viral Flashcards

1
Q

basic virus structure

A

DNA or RNA forms the core, which is surrounded by a
protein coat.

Protein coat or capsid comprises protein units or
capsomeres

•Together the nucleic acid core and capsid form the
nucleocapsid

•In some viruses, the nucleocapsid is surrounded by an

  • *envelope, a lipid bilayer of host cell origin**.
  • envelope is studded with virus-encoded glycoproteins.
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2
Q

‘spikes’ in the viral envelope

A

attach virus to cell surface
mediate virus entry into cells
targets for antibodies

has carbohydrate side chain & transmembrane anchor

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3
Q

viral life cycle

A

extracellular phase in which virus particle
(“virion”) is metabolically inert and
intracellular phase in which virus genome
expression occurs
; this, together with
involvement of host proteins (animal, plant or bacteria)
and other host functions, achieves production of
new progeny virions.

Viruses are obligate intracellular pathogens

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4
Q

enveloped vs nonenveloped

A

Non-enveloped “naked” viruses tend to survive well
(& may be bile resistant)
– e.g_. picorna (polio; hepatitis A) norovirus_

Enveloped viruses often survive transiently outside
host
. Spread by close or intimate contact
– e.g_. Influenza, HIV, Hepatitis B virus_

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5
Q

virus classification criteria

A
  1. Type of nucleic acid (DNA or RNA).
  2. Symmetry of nucleocapsid
  3. Lipid envelope (presence or absence).
  4. Number of strands of nucleic acid (ss/ds) & their physical construction (e.g. segmented)
  5. Polarity of viral genome (e.g. + or - strand RNA).
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6
Q

DNA viruses

A

enveloped:

poxvirus

baculovirus

herpesvirus

naked:

adenovirus

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7
Q

viral replication steps

A
  1. Attachment - to susceptible target cells
  2. Penetration - to cell interior (traverse membrane)
  3. Uncoating - primes for transcription
  4. Transcription - production of viral RNA
    * *5. Translation** - viral proteins produced
  5. Replication - DNA or RNA, driven by viral proteins
  6. Assembly - new virions formed
  7. Release - & dissemination or transmission

key point: many critical functions and activities
are provided by the infected hos cell

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8
Q

how DNA virus replicates its genome

A

DNA viruses with large genomes e.g. poxviruses, herpesviruses encode 100 or more genes, including many of the enzymes required for genomic
replication (e.g. DNA polymerase) and are
more “autonomous”

DNA Viruses with small genomes e.g. papillomaviruses
encode only a few genes and use the host cell DNA polymerase etc

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9
Q

how RNA viruses replicate

A

Most RNA viruses encode their own
RNA-dependent RNA polymerase
,
which uses complementary RNA as template

  • *Retroviruses (& DNA Hepadnaviruses) ** encode Reverse Transcriptase - RNA-dependent DNA polymerase =>
  • make dsDNA from RNA, for new genome synthesis

RNA dependent polymerases lack proofreading ability,
→ RNA viruses mutate quickly (& often replicate faster)

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10
Q

PLUS-STRAND RNA

A

Positive-stranded RNA is:

equivalent to mRNA and can often be immediately translated into proteins once the viral genome gains entry into the cytoplasm.

Therefore, protein synthesis is the first step, and
_one of the proteins synthesized is the viral
polymerase.
_The _polymerase then synthesizes
a *negative-strand copy of the +veRNA*, which is
then copied back into +veRNA messages.
_

Translation of these messages produces
structural proteins that are used to package
progeny +veRNA into virions.

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11
Q

MINUS-STRAND RNA

A

Negative-stranded RNA:

must first be converted into +veRNA (mRNA) by the RNA-dependent RNA polymerase (RDRP) incorporated in the virion.

The mRNA can then be translated into proteins.

Replicative enzymes (RDRP) synthesize a negative-strand copy of the +veRNA.

Structural proteins translated from the mRNA are
then used to package progeny -veRNA and RDRP into virions.

These types of viruses must package a polymerase into the viral capsid, because cells lack enzymes that will make a +veRNA copy of the viral -veRNA strand.

