Virology Test 2 MAYAs Review from CMV on...

-HHV5

-has the largest genome of the HHVs

-the most prevalent cause of congenital infections

-heterophile negative infectious mononucleosis (milder version of heterophile + infectious mono)

-infections of multiple organs in AIDS pts

-organ rejections

-"owl's eye" basophilic intranuclear inclusion body:
such infected cells can be found in any tissue of the body or in urine and are thought to be infected epi cells

***50% OF ADULTS IN THE US HAVE CMV, IN MOST CASES SHEDDING IS ASYMPTOMATIC

-saliva
-urine
-blood
-throat washings
-tears
-tit milk
-man juice
-shit
-vag secretions
-transplant tissues

-orally and sexually
-in blood transfusions
-tissue transplants
-in utero
-at birth and by nursing

-Acyclovir
-Ganciclovir
-Valganciclovir
-Cidofovir
-Foscarnet

-passive administration of CMV serum Igs is commonly used for prevention or treatment of CMV disease following organ transplant

-pt may be viremic for 3-6 days prior to symptoms

-initially fever and chills, severe headache, back pain, general muscle aches, nausea fatigue, and weakness

-phase may be followed by a short period of symptom remission

-in 15% of pts, the next phase

-fever returns w/ headaches, back pain, nausea, vomit, ab pain, fatigue

-Hepatic coagulopathy produces hemorrhagic symptoms:
1. hematemesis (black vomit)
2. Epistaxis, gum bleeding, and petechial and purpuric hemmorhages (bruising)

-no specific medication for treatment:
-may take analgesics with acetaminophen and NOT asprin**
-rest, fluids

-Live, attenuated vaccine available-->highly effective

-single dose confers immunity for 10 or more years

-booster dose every 10 yrs for people living in high risk areas

-Adults and children > 9 months can take this vaccine

-sudden onset of fever, severe headache, myalgias, arthralgias, leukopenia, thrombocytopenia and hemorrhagic manifestations

-occasional shock and hemorrhage--> leading to death

-is key

-medical personnel still unclear how best to treat hemorrhagic cases

-transmitted by mosquito bites

-abolish mosquito breeding grounds including no stagnant water, proper disposal of garbage

-Risk of indoor mosquito bites is reduced by use of
1. Air conditioning or screens on windows and doors
2. Proper application of mosquito repellents containing 20-30% DEET
-I personally prefer 100% DEET nothing fucks with you

-Filoviradae Family

-enveloped, helical capsid, - ssRNA

-rash on trunk (early stages)

-pts bleed from their orifices, their mucus membranes

-MASSIVE internal and external hemorrhage

-Mortality rate 25-100%

-direct contact with an infected person or with their bodily fluids

-handling dead gorilla carcases
*Laura is a high risk individual

-eating infected primate meat

-->02/03 Ebola epidemic in C. Africa

Arenaviridae Family

-enveloped, beaded NC, -ssRNA

-Inhalation of infected aerosols of rat droppings, urine, hair etc

-eating food contaminated with the above

-95% of infected pregos suffer abortions
***noted

-carried to humans by wood tick Dermacentor Andersoni
(which bacterial disease does this tick also cause....)

-Reoviradae family, Coltivirus genus

-naked, icosahedral capsids (2), dsRNA segments

-multiplies in arthropods (ticks) and vertebrates (humans)

-Hosts: ground squirrels, porcupines, chipmunks, and mice of the genus Peromyscus

-biphasic fever and conjunctivitis

*Fever is nearly always present
-a fever pattern noted in about half the cases is "saddleback" fever which is suggestive of diagnosis

*rash is infrequent
-macular, maculopapular, and petechial
-distribution is often truncal (more acral rash in RMSF)

-rash is short lived (diff than RMSF)

-Petechiae occur in rare cases and may be complicated by thrombocytopenia

*Rash appears on the palms and soles

-later becomes generalized and may become hemorrhagic

-microscopy using DFA of skin lesion biopsy allows confirmation within hours

-Rash appears on trunk and is short lived

-immunoflourescent staining of blood smears to test for viral Ags on the surface of RBS

