The human herpes virus

Question 1

what are the three main sub families of herpes virus ?

Answer 1

alphaherpes viruses
betaherpes viruses
gamma herpes virus

Question 2

what is in the the alpha family ?

Answer 2

HSV1
HSV 2
HHV 3 - varicella zoster virus

Question 3

what is in the beta family ?

Answer 3

HHv5 - cytomegalo virus
human herpes virus 6
human herpes virus 7

Question 4

what is in the gamma family

Answer 4

HHV4 EBV

HH8 Kaposi sarcoma

Question 5

what are the types of herpes simplex virus ?

Answer 5

HHV1

HHV2

Question 6

what is the mode of infection of HSV ?

Answer 6

direct contact

Question 7

what are the types of infection ?

Answer 7

primary infection
recurrent infection
initial non-primary

Question 8

what is HSV1 commonly associated with (clinical presentation)?

Answer 8

orolabial herpes

Question 9

what is HSV2 commonly associated with (clinical presentation)?

Answer 9

genital herpes and usually acquired through sexual contact

Question 10

what may genital ulcers of HSV2 increase the risk of ?

Answer 10

HIV infections

Question 11

what are the triggers of a HSV infection ?

Answer 11

• physical and emotional stress
• fever
• exposure to UV light
• tissue damage
• immunosuppression

Question 12

which ganglia does the HSV-1 rest in ?

Answer 12

trigeminal ganglia

Question 13

what ganglia does the HSV-2 rest in ?

Answer 13

sacral ganglia

Question 14

what are the clinical manifestation of HSV disease ?

Answer 14

primary infection - often asymptomatic

reactivation - may be symptomatic is asymptomatic

Question 15

in what type of patients is reactivation common ?

Answer 15

immunocompromised

Question 16

what is a subclinical infection ?

Answer 16

asymptomatic viral shedding not being treated

Question 17

what does the primary lesion look like ?

Answer 17

painful grouped vesicles on an erythmatous base

Question 18

why do recurrent infections with herpes happen ?

Answer 18

due too the latency of the virus

Question 19

what are the clinical presentations/manifestations of herpes virus ?

Answer 19

orolabial herpes 
herpetic whitlow 
herpes gladitorum 
erythema multiforme
eczema herpeticum 
keratonconjuctivitis 
genital herpes 
neonatal herpes 
HSV encephalitis

Question 20

what are the types or orolabial herpes ?

Answer 20

herpetic gingivostomatitis

cold sores

Question 21

what are the types of genital herpes ?

Answer 21

primary and recurrent ( primary being more severe )

Question 22

which herpes simplex virus is the most likely causative factor in neonatal herpes ?

Answer 22

HSV-2 , if mother has primary genital infection in the third trimester

Question 23

what is the clinical spectrum of neonatal herpes ?

Answer 23

• can be localized to the skin, eyes and mouth
• could affect the CNS causing encephalitis with or without skin involvement
• become disseminated and cause encephalitis, hepatitis or pneumonia

Question 24

what is the laboratory diagnosis for neonatal herpes ?

Answer 24

test vesicle fluid
vesicle swab
CSF for viral nucleic acid

Question 25

what is the treatment for neonatal herpes?

Answer 25

intravenous acyclovir for 3 weeks

Question 26

what is the gold standard of diagnosis for HSV encephalitis ?

Answer 26

PCR of CSF

Question 27

``` primary or reactivation ? gingivostomatits herpes labials keratonconjuctivitis genital herpes neonatal ```

Answer 27

``` primary reactivation primary , reactivation primary, reactivation primary ```

Question 28

how is a diagnosis of HSV made ?

Answer 28

``` mainly clinical PCR serology Skin biopsy Tzanck Smear ```

Question 29

what is the prophylaxis of HSV ?

Answer 29

- avoid triggering factors - awarness - screening for HSV in pregnant women - C section with women who have genital herpes - prophylactic acyclovir in the third trimester

Question 30

what is the route of admission of acyclovir in neonatal and encephalitis ?

Answer 30

IV

Question 31

why is valaciclovir used rather than acyclovir?

Answer 31

valaciclovir has a higher drug bioavailability