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12
Q

outcome after viral infection of cell

A
  • *• Clearance** following acute phase of cell death
    e. g. influenza, viral gastroenteritis, poliovirus, measles

Persistent infection with continued production of infectious virus and immune evasion
e.g. hepatitis B, HIV

Latent infection with virus persistence after initial clearance, and asymptomatic or symptomatic reactivation
e.g. Herpes viruses – herpes simplex, varicella zoster

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13
Q

latent virus infections

A

Viral DNA persists but does not replicate to
produce new infectious virus

• May never cause signs of disease.
• May activate on one or more occasions, and be
asymptomatic or cause disease.
• Some latent infections may lead to malignant
disease.

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14
Q

exposure

A

potential physical contact with virus

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15
Q

tropism

A

which cells/tissues (or host) are susceptible?

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16
Q

virulence

A

capacity to cause disease

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17
Q

VIral pathogenesis mechanisms

A

Cell death:

  • Lytic infection, apoptosis,
  • Immune mediated e.g. AIDS is attributable to the progressive loss of helper T cells

Interference with cellular function
hepatitis, myocarditis, neuralgia

Body’s response to cell damage
– INCREASED mucous production in respiratory tract infections

Cell transformation and oncogenesis

Local effects of the immune response
– swelling, congestion, arthropathy, rashes

Systemic effects of the immune response
– fever

Immunosuppression
– Cytomegalovirus
– Measles

Triggering autoimmune response
post-infectious encephalomyelitis

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18
Q

Defence:

Innate mechanisms

A

macrophages, neutrophils, NK, complement, interferon

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19
Q

defence: antibodies do what?

A

neutralise further spread

20
Q

Viral mechanisms of Immune Evasion
Interference with cytokine network

A

mimic cytokine receptors - poxviruses

mimic inhibitory cytokines - EBV

inhibit interferon - adenovaccinia, influenza

suppress m-derived cytokines- measles

21
Q

immune escape - antigen variation

A

mutation of epitopes RNA viruses > DNA viruses

antigenic “shift”/reassortment : influenza virus

22
Q

ECLIPSE PHASE

A

Period from virus entry until new infectious virions released

23
Q

INCUBATION PERIOD

A

Interval between exposure and appearance of rash/sign

24
Q

PRODROME

A

Non-specific symptoms appearing before more specific features (usually rash)

25
Q

REPRODUCTIVE NO R0

INFECTIOUSNESS

A

Average number of secondary cases arising from a single index
case in a totally susceptible population

26
Q

family HERPESVIRIDAE

A

Structure
• Members share common architecture →
morphologically identical under EM
Large double-stranded DNA genome
– EBV 162 kB; CMV 360 kB
Icosahedral capsid
Lipid envelope derived from host cell bearing
virus-encoded glycoproteins

Over 100 herpesviruses have been identified
• Biological properties and genomic structure
Sub-families alpha-, beta-, gamma- herpesvirinae

• Viruses of each species are numbered in
chronological order of discovery

Eight human herpes viruses have been identified to
date

27
Q

Herpesviruses species

A

Alphaherpesvirinae:

Herpes simplex virus type 1 HSV-1
Herpes simplex virus type 2 HSV-2
Varicella zoster virus VZV

Betaherpesvirinae

Cytomegalovirus CMV
Human herpesvirus 6 HHV-6
Human herpesvirus 7 HHV-7

Gammaherpesvirinae
Epstein-Barr virus EBV
Human herpes virus 8 HHV-8

28
Q

natural history of herpes v infections

A

• Primary infections are frequently asymptomatic
• Virus is not cleared but persists in a latent state
• Reactivation may be clinical or sub-clinical
• Infection is usually widespread in the natural
host

29
Q

Seropositive status indicates____

A

infection, not immunity

30
Q

antiviral agents do what against herpes viruses?

A

e.g. Aciclovir, Ganciclovir can control
productive herpes virus infections but cannot
eradicate/control latent infection

31
Q

what does varicella zoster virus do?

