What are the treatments for cutaneous sporotrichosis?
potassium iodide orally in juice or milk
potassium iodide – topical application on open lesions
fungus cannot withstand heat – heat packs
what is the treament for lymphocutaneous sporotrichosis?
antibiotic of choice – amphotericin B
systemic mycoses are also called?
true pathogens
what is the mode of infection for systemic mycoses?
inhalation of dried yeast cells
colonize lower respiratory tract
asymptomatic or primary pulmonary infection (PPI) that parallels TB
disseminated to other organs due to compromised defense mechanisms
What is the major infection of systemic mycoses?
cryptococcosis
what is the causative agent for cryprtococcosis?
Cryptococcus neoformans
what is the resovoir for cryptococcosis?
soil, high association with pigeon droppings
Where does the primary infection of Cryptococcosis take place?
Lung (PPI)
where does the secondary infection of Cryptococcosis take place?
disseminated sites - (brain, meninges, CNS and mucicutaneous systems)
what are the initial symptoms of Cryptococcosis?
fever, cough, nodules of lung
what are the later symptoms of Cryptococcosis?
arise dues to tumor-like masses at secondary sites, headaches, mental changes, coma, parlysis, eye disturbances and seizures.
What are the two risk groups of Cryptococcosis?
Occupational risk - (outbreaks associated with workers demolishing buildings where pigeons have roosted)
AIDS patients - highest case rate U.S - chronic meningitis (most common)
How do you diagnose Systemic Mycoses?
The presence of the capsule
What are the 4 different "presence of capsule" types you can have for systemic mycoses?
India Ink Preparation
Quelling Reaction
Sabouraud Agar
Latex Agglutination Test
India Ink Preparation
wide, clear capsular halo
Quelling reaction
capsular swelling
Sarbouraud Agar (SDA)
slimy, mucoid colony
Latex Agglutination Test
presence of crptococcal capsular polysaccharide
What is bird seed agar used for in spcies identification for cryptococcus?
pigmentation
What are the treatments for systemic mycoses (cryptococcosis)?
amphotericin B and fluconazole
What is the endogenous type infection of opportunistic mycoses caused by?
normal flora
Normal flora for the opportunistic mycoses is found where in the body?
respiratory tract, mouth, intestinal tract and vagina
What is the process of an opportunistic infection?
overgrowth of normal flora
inflammation of epithelial surfaces (most frequently oral cavity and vagina)
dissemination
infectivity of internal organs
What is the main type of infection that is opportunistic mycoses?
Candidiasis infections
What are the two types of candidiasis infection?
cutaneous infections and disseminated infections
What is the causative agent of the candidiasis infection?
Candida albicans
What are the four types of candidiasis cutaneous infections?
Thrush or oral candidiasis
Vaginal candidiasis (VC)
Esophageal candidiasis
General candidiasis
Why do candidiasis cutaneous infections arise?
due to host's conditions.
diabetes, natural immunological deficiencies, or exposure of skin to moist environment
What is the mode of infection for candidiasis cutaneous infections?
adherence of blastoconidia to epithelial surfaces
fungal proliferation
invasion of epithelial tissue
Which candidiasis is the most common?
Thrush or Oral Candidiasis
what is the symptomatic appearance of thrush or oral candidiasis
white, adherent patches (pseudomembranes) attach to the epithelial membranes of the tongue, gums, cheeks or throat
What is another term for the oral candidiasis pseudomembrane ?
fungal mat
What is the composition of the oral candidiasis pseudomembrane?
yeast, hyphae and epithelial debris
Who has increased susceptibility to oral candidiasis?
newborns
how is oral candidiasis transmitted to a newborn or child?
mother -> child
What is the most common form of vaginal infection?
Vaginal candidiasis (VC)
What are the symptoms of vaginal candidiasis?
yellow to white milky discharge, inflammation, painful ulcerations and itching
What is the candidal overgrowth associated with vaginal candidiasis related to?
an increased glucose content of vaginal secretions
who is likely to get vaginal candidiasis?
diabetic women, pregnant women and broad spectrum of antibiotic therapy users
What is Esophageal Candidiasis?
complication of AIDS patients
What are the symptoms of Esophageal Candidiasis ?
painful bleeding, ulcerations, nausea and vomiting
What is general candidiasis infections?
infections of epidermal tissue
What are examples of areas that are succeptible to general candidiasis infections?
folds of skin on obese people (usual sites – upper legs or underarms)
tissue that remains wet (occupation –dishwasher)
skin covered by wet diapers (diaper rash)
What are the two types of disseminated infections?
cutaneous infection
Iatrogenic infections
A disseminated cutaneous infection produces what kind of disease?
a multi-system disease
What is disseminated iatrogenic infections?