-Serology:ELISA to test for IgM or IgG levels in acute and convalescent sera

-infects erythroid precursors

-persists in adult RBCs and this protects the virus from being cleared (immune evasion)

-first 10 days - high levels of interferon

-viremia can persist for wks/months which promotes transmission to the tick vector

-western and NW areas of the US and Canada, where the wood tick is found

-tick AKA Rocky Mt wood tick

-acquire the virus by feeding on an infected host and transmit it to a new host in its saliva, during feeding

-Supportive treatment (acetaminophen and analgesics)
-Protective clothing
-Avoid tick infested areas
-Remove ticks before they bite
-NO vaccine
-DO NOT donate Blood (virus is transmissible via blood)

-member of the:

1. Retroviridae family

2. Lentivirus genus

Virulence: High

Ability to transmit: High

Prevalence: Global

Purported Origin: Chimps

***causes the majority of HIV infections globally

Virulence: Low

Ability to transmit: Low

Prevalence: West Africa

Purported Origin: Sooty Mangabey

-GP120 binds to the CD4 receptor

-CD4 is a glycoprotein expressed on the surface of T-help cells, T-reg cells, monocytes, macros, and dendritics

HIV induced immunosuppression (AIDS) results from a reduction in CD4 and T cells

-RT lacks proof reading abilities, resulting in ~5 errors/genome

-this genetic instability is responsible for emergence of new strains during disease

-initial symptoms could subside after 2-3 weeks

-Virus replication in the lymph nodes

-->May be asymptomatic or persist as generalized lymphadenopathy for years

-Oppurtunistic infections

-fungal, bacterial, protozoal, viral
-oppurtunistic neoplasias

-bc the CD4 counts are so variable some HC providers prefer to look at CD4% which refer to total lymphocytes

***This % is > stable than the CD4 cell number
***Normal range between 20-40%

>500 ~ 29%

20-500 ~ 14 - 28%

<200 ~ <14%

-some HC providers start agressive ART when CD4% < 15% even if the CD4 count is high

-CD4% < 14% indicates serious immune damage, it is a sign of AIDS in ppl with HIV infection

CD4% is a predictor of HIV disease progression

CD4:CD8 ratio:
-healthy ratio is .9 - 1.9, indicating 1-2 CD4 cells per CD8 cell

-ppl with HIV, ratio drops, indicating more CD8 cells than CD4 cells

-bc they are such an important indicator of the strength of the immune system CD4 counts should be monitored every 3-4 months

-ELISA on blood is the most common tests: looks for Abs to HIV

A + reaction is confirmed by Western Blotting
Specimens used: blood, oral fluid (not saliva), urine

-in order to evade immune detection

-to inactivate key players of immune response

-loos of major activator of the immune response and the DTH response

kinda like HIV is the terminator and John Connor is the CD4 T Cell, there can be no resistance if HIV is successful in inactivating CD4 T cells

1. Taking combination therapy during preggers and taking AZT during labor and birth

2. C section

3. Administering AZT to newborn for up to 6 weeks after birth

4. using formula milk, milk bank milk instead of breast feeding

-know the antiviral drugs that can limit disease progression in HIV infected pts

-know why HIV protease is important

-know what the standard of care is for therapy

-retroviridae family

-oncovirinae subfamily

-adult acute T-cell lymphocyte leukemia (ATLL)

-HTLV-1 associated myelopathy (neurologic)

-long latency period (30+ yrs)

-spreads through blood transfusion, sex, breast feeding

-infects T cells: CD4 + Th and DTH Tcells

-usually asymptomatic

-ATLL is a neoplasia of CD4 helper T cells

-T cells express high levels of IL-2R

-Acute ATLL is usually fatal within one year

-Endemic to southern Japan, found in the Carribean and among blacks in the SE U.S.
(this sounds racist, Maya is Indian right? so is Krishna and he is racist so at least he wont forget this one)

-Okinawa: 35% are seropositive

From mom to child (placenta/milk)

-making whoopi (throwback term)

-Blood transfusions

-IV drug use (shared needles)

-AZT and INF

-no current approved treatment

-Abs against the IL-2R (tagged w/ toxins/radiations)

-sexual precautions, screening of blood

***maternal screening needs to be implemented

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