q

What is LTR for in the retroviral genome?

A

Long terminal repeats. These bind cellular and viral transcription factors

304
Q

Where does reverse transcriptase do its job?

A

Cytoplasm

305
Q

What incorporate the newly made viral dsDNA into the host DNA

A

LTRs and intergrase

306
Q

What must occur for a mature infectious virus to occur?

A

cleavage of gag-pol precursors on budding immature particles

307
Q

Is the new dsDNA linear or circular before it is integrated into the host genome?

A

circular

308
Q

What is a provirus?

A

DNA copy with LTR integrated into the host

309
Q

What is an example of a Spumavirus?

A

Human foamy virus

310
Q

Is spumavirus considered pathogenic.

A

Nope.

311
Q

What are oncoviruses?

A

retroviruses that can immortalize or transform cells

312
Q

What important about oncoviruses in relation to cancer?

A

they may contain growth-regulating oncogenes that if overproduced or altered stimulat cell growth, causing tumors

313
Q

What is the only human oncovirus?

A

HTLV

314
Q

What can HTLV-1 cause?

A

Adult T cell leukemia and Tropical spastic paraparesis

315
Q

Where is HTLV-1 endemic?

A

Southern japan and the carribean

316
Q

How is HTLV-1 transmitted?

A

Sex
mother-to-infant (breastfeeding)
[requires cell-to-cell contact]

317
Q

What is important about Tropical Spastic Paraparesis?

A

It is a non-neoplatic neurologic disorder

318
Q

What does HTLV-1 contain?

A

tax, binds in LTR to promote viral replication

319
Q

What are flower cells?

A

multi-lobulated lymphocytes that are seen in patients with ATLL

320
Q

In what group is HTLV-II prevalent?

A

IV drug users

321
Q

How are HTLV viruses diagnoses?

A

ELISA to find anitbodies against viral antigens

322
Q

What is another name for Tropical Spastic Paraparesis?

A

HTLV associated myelopathy (HAM)

323
Q

How is ATLL treated?

A

anti-cancer therapy

324
Q

How is HAM treated?

A

anti-retrovirals

325
Q

What genomic elements is found in all retroviruses?

A

tax

326
Q

How do lentiviruses progress?

A

slowly

327
Q

What do lentiviruses cause?

A

neurological disorders and immunosuppression

328
Q

What are some examples of lentiviruses?

A

HIV-1 and HIV-2

329
Q

What is unique about the HIV virion

A

it has a coffin-shaped capsid

330
Q

Which of the 2 HIV viruses is less virulent?

A

HIV-2

331
Q

What parts of HIV-1 and HIV-2 cross react? What parts don’t?

A

Caspid antigens.

Envelope antigens.

332
Q

Which HIV virus predominates in most of the world?

A

HIV-1

333
Q

How do the products of gp160 precursor protein interact?

A

gp120 (globular head) associates with gp41 (stem)

334
Q

How dogp120 and gp41 interact?

A

noncovalently

335
Q

How many potential N-linked glycosylation sites are there?

A

30-38

336
Q

How does HIV bind?

A

gp120 binds to CD4, inducing a conformational change

This changes allows gp120 to bind CCR5/CXCR5

gp41 can then initiate fusion

337
Q

How asre TAT, REV, and NEF made?

A

splicing

338
Q

What is tat?

A

protein that is a positive regulator of transcription

339
Q

What is rev?

A

protein that regulated expression of viral mRNA for structural genes

340
Q

What is nef?

A

protein needed for high levels of virus associated with disease progression; down regulates CD4 and MHC class I

341
Q

What is required for HIV-1 replication in primary cells?

A

vif

342
Q

How does vif function?

A

inhibits APOBEC-3G

343
Q

What is VPR’s function?

A

down regulating response that limit viral infection

344
Q

In what HIV type is VPU found?

A

HIV-1

345
Q

In what HIV type is VPX found?

A

HIV-2

346
Q

How is HIV transmitted?

A

sexual contact

347
Q

What does HIV target?

A

Cells with CCR5 or CXCR5

CD4 T cells, macrophages, DCs, Langerhans cells

348
Q

What viruses are preferentially transmitted by HIV?

A

viruses that use the CCR5 co-receptor

349
Q

Is it possible to get an HIV infection without the co-receptor?

A

no.

350
Q

When do anti-HIV antibodies appear?

A

3-8 weeks after infection

351
Q

What does diagnosis of an acute HIV infection require?

A

Detection of the virus using RT-PCR

352
Q

Are antibodies found during the window period?

A

No

353
Q

If someone has a positive Rapid HIV antibody test, what is the next step?

A

ELISA/ Western blot

354
Q

How can mother-infant transmission of HIV occur?

A

In utero, at birth, through breast feeding

355
Q

Should HIV+ mothers breastfeed?

A

Nah

356
Q

How is an infant diagnosed with HIV?

A

PCR for viral DNA

357
Q

What are the stages of HIV infection?

A 
Primary infection
Clinical Latency
Constitutional symptoms
Opportunistic infection
Death
358
Q

What occurs during the HIV primary infection?

A

acute drop in T cell count

increase in HIV RNA copies

359
Q

What occurs during the HIV Clinical latency period?

A

No symptoms, increase in T cells keeps HIV in check

360
Q

What occurs during the HIV constitutional symptoms?

A

drop in T cell count, onset of AIDS.

Opportunistic infection can occur

361
Q

What is the CD4 count in Stage I?

A

500 cells/mL

362
Q

What is the CD4 count in Stage II?

A

200-499 cells/mL

363
Q

What is the CD4 count in Stage III?

A
364
Q

What is an early stage predictor of HIV?

A

viral load

365
Q

What is a most important late stage predictor of HIV?

A

CD4 T cell count

366
Q

What are elite controllers?

A

below 50 copies/mL

no progression/pathogenesis observed for a LONG time

367
Q

What are long term non-progressors?

A

Have a very low viral load

Will have a longer latency period

368
Q

What are progressors?

A

have a high viral load

much shorter latency period, quickly progress to AIDS

369
Q

What is an AIDS defining illness?

A

A condition that, if present, means the patient has AIDS, no matter what their CD4 count is

370
Q

What also HIV to escape the immune response?

A

antigenic drift and glycosylation of gp120

371
Q

What is the purpose of anti-retroviral therapy?

A

To decrease the viral load and maintain the CD4 T cell count

MIP (4 decks)

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