(produced by physicians) – usage of catheters or prosthetic devices
How can you diagnose a candidiasis infection?
microscopic examination : gram stain the lesions or exudates. (gram positive = budding yeasts cells)
Macroscopic examination: cultures on SDA– (white to cream colored colony, pasty with a yeasty odor) // clutures on corn meal agar – (chlamydospore formation)
Germ tube test : yeast cells + serum + (incubation for 2-4 hours) = germ tube formation
What are the treatments for the candidiasis infections?
cutaneous - imidazoles
disseminated - amphotericin B
Viruses are what in size?
hetergeneous in size
Viruses are obligate _________ parasitess
intracellular
what do viruses require to replicate ?
living cells
Where do viruses replicate?
the cytoplasm or the nucelus of infectedells.
what host cell machinery does the viruses use for their own replication?
RNA
DNA
protein synthesizing processes
what is the genetic material (genome) of viruses?
either RNA or DNA (NOT BOTH)
How is viral pathogenesis inititated?
have to enter the host and replicate in particular cells or organs.
Viral pathogenisis is the study of?
study of how viruses cause disease in their target hostsusually carried out at the molecular or cellular level.
what must viruses do to produce diesease (the process)
viruses must enter a host, come in contact with susceptible cells, replicate and produce cell injury or cell death.
What are the four routes in which viruses can enter the host.
Fecal-oral route
respiratory route
arthropod-borne route
sexually transmitted route
How through viruses enter the host via the fecal-oral route?
contaminated food or water
How through viruses enter the host via the respiratory route?
through the air
How through viruses enter the host via the arthropod-borne route?
bite of insects or animals
How through viruses enter the host via the sexually transmitted route?
unprotected sex
what diseases result from viruses entering via the fecal-oral route?
poliovirus, rotavirus, hepatits A virus
what diseases result from viruses entering via the respiratory route?
what diseases result from viruses entering via the arthropod-borne route?
encephalitis viruses, rabies virus
what diseases result from viruses entering via the sexually transmitted route?
herpes viruses, haptatitis B, C and D viruses, HIV
What are the two different genome a viruses can have?
DNA/RNA
Capsid
The protein shell that surrounds the genome
Nucleocapsid
the structure of the genome AND the capsid
true or false, all viruses contain enzymes associated with its genome?
false, only some
virion-associated enzymes
enzymes associated with its genome
in some viruses, an ________ encloses the capsid
envelope
What is the enevelope made of?
viral glycoproteins and lipid bilayer derived from the membrane of the infected cell
In some viruses, the envelope contains glycoproteins in the form of spikes called _________.
peplomers
peplomers
glycoproteins in the form of spikes in the envelope
Viruses containing peplomers, _______________ prior to entry into the cells.
attach to the host cell receptor
Virion
The complete, infectious virus particle
capsomer
structural subunits of the capsid
What is the criteria for virus classification?
the organization of the genome :
RNA or DNA
Single or double strandedness
Manner in which the genome is expressed after uncoating in cyotplasm or infected cell.
Explain how the viral genome displays its expressions.
1. After uncoating in the infected cell
2. Synthesis of virus-specific mRNAs that
are translated
into virus-specific
protein(s). Use
virus-specific enzymes
or host enzymes
for this process
3. All viruses use host protein synthesizing machinery to make virus-specific protein(s).
How is the genome expressed?
synthesis of virus-specific messenger (m) RNA molecules that are translated into virus-specific protein(s).
What is the strandedness for most RNA?
single stranded
what is the segmentation of RNA?
1 or more segments
What are the two kinds of polarity of RNA?
