DNA VIRUSES

DNA Viruses!

All replicate in the nucleus except

POXVIRUS which replicates in cytoplasm.

All are double-stranded except

PARVOVIRUS which is single-stranded.
This Photo by Unknown Author is licensed under CC BY-SA
Hepadnaviridae
HEPATITIS B virus
dsDNA, enveloped
• Transmission: via needles, sexual contact, across
placenta
• Incubation period: 70-100 days
• Disease: Hepatitis can be acute
or chronic (a carrier) which may
progress to cause hepatic cancer
• Treatment: Antivirals
(Lamivudine, Adefovir,
Telbivudine, Entecavir) Interferon
alpha
• Prevention: Hepatitis B vaccine
Hepatitis B – terminology and
Markers
HBsAg
- surface antigen
-Found during acute disease and persistent
infections
-Presence of HBsAg past 6 months indicates chronic
infection
HBsAb
-antibody to the surface antigen
-Provides immunity to HBV
Hepatitis B – terminology and Markers

HBcAg
-HBV core antigen
-HBcAb
- Antibody to the HBV core antigen
- First antibody to appear
- IgM antibody to core is important test in
screening for recent infection
 What is
hepatitis?
• Liver inflammation
• Signs and symptoms:
• symptoms may occur years after
• Diagnosis: initial infection
Initial diagnosis • jaundice, abdominal pain, fatigue,
includes observation of nausea, vomiting, appetite loss
jaundice, enlarged • host immune response responsible
liver, or fluid in the for much of the liver damage
abdomen
Serological testing
(tests for the surface
antigen) in the blood
OR test for antibodies
formed against
Hepatitis B virus
antigens
Herpesvirdae:
dsDNA, enveloped
• HSV 1 – Oral lesions, affects brain and eyes
• HSV 2 – Genital lesions
• HHV 3 – Varicella Zoster Virus (chicken pox, shingles)
• HHV 4 – Epstein Barr Virus (mononucleosis, Burkitt’s lymphoma)
• HHV 5 – Cytomegalovirus (in immunosuppressed)
• HHV 6 – Roseola
• HHV 8 – Kaposi Sarcoma
 HSV-1
Herpes simplex virus 1
• Infection often in infancy
• Transmission: oral, respiratory
• Remains latent in trigeminal ganglia
• Lab studies: Tzanck smear
• Treatment: Acyclovir
• recurrence triggered by:
• excessive UV exposure
• emotional stress
• hormonal changes
(menstruation)

• complications:
– herpetic keratitis (cornea)
– herpes encephalitis (brain)
Tzanck Smear
HSV-2
• Herpes Simplex Virus 2 – Genital
herpes
• Incubation: ~1 week
• Symptoms in both males and females:
• primary vesicular lesions which break
down to form painful ulcers
• burning, painful urination
• most infectious when lesions present
 HSV-2
• Latency in sacral ganglia
• Recurrences triggered by: menstruation, emotional
stress, illness, fever
• Complications:
• neonatal herpes: can cross placental barrier, or
transmitted to baby coming through birth canal
• spontaneous abortion; mental retardation, vision and
hearing damage
• Encephalitis
• Ophthalmic herpes
• Whitlow

• Lab studies: Tzanck smear

• Treatment: Acyclovir, Valacyclovir
HHV-3
Varicella-Zoster virus (VZV)
• Transmitted: via respiratory route
• Initial infection induces immunity, enters latency
• More serious if infected at adult-age
• Symptoms: Chickenpox
• malaise, fever begins prior to rash
• Rash is mostly on face and trunk
• maculopapular then vesicular
• lesions form crust, which co-exist with
new lesions
• may involve mucous membranes
• contagious: 48 hrs before rash until all
lesions are crusted
• Treatment: acyclovir
• Prevention: vaccine available
Latency