A

• Primary infection causes chickenpox
(varicella)
• Latent in dorsal root or cranial nerve
ganglia
• Reactivation causes shingles (zoster)
• During reactivation virus travels down
sensory nerves and produce painful
vesicles in the area of skin served by
infected ganglion

32
Q

P{rimary VZV infection

A

Peak incidence in early childhood
• Only 5% over 18’s remain susceptible in
temperate zones

50% over 24 year olds in the tropics are
susceptible

• Incidence of varicella high in susceptible visitors
to temperate zones

33
Q

varicella clinical features

A

Incubation period 10-21d
• Asymptomatic infection uncommon
• Prodromal symptoms: fever, pharyngitis, malaise
• Itchy/painful lesions appear in crops
Macule →papule → vesicle → pustule → crusts
• More severe in adults / immunocompromised
• Varicella vaccine is licensed for routine childhood
immunisation in the USA

34
Q

varicella complications

A

Children
Acute cerebellar ataxia - 1:4000 cases (15y)

Adults
Pneumonia - 1:400 cases > hospital admission

35
Q

Zoster

A

Common condition
Reactivation of latent VZV
• Pain at site may precede eruption of painful
vesicles
Unilateral; 1-2 dermatomes involved
• _Ophthalmic division of trigeminal nerve →
involvement of eye in 50%
_
• Post-herpetic neuralgia especially in the elderly
Incidence increases with age and in the i.c. host
• Immunocompetent rarely suffer at most 2 attacks
decades apart during a lifetime

36
Q

zoster in immunocompromised host

A

More severe, extensive, prolonged rash.

Risk of disseminated infection

6-10 days after onset of localised rash

  • cutaneous
  • visceral

pneumonitis; hepatitis; meningoencephalitis

37
Q

VZV horicontal transmission

A

• Varicella is spread by respiratory route,
commencing 48h before onset of rash.

• Skin lesions of varicella and zoster are
infectious until crusted over.

38
Q

VZV vertical transmission

A

Congenital Varicella
Maternal varicella in the first 20 weeks of gestation
results in foetal defects in <2% of cases.
Maternal shingles does not damage the foetus

Neonatal Varicella
_Maternal varicella occurring within 7 days before or 7
days after delivery_is associated with a high mortality in
the newborn infant

39
Q

Post-exposure prophylaxis

A

Varicella zoster hyperimmune globulin - VZIG
Indicated for susceptible individuals at risk of severe
VZV infection following a significant exposure
incident
• Pregnant
• Immunosuppressed
• Neonate of seronegative mother

40
Q

VZV antiviral therapy?

A

• Not routine in uncomplicated childhood
varicella
• Advised for varicella in adults and in
immunocompromised individuals
• Recommended for treatment of zoster
• Ophthalmic zoster: mandatory
ophthalmological assessment

41
Q

VZV first line treatment

A

Aciclovir po or iv

Valaciclovir po

• Famciclovir po

These are also the first line agents for HSV, but as
VZV is less susceptible, higher doses are required

42
Q

Oka varicella vaccine

A

• Live attenuated vaccine
• Part of routine childhood vaccination
schedule in USA
• 2 dose schedule
• Recommended in UK for
– susceptible healthcare workers
– Susceptible household contacts of
immunocompromised patients

43
Q

Viruses in general often interfere with immune system processes

HIV

EBV

HSV

A
  1. HIV overwhelmingly most important
  2. Uses CD4 molecule to invade host cell : T-cells, also macrophages and glial cells
  3. Also uses chemokine receptors CCR5/ CXCR4
  4. Decline in CD4+ cell numbers inexorable whilst virus proliferates
  5. Major defects in immunity follow loss of CD4 T cells: Lower IL-2, INF, B cell growth factors

Epstein Barr virus (EBV) : infects B cells and causes random proliferation
Herpes simplex virus (HSV): down-regulates MHC in the cells it infects

44
Q

retrovirus

A

enveloped

RNA

ss+

icosahedral

45
Q

orthomyxovirus

A

enveloped

RNA

ss-

helical

46
Q

herpesvirus

A

enveloped

DNA

ds

icosohedral

47
Q

DNA viruses

A
  1. poxoviridae
  2. herpesviridae
  3. adenoviridae
  4. hepadenaviridae
  5. papovaviridae
  6. parvoviridae