Chapter 24 Human Herpes Virus (HHV) 人类疱疹病毒

Outline Classification of herpesviruses Characteristics of herpesviruses Quick diagnosis of herpesviruses

1.Classification α-herpesviruses  -herpesviruses  -herpesviruses (P310 Table 24-1) HHV-1(HSV-1) HHV-2(HSV-2) HHV-3(VZV) α-herpesviruses HHV-5(CMV) HHV-6 HHV-7  -herpesviruses  -herpesviruses HHV-4(EBV) HHV-8

2.Characteristics  Shape and structure tegument Linear ds-DNA Glycoprotein spike 162 capsomeres Envelope tegument 120-130nm in diameter Cubic nucleocapsid Linear ds-DNA

 Cultivation human diploid cells and produce cytopathic effect ---- replicate in intranuclear of human diploid cells and produce cytopathic effect (except EBV) typical CPE: • intranuclear acidophilic inclusion body • cell fusion form multinuclear giant cells 核内嗜酸性包涵体 细胞融合形成多核巨细胞

 Pathogenicity • transmission (by many different routes) • infectious mode of virus on host cells proliferative latent infection infection activate • common infectious types *subclinical infection *primary infection and latent infection *congenital infection *integrative infection 人普遍易感,感染后大多无明显症状

3.Quick diagnosis Finding inclusion body Detection of viral Ag and specific Ab Detection of viral DNA (CMV) (HSV,CMV,EBV)

1.Serotype :HSV-1 and HSV-2 2.Pathogenicity Herpes Simplex Virus 1.Serotype :HSV-1 and HSV-2 2.Pathogenicity  Source of infection  Route of transmission  HSV-infection 病人和健康带毒者 • by direct contact • by sexual contact HSV-1:主要是直接密切接触, 也有性接触传播 HSV-2:性接触传播为主

• Latent and recurrent infection  HSV-infection 大多无明显症状或出现局部疱疹 • Primary infection (HSV-1, HSV-2) • Latent and recurrent infection primary infection latent infection (site of latency) HSV-1---三叉神经节 HSV-2---骶神经节 (reactivation of latent virus) (anew) recurrent infection 复发性局部疱疹 • Congenital and newborn infection • Associated with cancer HSV1---唇癌 HSV2---宫颈癌

Coldsore or fever blisters (唇疱疹或热性疱疹)

Varicella-Zoster Virus (VZV)  Single serotype  Route of transmission 通过飞沫和直接接触传播  Primary infection • varicella (chidren) • pneumonia (adults) 孕妇患水痘易致胎儿畸形、流产或死产 单侧成簇性水疱群沿神经支配的皮肤排列呈带状，伴有神经痛 Recurrent infection --- zoster(adults)

3.Pathogenicity 1.Species-specific 2.Cultivation Cytomegalovirus (CMV) HCMV只能感染人,只能 在人成纤维细胞中增殖 2.Cultivation (slow growth, typical CPE) 3.Pathogenicity 细胞肿胀、核变大,形成巨大细胞,核内有“猫头鹰眼” 的嗜酸性包涵体  Primary infection （usually asymptomatic infection） →latent infection (site of latent)  Route of transmission (transmitted by a variety of route)

potential •Vertical transmission congenital infection *隐性感染 *巨细胞包涵体病(CID) *流产、早产或死胎 *先天性畸形/出生后异常 congenital infection perinatal infection (耳聋和智力障碍) 经产道感染(围生期感染) • Horizontal transmission *by transfusion → post-transfusion mono-nucleosis and hepatitis *by close contact and sexual contact *patients with impaired immune function → activation of latent virus 肺炎/视网膜炎/食管炎等 • Cell transformation & oncogenic potential 致癌潜能

1.Specific antigen of EBV Epstein-Barr Virus (EBV) 1.Specific antigen of EBV  Expressive antigen in lentant infection (EBNA and LMP)  Antigen associated with proliferative infection ( VCA, EA and MA) 中和抗原

2. Infectious mode in B cell （嗜B细胞的人疱疹病毒，主要侵犯B细胞） Proliferative infection Non-proliferative infection →细胞溶解死亡 •lentant infection •malignant transformation proliferative infection activate →恶性肿瘤细胞

3. Pathogenicity  Route of transmission  EBV & human disease 主要通过唾液传播  EBV & human disease • primary infection *asymptomatic *infectious mononucleosis (puberty) • diseases associated with EBV- infection *Burkitt lymphoma (BL) *nasopharyngeal carcinoma(鼻咽癌)

infectious mononucleosis （传染性单核细胞增多症） * positive-heterophil antibody (80%~90%) abnormal lymphocyte 异嗜性抗体阳性 * positive EBV-specific antibody EB病毒的特异性抗体阳性 * abnormal lymphocytes↑(10%~20%) 与CMV感染引起的输血后传染性单核细胞增多症不同(两种抗体均阴性)