+ (mRNA) or - (Anti-mRNA)
What examples of RNA have a positiv3 polarity?
polovivirus and hepatitis A virus
the genome in a positive polarity is...
messenger-sense (+)
In positive polarity, the genome can directly act as an...
messenger RNA
In positive polarity the genome is translated directly to produce...
proteins (polyproteins)
Genomic RNA in infection in which polarity?
positive polarity
What is an example of a negative polarity virus?
rabies virus
the rna genome ____ directly translated into protein in negative polarity
CANNOT
the genomic RNA in not infectious in which polarity?
negative
what happens after uncoating in the negative polarity?
virion-associated transcriptase (RNA dependent RNA polymerase)-transcribes the negative-sense (-) RNA genome into m(+)RNA molecules
What is the main difference about the positive polarity genomes between class 1 and class 3?
The genome is class 3 has TWO identical positive (+) strands of RNA.
What is the viral example of the class 3 positive polarity?
HIV
The flow of infomation in the class 3 positive polarity is...
genomic RNA to DNA to mRNA
what happens after uncoating in the class 3 positive polarity?
virus contains a virion-associated reverse transcriptase, which transcribes the genome (RNA) into a complementary (c) ds-DNA
What happens with double stranded (ds) DNA in class 3 positive polarity?
it is translocated to the nucleus and integrates with host
genome (provirus).
What is responsible for the production of mRNA in class 3 positive polarity?
provirus
The genome (DNA) is transcribed by....
a host cell DNA-dependent RNA polymerase in the nucleus of the infected cell (few exceptions).
Class 1 of DNA replication involves what kind of viruses?
Viruses with double-stranded (ds)-DNA
What is the flow of information in the Class 1 DNA replication?
ds-DNA to mRNA (regulated) to viral proteins (classical pathway found in eukaryotic cells)
Where does the DNA replication of class 1 positive polarit take place?
the nucleus
What happens in class 1 dna replication After
uncoating and transcription of viral genome to make mRNA’s is REGULATED?
multiple cycles resulting in expression of alpha,beta and gamma genes
what kind of genes are the alpha?
immediate early genes - trancsription regulatory genes
What kind of genes are the beta?
early genes - required for viral DNA syntheis
what kind of genes are the gamma?
the late genes - transcribed after DNA synthesis and produce viral structural proteins
what is an example of a class 1 DNA replication virus?
herpesvirus
What kind of viruses are in the class 3 of DNA replications?
viruses with partially ds-DNA
The genome in dsDNA is partially ___________.
double stranded
A revers transcriptast step is involved in which replication process?
dsDNA
what is the relaxaed circuliar genome repaired and converted into a closed ciruclar form by?
virion-associated DNA polymerase
What is the genome after the RT Step transcribed into?
(i)mRNA that is translated to produce viral proteins and (ii) genomic length RNA that serves as a template for the synthesis of genomic DNA by a virion-encoded .RNA dependent DNA polymerase (RT)
what is an example of a class 3 DNA virus?
hepatitis B virus
what is the flow of information in the class 3 relpicatiom for DNA?
Genomic DNA to RNA to Genomic DNA
What happens after uncoating in the class 3 DNA replication?
virion genome is converted to complete ds-DNA by virion associated DNA polymerase
In class 3, DNA replication, what is da-DNA transcribed by?
HOST RNA polymerase
in class 3, DNA replication, ds-DNA is transcribed by HOST RNA polymerase to make....
(i) mRNA’s and (ii) genomic length (+) RNA
in class 3 in dna replication, The (+) RNA is converted to genomic DNA .....
virion-encoded reverse transcriptase (RT)
In class 3, of DNA replication is there an intergration of viral DNA in host cell DNA?
No
What is the order of the seven steps of dna/rna replication'?
adsorption
entry into cell
uncoating
synthesis of viral proteins
replication of viral genome
morphogenesis
release
ADSORPTION:
virion attach to an appropriate cell via virus-specific receptor
removal of capsidproteins in non-enveloped viruses (genome is free in the cytoplasm of cell) or release of nucleocapsid in cytoplasm (enveloped viruses)
SYNTHESIS OF VIRAL PROTEINS:
Expression of virus genome: RNA and DNAviruses have different strategies
REPLICATION OF VIRAL GENOME:
different strategies, depending on the nature of the genome(RNA or DNA).
