Herpes Simplex I And Ii 3u19c

Herpes Simplex I and II Dr.T.V.Rao MD

Dr.T.V.Rao MD

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Herpesviridae • The Herpesviridae are a large family of DNA viruses that cause diseases in animals, including humans The family name is derived from the Greek word herpein ("to creep"), referring to the latent, re-occurring infections typical of this group of viruses. Herpesviridae can cause latent or lytic infections. Dr.T.V.Rao MD

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Herpes Viruses DNA group • Most important Human Pathogens • Wide Host cell range • Life Long Infection – Periodic reactivation • Immunocompromised • Large number of genes, • Some viruses susceptible to treatment. Dr.T.V.Rao MD

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CLASSIFICATION (Human pathogens) • Alphaherpesvirinae – Herpes simplex virus type 1 – Herpes simplex virus type 2 – Varicella-zoster virus

HSV-1 HSV-2 VZV

• Betaherpesvirinae – cytomegalovirus – Human herpesvirus type 6 – Human herpesvirus type 7

CMV HHV-6 HHV-7

• Gammaherpesvirinae – Epstein-Barr virus Dr.T.V.Rao MD

EBV

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Infecting Humans. Herpes Simplex virus 1 and 2 Varicella Zoster Viruses Cytomegalovirus virus Epstein Barr virus Human Herpes viruses 6, 7. Kaposi's Sarcoma associated Viruses Dr.T.V.Rao MD

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Properties of Herpes Viruses. • Spherical in Shape • Icosahedral 150 to 200 nm in size • Genome – Double stranded DNA Linear • Envelope contains Glycoprotein's Dr.T.V.Rao MD

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Out Standing Characteristics • Encode many enzymes. • Cause Latent Infections. • Indefinite persistence. • Relation in Immunocompromised • Relation to Cancers. Dr.T.V.Rao MD

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Herpes Virus

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Classification of Human Herpes virus

• Subfamily – Alpha Neurons Herpes simplex 1,2 Varicella zoster Dr.T.V.Rao MD

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Subfamily Beta Glands and Kidney Cytomegalovir us Lymphoid tissues Herpes 6,7 Dr.T.V.Rao MD

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Subfamily - Gamma • Lymphoid tissue ( Herpes 5 ) Epstein Barr virus Kaposi Sarcoma (Virus Herpes 8)

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Intranuclear infection of infected cells

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Herpes Virus Replication Replicates in Host Cell Nucleus Form Cow dry A Type inclusion bodies. More than 50 different types proteins in infected cell. Large number of enzymes in DNA synthesis Dr.T.V.Rao MD

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Herpes Simplex 1 and 2

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Human Herpes Virus 1 and 2 • They are also called Human Herpes Virus 1 and 2 (HHV-1 and HHV-2) and are neurotropic and neuroinvasive viruses; they enter and hide in the human nervous system, ing for their durability in the human body. HSV-1 is commonly associated with herpes outbreaks of the face known as cold sores or fever blisters, whereas HSV-2 is more often associated with genital herpes. Dr.T.V.Rao MD

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Herpes 1and 2 • HSV-1 is commonly associated with herpes outbreaks of the face known as cold sores or fever blisters, whereas HSV-2 is more often associated with genital herpes. Dr.T.V.Rao MD

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Infections in Humans.( Herpes Simplex 1 and 2 )‫‏‬ • • • •

Wide spread in Humans Broad Host Ranges. Replicate in Many types of Cells. Produce cytolytic effects

• Most Common Diseases. • Gingival stomatitis, Keratoconjunctivitis • Encephalitis Genital diseases, • New Born Infections, Latent Infections in Nerve Cells, • Recurrence. Dr.T.V.Rao MD

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HERPES SIMPLEX VIRUS (HSV) • HSV 1 infect the upper part of the body - mouth and the face • HSV 2 infect the lower part of the body - genital infections • There is little cross protection • Therefore, one can get both the infections Dr.T.V.Rao MD

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Properties of Herpes Simplex Viruses Type 1 and 2 • • • • •

Similar in Organization Restriction Enzyme Differentiates H S V 1 with Saliva. H S V 2 Sexual Maternal infection ( Genital Infection spreads to New Born )‫‏‬ • Replicates in 8-16 hours. Dr.T.V.Rao MD

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Out characters of Herpes group of viruses • Out standing characters • 1 Encode many enzymes • Latent infections are common • Persist indefinitely in infected hosts. • Frequent reactivation in infected hosts • Some care cancer causing.

