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MedicalVirology PDF
MedicalVirology PDF
Viral replication
Adsorption: attachment of virus to host cell receptor.
Penetration: Virus enters host cell by direct penetration, endocytosis (entering in a vacuole), or fusion with cell membrane.
Uncoating: Loss of capsid. Genome enters cytoplasm most RNA viruses) or nucleus (most DNA viruses).
Eclipse/synthesis: Eclipse: several hours during which virions cant be detected. Synthesis: mRNA is produced. Directs synthesis of viral
particles.
Maturation/release: Genetic material assembled into protein coat. Virions migrate to cytoplasmic membrane. Released by
budding off, leaking out, or lysing host cell with enzymes.
Adenovirus Adenovirus serotypes 1-489 Respiratory, urinary tract, GI, & eye infections
Flavivirus Arboviruses (yellow fever virus, St. Louis Yellow fever, St. Louis encephalitis, dengue fever,
encephalitis virus, dengue virus, West West Nile virus infection
Nile virus)
Hepatitis C virus (HCV) Hepatitis C
Orthomyxoviruses Influenza A, B, & C Influenza
Paramyxovirus Measles virus Measles (rubeola)
Mumps virus Mumps
Parainfluenza virus RTI in children
Respiratory syncytial virus (RSV) RTI in infants, elderly, immunocompromised
Human metapneumovirus (HMPV) RTI
Picornavirus Enteroviruses (polioviruses, oxsackieviruses Polio, hand-foot-mouth disease, aseptic
A & B, echoviruses, enteroviruses) meningitis, others
Hepatitis A virus (HAV) Hepatitis A
Rhinovirus Common cold
Reovirus Rotavirus Most common cause of gastroenteritis in infants
& children
Retrovirus Human immunodeficiency viruses (HIV-1, AIDS
HIV-2)
Human T-lymphotropic viruses (HTLV-1, T-cell leukemia & lymphoma, tropical spastic
HTLV-2) paraparesis
Rhabdovirus Rabies virus Rabies
Togavirus Rubella virus Rubella (German measles)
Eastern, Western, & Venezuelan equine Eastern, Western, & Venezuelan encephalitis
encephalitis viruses
COMMON VIRUSES BY SITE
SITE OF INFECTION SPECIMENS COMMON VIRUSES
Centro nervous system CSF, throat swab, stool, brain tissue, blood Enterovirus, HSV, arbovirus
Genital tract Genital swab, vesicle swab or fluid, lesion HSV, HPV
biopsy
GI tract Stool, rectal swab Adults: noroviruses, adenoviruses, enteroviruses.
Infants/children: rotavirus, adenoviruses
Respiratory tract Nasal aspirate, throat swab, nasopharyngeal Influenza A & B, parainfluenza virus, adenoviruses,
swab, bronchoalveolar lavage, lung biopsy RSV, HMPV, rhinovirus, enteroviruses
Skin Vesicle fluid or scrapings HSV, VZV, measles, rubella, enterovirus, parvovirus
B19
Urinary tract Urine Adenovirus, HSV, CMV
Deliver immediately. If not possible, keep at 28C & deliver within 2 hr.
Transport
Exception: Keep whole blood at room temp.
Best to process upon arrival. If not possible, hold at 28C for up to 48 hr. >48
Storage hr, freeze at 70C.
(Not recommended.)
CELL CULTURES
CELL LINE DEERIVATION EXAMPLE FOR ISOLATION OF
Cells from mammalian tissue Primary monkey kidney (PMK) Influenza viruses,
parainfluenza viruses,
enteroviruses
Primary
Rabbit kidney Herpes simplex virus
Human embryonic kidney Adenovirus, enteroviruses
Cultures of connective tissue Human neonatal lung (HNL) CMV (only type of cell
cells culture that can be used)
Finite (diploid)
Fibroblasts (e.g. MRC-5, WI-38) VZV, HSV, rhinovirus,
enteroviruses (some),
adenovirus, RSV
HEp-2 RSV, adenovirus, HSV,
parainfluenza viruses (some),
enteroviruses (some)
A549 HSV, adenovirus,
Continuous (immortal, Malignant or transformed
enteroviruses
heteroploid) cells
MDCK Influenza viruses
LLC-MK2 Parainfluenza viruses, hMPV
Rhabdosarcoma (RD) Echovirus
Buffalo green monkey Coxsackieviruses
No single cell type grows all viruses. Several types should be inoculated.
Antigen detection
Fluorescent antibody staining
widely used to detect cell-associated viral antigens.
main applications is to detect respiratory, ocular, cutaneous, and bloodstream pathogens
major limitation is having an adequate number of cells in the specimen
EIA
versatile and widely used method that can be applied to the detection of antigens, regardless of whether they are cell
associated or in fluid phase
Advantages include applicability to diverse specimens and potential for automation
HEPATITIS VIRUS
Characteristics of Hepatitis
HIV
derived from primate lentivirus
illness (AIDS) first described in 1981
isolated in 1983
Properties of HIV:
retrovirus, member of the family of Lentivirus genus
unique morphologic characteristic of HIV is a cylindrical nucleoid in the mature virion
contain the four genes required for a replicating retrovirusgag, pro, pol, and envand follow the general pattern for
retrovirus replication
LABORATORY DIAGNOSIS
PCR amplification techniques are commonly used for detection of virus in clinical specimens.
Serology
Test kits commercially available for measuring antibodies by EIA
Most widely used confirmatory assay Western Blot
High titers of HIV are found in two body fluidsblood and semen
Ab against the Gag proteins (p17, p24, p55) appear earliest in the course of HIV-1infection, but decrease in titer with
progression of HIV-1 disease,
Antibodies to envelope (gp160 or gp120/gp41) usually persist even in advanced stages of HIV-1 disease
Prep. By: Terence Eday, RMT, MT(ASCPi), MPH for Minds Review Center