MORPHOGENESIS:
assembly of progeny virions in thecytoplasm (poliovirus) or in the nucleus of the infected cell (herpes virus) - depends on the virus and cell involved.
RELEASE:
progeny virions (newly synthesized) arereleased from infected cells by cell lysis (lytic cycle) or by the process of budding from the host cell membrane (enveloped viruses).
How many people are infected with HIV worldwide?
65 million people
How many people are living with HIV/AIDS?
33-36 million
How many aids-orphans are there?
over 16 million
Estimated, how many people die each die of AIDS?
15,000
How many people in the u.s are living with HIV/AIDS?
1.5 million
what percentage of men, and what percentage of women are living with aids in the u.s?
70% - men
30% - women
How many people in NYS are living with HIV/AIDS?
121,000
The New York City AIDS case rate is ____ times the national average?
three
How many people in buffalo are living with HIV/AIDS?
10/100,000
Origin of HIV
theory that simian immunodeficiency virus crossed into humans early 1900s
theory that HIV came to US from _____ in _____.
Haiti in 1969
HIV is an RNA virus with two ______.
identical strands of RNA
HIV integrates into hist genome and replicates in _____
host cell nucleus
Aids patients have ________ antibodies
anti-HIV
What are the 4 high risk groups for AIDS?
Homosexual and bisexual men
Intravenous drug users
Children born to mothers who are HIV+
Hemophiliacs (blood product recipients)
What is inside the capsid of HIV?
Genome (two identical strands of RNA)
What are the three virion associated enzymes present in the HIV capsid?
reverse transcriptase
integrase
protease
Reverse transcriptase (HIV)
RNA dependent DNA polymerase
Intergrase (HIV)
intergrates DNA into host chromosome
Protease (HIV)
cleaves certain certain proteins during replication
What are the three main things that the HIV enevelope is made up of?
GP41
GP120
GP160
GP41 (HIV)
stalk for GP120
GP120 (HIV)
site of attachment to host cell receptors
GP160 (HIV)
combination of GP41 and GP120
HIV targets cells of the immune system that have ______.
CD4 receptors
HIV kill __ Cells and also stops the production of new ones from _____.
T cells
from bone marrow and the thymus
What are the five cells that HIV targets?
T cells
Macrophages
Monocytes
Dendritic Cells in lymphocytes
Microglial cells in brain
What is the flow of info for HIV replication?
RNA -> DNA -> mRNA
HIV genomic replication occurs when?
within hours of virus entering the system
Why is HIV a very efficient replication?
because it brings it's own enzymes
Once the ______ is present, the HIV virus cannot be removed.
provirus
why might there be several strains present in the same individual (HIV)?
HIV undergoes rapid genetic changes
What are the 7 steps of HIV replication?
attachment of GP120 to host cell CD4 receptor
fusion - viral envelope and host cell plasma membrane fuse together and release viral core into cytoplasm
virion -associated reverse transcriptase synthesizes a complementary double stranded DNA
Complemenetary DNA is intergrated into host chromosome (provirus) by integrase
The provirus is transcribed to produce genomic RNA (genome) and mRNA (viral proteins)
Assembly of new viruses occurs in the cytoplasm
Viruses are released by budding - acquires envelope and GP120
Ptahogenesis and disease of HIV is caused by....
the destruction of immune system cells
Death from HIV is usually caused by...
a secondary or opportunistic infection
What are the factors that determine the speed and severity of the disease?
age
host cell environment
treatment
nutrition
viral strain
tuberculosis (enhances pathogenesis)
The course of the HIV disease is divided into ___ stages
4
Stage 1 of HIV?
Acute or primary HIV disease stage
Stage II of HIV?
asymptomatic HIV disease stage
Stage III of HIV?
Chronic symptomatic HIV disease stage
Stage IV of HIV?
Crisis stage of AIDS
Acute retorviral is in what HIV stage?
Stage 1
Stage 1 of HIV develops ________ weeks after exposure
2-8
HIV stage I lasts how long?
2-4 weeks
Stage 1 HIV is characterized like...
mononucleosis
What are the symptoms of stage 1 HIV?
fever, sweat, lethargy, headache, diarrhea
In Stage 1, the viruses spread throughout the body with no notable immune response because...
there are high levels of the virus
What is it called when the HIV virus spreads throughout the body but there is no notable immune response?