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HSV 1 differs from HSV 2 •

HSV 1

• Monoclonals differs • On CAM HSV 2 larger pocks • Replicate well on Chick embryo fibroblast • More neurovirulent • Type 2 strains are more antiviral resistant • Restriction endonulease analysis diffentiates

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HSV 2

• Monoclonal's differentiate • Smaller • No • Lesser • Lesser

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Virus Grows in the following. • • • •

Primary and Continues Cell lines. Monkey and Rabbit Kidney, Human Amnion Syncytial formation and Giant cell formations • Multiplies in Chorio Allontoic membrane • Monoclonal Antibodies differentiates Type 1 and 2 types. Dr.T.V.Rao MD

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Sources of infection - Saliva - Skin lesions Oropharyngeal lesions - Carriers Dr.T.V.Rao MD

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Pathogenesis. • Most Common Human Viral Infection • Causes catalytic effect causes the necrosis of cells. • Infects Skin and Mucous membrane • Cowdry type A inclusions are produced • Multinucleated Giant cells are demonstrated Dr.T.V.Rao MD

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Pathogenesis Entry by skin or mucous membranes viral multiplication

sensory nerve

lysis of cells

root ganglia

vesicles

latency REACTIVATION

ulcers

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COLD FEVER SURGERY UNKNOWN 25

Transmission • • • • • • • •

Close Skin and epithelial , Defects in Mucosal membrane Multiples Locally, Enters through cutaneous nervefibers Intraaxonally to Ganglion Centrifugal Migration Recurrent manifestation in Skin and Mucosa. Dr.T.V.Rao MD

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Predisposition of Latent Infection in • Ganglion • Trigeminal HSV 1 • Sacral HSV 2 • Immunity. • Cell Mediated ( CMI )‫‏‬ • Predisposing Factors Axonal Injury Physical and Emotional stress U V light 80% Adults harbour Antibodies to HSV

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Clinical Manifestations • Oropharyngeal Disease Buccal Gingival Mucosa Incubation 3 to 5 days • May last for 2-3 weeks • Gingvo stomatitis Sub mandibular lymphadenopathy • Present with painful ulcers. Dr.T.V.Rao MD

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Recurrent Blisters in Herpes simplex 1

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Herpes lesions in the oral cavity

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Eye Infections and Genital Infections. • Corneal ulcerations pacifications • Blindness • Vesiculo ulcerative Lesions penis, Cervix, Vulva and Vagina. Manifest with Painful lesions.

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Herpes simplex 1 infecting eye

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Herpes 2 producing Genital Lesions

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Skin Infections • Infect abrasions • Dentists, ( Herpetic Whitlow) Health care workers, • Eczema , Burns

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Neonatal Herpes. • • • •

In Uterus At Birth After Birth. Delivery By Caesarean Section Reduces the Infection Dr.T.V.Rao MD

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Neonatal Infection – Normal delivery

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Other Manifestations. • Meningitis, • Encephalitis • Multi organ Involvement • Increased incidence in Immune compromised AIDS, • Haematological Malignancies. Dr.T.V.Rao MD

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Recurrent infections in HSV 1 and 2

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Immunity • Mothers Ig G protects for 6 months. • Primarily Ig M Later Ig g produced. Main Participants in Immunity. C M I and Killer Cells and Interferon play major role in immunity Dr.T.V.Rao MD

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Laboratory Diagnosis • Microscopy, • Antigen Detection • DNA detection PCR. • Viral Isolation. • Serology Dr.T.V.Rao MD

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Microscopy, • Tzanck Smear • Intranuclear Type A Inclusion Bodies • Electron Microscopy • Fluorescent Antibody

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Specimens for Diagnosis.

•Saliva. •CSF •Vesicle fluid. Dr.T.V.Rao MD

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Viral Isolation • Chick embryo • In Tissue Cultures Primary Embryonic Kidney Human Amnion Dr.T.V.Rao MD

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Serology, • ELISA Test • Neutralization Tests • Complement

Fixation Tests Dr.T.V.Rao MD

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Chemotherapy • Idoxuridine used topically in eye and skin infections – first successful antiviral agent. • Acyclovir and vidarabine helps in systemic infections • Other Drugs – Valaciclovir, Famiciclovir, • Orally effective • Foscarnet. Dr.T.V.Rao MD

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Epidemiology. • • • • • • • •

World Wide Distribution HSV 1 early in life 6 months to 3 years. 70% to 90% Adults have Antibodies Poor Living Conditions HSV 2 Sexually transmitted. Risk to mother and foetus Abortions < 20 weeks gestation HSV 2 increases predisposition to HIV infection Dr.T.V.Rao MD

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• Programme Created by Dr.T.V.Rao MD for Medical and Paramedical Students for Global education on Infectious Diseases • Email • [email protected] Dr.T.V.Rao MD

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