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I & I Part II > HSV I > Flashcards

HSV I Flashcards

1
Q

HSV

A
  • Herpes Simplex virus genus of the Herpesviridae family
  • Two Types - 1 and 2!
  • linear, ds DNA enveloped
  • numerous strains
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2
Q

HSV Structure

A
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3
Q

Herpes Simplex Viruses Genomic Organization

A
  • 150 kb in length
  • Can encode up to 70 polypeptide
  1. a - genes (immediate early genes): encode 5 regulatory proteins (a -0, 4, 22, 27, 47), latency associated transcript (LAT1)-antisense to a -0 gene
  2. b - genes (early genes): encode DNA binding proteins, DNA polymerase, and thymidine kinase
  3. g - genes (late genes): encode structural proteins (glycoproteins)
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4
Q

HSV Replication

A
  • DNA released in the cytoplasm
  • DNA migrates to the nucleus
  • mRNA (transcription) synthesis takes place in the nucleus by using host RNA polymerase
  • nuclear membrane
  • mRNA transported to the cytoplasm
  • virus replication involves regulatory proteins
  • New viral proteins made and migrate to nucleus
  • Genomic DNA (replication) synthesis takes place in the nucleus by using viral DNA polymerase
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5
Q

HSV 1 vs HSV 2 Infection Sites

A
  • HSV 1 above umbilicus
  • HSV 2 below umbilicus
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6
Q

HSV 1 Transmission

A

•primarily by direct contact

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7
Q

HSV 1 Incubation

A

•Incubation period: 7-10 days

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8
Q

HSV 1 is acute, latent or both?

A
  • Acute and latent infection
  • Primarily asymptomatic
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9
Q

HSV 1 site of primary infection?

A
  • Gingivostomatitis – primary infection l most common in children 1-6 years, fever, oral blisters on buccal mucosa, tongue, gums vesicles which ulcerate 7-10 day duration
  • Labialis (cold sores) - reactivation l vesicles at mucocutaneous junction of lips recurrent (latent) vesicles ulcerate, painful
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10
Q

Where does reactivated HSV 1 show up?

A

•Reactivated HSV is at near or same site of primary infection

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11
Q

HSV 1 Keratoconjunctivitis

A

•corneal ulceration, recurrent, blindness (one of the major causes of blindness in the U.S)

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12
Q

HSV 1 Encephalitis

A

•Temporal lobe, high mortality

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13
Q

HSV 1 Eczema herpaticum

A
  • mild or fulminant
  • Injured skin, burn patients, ulceration
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14
Q

HSV 1 Herpetic Whitlow

A

•tips of finger and nails, occupational

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15
Q

HSV 2 Transmission

A

•sexually transmitted

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16
Q

HSV 2 Incubation

A
  • 2-12 days
  • 80% of the patients develop recurrent infection within 12 months
17
Q

HSV 2 Vulvovaginitis

A
  • mucous membranes and skin of labia, lower vagina, cervix
  • Lesions become ulcerated, painful, fever
18
Q

HSV 2 Progenitalis

A

•ulcers on penis and/or on skin in groin or perianal area

19
Q

HSV 2 Asceptic Meningitis

A

•self limiting

20
Q

HSV 2 Neonatal Herpes

A
  • 30-60% transmission rate with primary infection, lower rates in recurrent infection
  • Contracted during delivery
  • 6-10% babies develop neonatal herpes
  • Widespread organ involvement
  • High mortality - more than 60%
  • Neurologic sequelae in survivors
21
Q

HSV Latency

A
  • All Herpes viruses establish latent infections
  • Site of latency and features of reactivation disease are different for each virus
  • During latent infection, certain viral proteins are produced, but no complete viral particles.
  • The genome is present as a circular extrachromosomal element in the nucleus of the infected cell.
  • Latent stage is not affected by treatment.
22
Q

HSV Reactivation

A
  • Reactivation - same site as primary infection
  • DNA resides in ganglia (trigeminal root ganglion, sacral AREA, but dorsal root ganglion)
  • Reactivation: trauma, fever, sunlight, excitement, emotional stress (EXAMS)
23
Q

How does latent herpes reach peripheral sites?

A
24
Q

HSV Diagnosis

A
  • isolate virus in cell culture
  • stain biopsy material (immunofluorescence)
  • DNA detection by PCR (mainly in latency)
25
Q

HSV Treatment

A
  • Most effective drug is acyclovir
  • Foscarnet is active against acyclovir-resistant HSV
  • eye infections (topical), acyclovir, idoxuridine (IUDR), adenine arabinoside, trifluorothymidine
26
Q

HSV Encephalitis Treatment

A

•Intravenous -Acyclovir, Vidarabine

27
Q

HSV Genital herpes Treatment

A

•Acyclovir (oral and topical), Vidarabine

28
Q

HSV Neonatail Treatment

A

•Vidarabine, Acyclovir

29
Q

HSV Treatment

A
  • Avoid contact with lesions
  • Safe sex practices, condom usage

I & I Part II (25 decks)

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