"window of infectivity before sensitization"
the window of infectivity before sensitization
The body has not had enought ime to produce an immune response by cells are making more viruses
In stage 1 a person is highly infectious but shows HIV ________.
negative
Stage II of HIV is?
Asymptomatic HIV disease stage
How long does stage II of HIV last?
anywhere from months to 11 years
in stage II of HIV, HIV level in blood drop and the bodies make....
antibodies against HIV
In stage 2 of HIV there is a balance between the level of HIV and the level of ________.
antibodies
what stage is when the proviral DNA is in laten stage - viral genome is intergrated into host genome?
stage 2
in stage 2 of HIV patient is still infectious but there are lower levels of _____
the virus
What is stage 3 of HIV?
chronic symptomatic HIV disease stage
How long can stage 3 of HIV last?
for months or years
in stage 3 of HIV, virus replication destroys....
T4 cells
in stage 3 of HIV, the t4 cell count is ____ or less per microliter of blood
200
In what stage of HIV does viremia begin?
3
Viremia
high levels of virus in blood which can infect more host cells
What are the symptoms of stage 3 of HIV?
fever, weight loss, malaise, fatigue, night sweats, headaches, and swollen lymph glands
In stage 3 of HIV, destruction of T4 cells leads to...
the loss of immune response and the onset of opportunsitic infections and cancer
What is stage 4 of HIV called?
Crisis stage or AIDS
What does the patient aquire in stage 4 of HIV?
opportunistic infections and cancer
in what stage of HIV is there a marked destruction of immune system cells leading to sever immunodeficiency?
stage 4
What are the common organism involved in opportunsitic infection in AIDS?
characteristic of measles; red/yellow spots with white ceter around molars in the mouth
warthin-finkeldey syncytial cells (function)
as virus infects neighboring cells it causes them to fuse together resulting in giant, multinucleated cells, characteristics of measles
Maculopapular rash
reddish rash on the hands and face which can spread to rest of body
measles (rubeola) immunity
permanent immunity, IgG antibodies persist for life
measles (rubeola) diagnosis?
serodiagnosis (test for antibodies)
is there a vaccine for measles (rubeola) ?
yes. MMR vaccine
how many serotypes does influenza have?
3
What are the three serotypes of influenza?
A,B and C
What influenza serotypes cause infections in humans?
only A and B
what is the influenza resovoir?
Pigs and birds
_____ have a receptor for human, avian and swine influenza viruses
pigs
The influenza genome is segmented into how many pieces?
8
each influenza genome segment has its own....
transcriptase that makes mRNA
the influenza viral envelope has ____ peplomers.
2
what are the two peplomers that the influenza viral envelope has?
H or HA - hemagglutinatinin for attachment to cell receptor
N or NA - neuraminidase for release from infected cells
the influenza lipid bilayer is derived from the...
host cell membrane
influenza undergoes ______ changes each year
antigenic
What do we need to do to respond to antigenic changes?
make a new vaccine each year
How can the RNA for peplomers change?
by two mechanisms
point mutations
minor antigenic shift
point mutation (action)
virion-associated transcriptase changes one or two nucleotides which slightly changes the antigenic properties of the peplomers
influenza transmission
respiratory route
influenza incubation period?
1-2 days
influenza clinical symptoms
abrupt onset of fever which lasts 3-4days
severe headache
myalgia (muscular aches)
common complication - pneumonia
influenza immunity
no permananet immunity
What is there no permamnent influenza immunity?
antigenic changes in the virus
influenza diagnosis
serodiagnosis
influenza treatments
anti-influenza drugs :inhibit uncoating
Neuraminidase inhibitors
What are the anti-influenza drugs?
amantadine
rimantadine
The anti-influenza drugs only work for which type of influenza?
type A
today, most if not all strains of influenza are resistant to....
anti-influenza drugs
What are the neuraminidase inhibtors?
Relenza (zanamivir) - nasal spray
Tamiflu (oseltamivir) - tablet
What drugs work for type A and B influenza?
neuraminidase inhibitors
How do neuarminidase inhibitors work?
prevent the release of virus from infected cells, decreases the severity and duration of infection.
all influenza vaccines contain what?
two subtypes of influenza A and one subtype of influenza B
Why does influenza vaccine composition change each year?
to respond to antigenic changes of the virus
What are the two FDA approved influenza vaccines?
