Virus DNA Hepatitis virus Herpes virus Characteristic Hepatitis

Virus DNA Hepatitis virus Herpes virus

Characteristic Hepatitis Virus

Hepatitis virus • Produce acute inflammation of the liver ▫ In Chronic active hepatitis : Histologic change from inflammation and necrosis to collaps of the normal reticulum framework with bridging between the portal triads or terminal hepatic vein • Resulting in a clinical illness ▫ Fever ▫ Gastrointestinal symptoms: nausea, vomite ▫ Jaundice

Hepatitis B

Replication of hepatitis B virus

Virus Hep-B • HBV establishes chronic infection • Major factor in the evantual development of liver disease and hepatocelluler carcinoma • Transmission modes and response to infection is vary ▫ Depending on the age at time of infection ▫ Infant: during infancy, from infected household contact chronic ▫ High-risk group

High-risk group infected by HBV • • Parenteral drug abusers Health care personnel Multiply trasfused patients Organ transplant patients Hemodialysis patient and staff Newborn infant to mother with Hep-B etc

HBV • HBs. Ag can be detect: ▫ Saliva, nasopharyngeal washing, semen, mestrual fluid, vagina secretion, blood • How HBV transmit to other person? • HBe. Ag + in carrier person assumed all the body fluids is infectious • Precaution: vaccination • Laboratory feature: ▫ Interpretation of HBV serologic markers

Clinical and serologic event HBV

Herpes Viruses • Ability : ▫ establish lifelong persistent infections in their host ▫ To undergo periodic reaction • Frequent reactivation: ▫ in immunosupressed patients cause serious health complications ▫ May be clinically quite different from the primary infection • A large virus

Herpes simpleks virus • Extremely widespread in human population ▫ ▫ Broad host range Able to replicate in many types of cells Grow rapidly and highly cytolytic Common recurrences • Two distinct HSV: ▫ HSV type 1 spread by contact (often saliva) ▫ HSV type 2 transmitted sexually or maternal genital infection to a newborn

HSV… • HSV-1 : site latency at trigeminal ganglia • HSV-2: site latency at sacral ganglia • How the virus enconter the host? ▫ Mucosal surface or broken skin • the clinical finding for HSV infection ▫ ▫ ▫ Oropharyangeal infection Keratokonjunctivitis Genital herpes Skin infection Encepalitis Neonatal herpes

Laboratory finding • Stain (giemsa stain) ▫ Scraping base of vesicle multinucleated giant cell • PCR • serology

Varisella zozter virus • Highly contagious disease, chiefly of children • Characterized clinically: ▫ Generalized vesicular eruption of the skin and mucous membranes ▫ A rash limited in distribution to the skin innervated by a single sensory ganglion • may be severe in adult and immunocompromised children

Pathogenesis varisella:

Varisella zozter virus • Acute skin lesion ▫ Also acute inflammation of the sensory nerves and ganglia ▫ Induce vesicle formation ▫ Often only single ganglion may be involved • Distribution skin lesion corresponds closely to the areas of innervation from an individual dorsal root ganglion • It is not clear what trigger reactivation of latent varisella-zozter virus in ganglia

Varisella-zozter virus symptom • Varisella: ▫ malaise, fever, rash start from trunk, then face, limb, buccal, paryngeal mucosa ▫ In 5 days: develop hundreds skin lesion • Zozter ▫ Start with severe pain in the area of skin or mucosa ▫ Few days after: vesicle appears over the skin supplied by the affected nerves ▫ Complication: post herpetic neuralgia

Laboratory finding • Tzanck smear: ▫ Scraping or swab based of vesicle • Rapid diagnostic prosedure: ▫ Viral DNA/virus specifis antigen in vesicle fluid, skin scraping, or biopsy material • Cell culture

Therapy and prevention • The efectivity of antiviral: ▫ For immunosuppresed patients, halt progression • The prevention: vaccin

Cyto Megalo Virus (CMV) • Largest genetic content in herpesvirus • Very spesies-spesific and cell type-specific ▫ Replicate in vitro inhuman fibroblast • Infect intrauterin congenital anomalies • Most CMV infection is in subclinical ▫ Clinical: An infectious mononucleosis-like syndrome cell enlarged ▫ Severe infection in immunosuppressed

patology

CMV • How virus transmission • Laboratory diagnosis? • What are the treatments?