• latent varicella-zoster: dorsal

root ganglion (near spine)
• Recurrence of chickenpox:
shingles
• Herpes Zoster Ophthalmicus
• Latent HSV-1: trigeminal nerve
ganglia (face-CNS)
• cold sores
• Latent HSV-2: sacral nerve
ganglia (base of spine)
• genital herpes
 HHV 4
Epstein-Barr Virus
• incubation 4-7 weeks
• EBV multiplies within B cells
• Transmission: often acquired during childhood/adolescence: kissing disease
(saliva, blood, semen)
• Disease: Infectious mononucleosis (“mono”)
• Symptoms: sore throat, fever, swollen neck lymph nodes, general weakness
- usually self-limiting, infection = immunity
- Heterophile positive mononucleosis
- death may be caused by splenic rupture
during vigorous activity
• Lab Studies: peripheral blood smear
shows atypical lymphocytes.
Positive monospot test.
• Treatment: Self-limiting (after a month)
2) Burkitt’s Lymphoma
• EBV isolated from tumors of
Burkitt’s lymphoma
• Most commonly turns
malignant in patients who
become infected with EBV
whom are HIV +
• EBV has oncogene properties
(gene named c-myc), this
drives cell growth in large
quantities causing cancer
• Treat with chemotherapy
 HHV 5
Cytomegalovirus:
• Transmission: body fluids: saliva, semen,
breast milk, kissing, sexual contact, transfused
blood, transplanted tissue
• CMV remains latent in leukocytes
• infected cells have distinct ‘inclusion
bodies’, visible by microscopy called owl’s
eye inclusions
• the infected cells swell (cyto=cell,
megaly=enlargement)
• CMV is a common opportunistic pathogen
• Normally present in people but
reactivates when host becomes
immunocompromised
Cytomegalovirus (CMV)
• Disease: primary CMV infection during
pregnancy (crosses placenta)
• serious damage to fetus can result
• severe mental retardation, hearing loss, enlarged liver
and spleen (hepatosplenomegaly)
- Other infections by CMV: pneumonia,
mononucleosis (negative monospot), retinitis,
esophagitis
• Lab studies: owl’s eye inclusions
• Treatment: gangciclovir in immuno-
• compromised
Retinitis

Owl Eye
Inclusion
Congenital CMV infection
 HHV 6
Roseola
• Transmission: respiratory droplets

• Symptoms: runny nose, a sore throat, and a cough, along with (or
followed by) a high fever (39.4 ºC). About three to five days after the
fever subsides, a maculopapular rash may begin to appear on the
chest and abdomen and can spread. NOT VESICULAR RASH.

• Diagnosis: clinical diagnosis

• Treatment: Self-limiting

High
fever

Full body
rash
 HHV 8
Kaposi's sarcoma-associated
herpesvirus
• Transmission: through sexual
contact
• Purple red (portwine) raised
lesions
• Disease: Kaposi’s Sarcoma
(Cancer of endothelial cells
causing blood vessels proliferate)

• Seen in HIV/AIDS & transplant patients

• Treatment: Radiation & chemotherapy
 Adenoviridae
dsDNA, non-enveloped
• Transmission: direct contact,
respiratory, fecal-oral route
• Diseases caused by
Adenovirus
• Diseases: pharyngitis,
conjunctivitis (non-purulent),
pneumonia, acute
hemorrhagic cystitis
• Treatment: Self-limiting
Diseases caused by
Adenovirus
Serotypes are associated with specific
syndromes
- type 3, 4, 7, 21 respiratory diseases
- 8 and 19-> keratoconjunctivitis
- 11 and 21-> hemorrhagic cystitis
- 40 and 41 infantile gastroenteritis (2nd
leading cause after Rota virus)
 Poxviridae
dsDNA, enveloped
• Transmission: respiratory droplets,
direct contact

• Disease: smallpox (rash with flu-like

symptoms), molluscum contagiosum
(causes epidermal growth – flesh
colored dome with central
umbilicated dimple)

• Treatment: self-limiting, cryotherapy

for molluscum lesions
Papillomaviridae
Human Papillomavirus
dsDNA, non-eneveloped
• Transmitted: direct contact
• 200 strains of HPV found, 14 of these strains
are oncogenic
• Diseases: common warts, anogenital warts
(type 6 & 11), Cervical cancer (type 16,
18, 30’s) – these inactive tumor suppressor
genes (p53 and Rb), oropharyngeal
cancer, anal cancer, vaginal cancer,
vulvar cancer, and penile cancer.
 HPV
• Lab studies:
koilocytic cells seen
on pap smear
• Treatment:
cryotherapy
• Prevention:
VACCINE protects
against type 6, 11,
16, 18
 Polyomaviridae
dsDNA, non-enveloped
• Transmission: respiratory
• Diseases: JC virus
causes Progressive
multifocal
leukoencephalopathy
(PML) in HIV patients
which damages white
matter in CNS.
• Treatment: supportive
only
 Parvoviridae
ssDNA, non-enveloped
• Transmitted:
respiratory droplets,
placenta
• Parvovirus enters
progenitor This Photo by Unknown Author is licensed undr CC BY

erythrocytes, replicate
and lyse them
afterwards
 Parvovirus
• Diseases: caused by Parvovirus
B19
 Fifths Disease/Erythema
Infectiosum (cold-like
symptoms followed by
“slapped-cheek face
rash” in children which
then spreads); Adults
experience joint pain and
swelling with no rash
 Hydrops Fetalis: in
pregnant women, RBC
destruction & inhibition of
RBC formation, leads to
death of fetus.
 Anemia in sickle cell
patients.
• Treatment: self-limiting