Inactivated virus vaccine given to high risk groups
live, attenuated intranasal vaccine (LIAV) given to healthy people (2-49yo)
Who are the high risk groups for influenza?
elederly, people with immune, cardiovascular, pulmonary or metabolic disorders, infants, people on aspirin therapy or people with asthma.
in influenza, temperature sensitive mutants can grow in....
lower temperatures
influenza mutants only grow in the....
Upper respiratory Tract (URT)
What are two contradictions for LIAV (influenza vaccine)
vaccine is grown in chicken eggs, so shouldnt be given to someone with allergies to eggs
Vaccine should not be given to people who have a fever or those who are not fully healthy.
North america swine influezna virus contains genes from...
H of H1N1
Asian and Europen swine influezna virus contains genes from...
N of H1N1
North American avian virus has what subunit?
transcriptase subunit 1
Human influenza virus has what subunit?
transcriptase subunit 2
Hepatits A virus has what kind of infections?
subclinical or asymptomatic
acute viral hepatitis A infection
Which Hepatits A virus infection has a higher incidence than other Hepatits A virus infections?
subclinical/asymptomatic infection
which Hepatits A virus infection occurs, but shows no symptoms, having the host not even know it's infected?
subclincial or asymptomatic infection
subclinical or clincal aysmpotomatc has ______% antibodies to the virus.
50%
does acute viral hepatitis A infection have a carrier state?
no
acute viral hepatitis A infection incubation period
15- 50 days
What is the two symptom phases of acute viral hepatitis A infection?
preicteric
icteric
acute viral hepatitis A infection preicteric phase
virus is replicating in intesitnal cells;
abrupt onset of fever
fatigue
anorexia (loss of appetite)
acute viral hepatitis A infection preiteric phase time length?
a few weeks to several years
acute viral hepatitis A infection icteric phase
viremia - liver infected
dark urine
janduice
acute viral hepatitis A infection icteric phase time lentgh?
1-2 weeks
The majority of individuals with acute viral hepatitis A infection __________ recover
fully
acute viral hepatitis A infection trasnmission
fecal-oral route (contaminated food)
acute viral hepatitis A infection immune response
IgM and IgG antibodies are produced
in acute viral hepatitis A infection IgM lasts for....
a few months
in acute viral hepatitis A infection IgG last for
entire lifetime
acute viral hepatitis A infection diagnosis
test for presence of IgM and HAV antibodies
acute viral hepatitis A infection treatments
passive and active immunization
acute viral hepatitis A infection passive immunization
human gamma globulins - give person specific antibodies for immediate but short lived protection
acute viral hepatitis A infection active immunization
vaccines
what are the two vaccines for acute viral hepatitis A infection?
inactivated hepatitis A vaccine
twinrix
inactivated hepatits A vaccine
used for children between 12 and 23 mos old, two doses spaced six months apart
twinrix
combined hep A and hep B vaccine - used for persons 18 years and older.
Hepatits B virus is also called
The Dane particle
an estimated _____% in the U.S ifected with Hepatits B virus develop acute hepatits.
25
10-25% of people who develop acute hepatits from Hepatits B virus will become...
carriers of Hepatits B virus and have a higher risk of chronic liver disease.
Hepatits B virus is the major cause of what 3 diseases?
chronic hepatits
cirrhosis
primary hepatocellular carcinoma (HCC)
can Hepatits B virusbe grown in cell celtue
no
Hepatits B virus genome
partially double stranded DNA with a virion-assoicated polymerease
Hepatitis B surface antigen
envelope protein that is specific to Hepatits B virus
HBV surface antigen function
differentitate between hap A and hep B
30 - 70% of Hepatits B virus infections are....
asymptomatic
HBsAG is present in serum for....
1-2 months
IgG and HBsAg antibodies persist for life giving.....
lifelong immunity
Acute Hepatits B virus clinical symptoms?
similar to HAV (have iteris and preucteric phases)
acute Hepatits B virus infection incubation period
43-180 days
HBsAg is transiet and is present in serum for....
less than six months
theres a theory that fulminant hepattli is caused by ...
HBV and HDV
what causes severe cirrhosis of the liver and has a high mortality rate?
fulminant hepatitis
transmission of subclinical and actue Hepatits B virus
sexual contact or by contaminated food
chronic hbv infection carrier state
chronic carrier state
persistent viral hepatitis
one of the common long term sequela (pathological condition resulting from disease) of acute hep B.
HBsAg is in seruj for life, but a _____ amount of antibodies are produced.
small
Chronic HBV transmission
from infected mother to infants
theres a 70=90% chance for infection of Chronic HBV if the mother is a....
carrier
Chronic HBV immune response
IgG and HBsAg antibodies are produce and give lifelong immunity after infection
Chronic HBV diagnosis (2)
perform a test to detect the presence of HBsAg (only indicates the presence of an infection, not the type)
perform further tests, spaced 6 months apart to determine type
Chronic HBV treatment passive immunization
Hepatitis B immunoglobulin (HBIG) - more selective, higher amount of antibodies for the virus
standard immune serum globulin
human gamma globulin
Chronic HBV activve immunization
Recombinant vaccines used for 0-18 year olds
twinrix
for infants born to HBsAg postive mothers
Chronic HBV recombinant vaccines?
recombivax HB
energix-B
how are recombinant vaccines made?
isolating the genes for antigen production and putting them into a yeast cell which can make the antigen thich is purified and used as a vaccine
infants born to HBsAg positive mother should recieve 3 or 4 doses of ______ starting at birth.
recombivax HB
What causes post-tranfusion hepatitis?
HCV
60 - 70% of HCV infections are ....
asymptomatic
in most cases an HCV acute infection results in...
the establishment of a persistent infection
What makes it hard to remove the HCV chronic virus?
high rate of chronic/persistent infection leading to hepatocellular carcinoma
in HCV chronic infection _______ occurs serveral weeks after infection and can last for years
viremia
HCV infections are slow or fast?
slow
time takes for HCV clinical hepatitis?
>10 years
time takes for HCV liver cirrhosis?
>10 years
time takes to develop HCV HCC?
>29 years
HCV transmission
parentally or by sexual contact
HCV diagnosis
use antibody testing to detect the presence of HCV antigens (not type)
treatment of HCV chronic infections?
combined interferon-alpha2b and ribavirin
combined interferon-alpha2b and ribavirin
combination of two has a synergistic effect; used to reduce the level of virus which prevents or slows liver cirrhosis and HCC (cant completely remove virus)
HDV is also called...
Delta agent
HDV has defective...
RNA virus that cannot replicate itself
For HBV carrie that have HDV what is needed for replication?
requires the presence of HBV for replication and trasmission
HDV share similar characteristics with...
plant viruses (viroids)
HDV trasmission is similar to that of...
HBV
Coinfection of HBV and HDV may result in...
fulminant hepatits (higher mortality rate)
HDV diagnoses
detection of anti-HDV IgG antibodies
Herpesviruses are anciet and may have infected...
dinosaurs
what are the 8 known herpes viruses that infect humans?
HSV-1
HSV-2
Varicella Zoster Virus VZV
Epstein Barr Virus EBV
Cytomegalovirus CMV
HHV6
HHV7
HHV8/KHSV
the herpesvirus lipid membrane is derived from....
the host cell (w/ glycoprotein spikes)
glycoprotien spikes
proteins made by the virus that aid in attachment
herpesvirus structure components?
lipid membrane w/ glycoprotein spikes
tegument
nucleocapsid
DNA core
tegument
viral proteins that help start the infectious process in cells
nucleocapsid
icosahedral shaped structure that contains genetic material
DNA core
genetic material inside the nucelocapsid; usually double stranded linear DNA .
primary herpesvirus infection is usually
asymptomatic
the major feature of herpesvirus pathogensis is...
latent phase
herpesvirus reactivation (second infection) gives rise to
symptoms
herpesvirus reactivation is caused by...
certain signals in the host when immune system is weakened
a primary herpesvirus infetion causes ubiquitous.....
infection
Most people are infected with ____ out of the 8 herpesviruses, with the exceptions of what two ?
