#11 Chua, Jessika Iza A. #12 Concepcion, Christine Keith M. #21 Endaya, Darnellie ae M. 2A!

" Class I# ds D$A "erpes%iruses# "erpes si&ple' %irus Characteristics# En%eloped, icosahedral particles () n& in dia&eter Clinical i&portance# "*+1 in,ects oral &e&-ranes in children. /()0 are in,ected -y adolescence. ollo1in2 the pri&ary in,ection the indi%idual retains the "*+1 D$A in the tri2e&inal ner%e 2an2lion ,or li,e and has a 3)0 chance o, de%elopin2 4cold sores5. "*+2 is responsi-le ,or recurrent 2enital herpes. !atho2enicity# A. !ri&ary In,ection 6 Man is the only natural host to "*+. 7he %irus is spread -y contact. 7he usual site ,or the i&plantation is skin or &ucous &e&-rane. 7he inter&ediate and -asal under2o acantholysis leadin2 to %esicle ,or&ation. In &ucous &e&-ranes, the roo, o, the %esicle is unsa,e and soon collapses to ,or& a characteristic herpetic ulcer. Durin2 the pri&ary in,ection, "*+ spreads locally and a short6li%ed %irae&ia occurs, 1here-y the %irus is disse&inated in the -ody. In &ost cases, the seedlin2s co&e to nau2ht, unless spread to the -rain occurs. Most i&portantly is the spread o, the %irus to the craniospinal 2an2lia. 8. 9atency 6 "*+ is a-le to escape the i&&une response and persists inde,initely in a latent state in certain tissues. Appropriate techni:ues re%eal %irus in 3)0 o, nor&al hu&an tri2e&inal 2an2lia and, to a lesser e'tent, in cer%ical, sacral and %a2al 2an2lia. 7his is irrespecti%e o, the person;s herpetic history. 7he e'act &echanis& o, latency o, the %irus is unkno1n, it &ay either -e .6 <i= true latency 6 the %irus is non6 replicati%e and is &aintained 1ithin the cell either inte2ration into the cellular chro&oso&e or in an episo&al ,or&. <ii= %irus persistence 6 this is -est descri-ed as dyna&ic latency, 1here-y there is a ti2htly controlled lo1 2rade producti%e %irus in,ection not leadin2 to the lysis o, the cell. C. >eacti%ation 6 It is 1ell kno1n that &any tri22ers can pro%oke a recurrence. 7hese include. <1= *tress 6 physical or psycholo2ical <2= pneu&ococcal in,ection <?= &enin2ococcal in,ection <@= ,e%er <3= irradiation, includin2 sunli2ht <A= &enstruation <B= others. 7he &echanis& o, reacti%ation is still uncertain, the source

o, the %irus is in the craniospinal 2an2lion responsi-le ,or the inner%ation o, the location o, the recurrence. *e%eral &odels o, reacti%ation are proposed 1hich depends on the static and dyna&ic latency theories. Class III# ds >$A My'o%iruses# In,luenza %irus Characteristics# En%eloped particles, 1))n& in dia&eter 1ith a helically sy&&etric capsid. hae&&a2lutinin and neura&inidase spikes proCect ,ro& the en%elope. Clinical i&portance# 7hese %iruses are capa-le o, e'tensi%e anti2enic %ariation, producin2 ne1 types a2ainst 1hich the hu&an population does not ha%e e,,ecti%e i&&unity. 7hese ne1 anti2enic type can cause pande&ics o, in,luenza. In natural in,ections the %irus only &ultiplies in the cells linin2 the upper respiratory tract. 7he constitutional sy&pto&s o, in,luenza are pro-a-ly -rou2ht a-out -y a-sorption o, to'ic -reakdo1n products ,ro& dyin2 cells on the respiratory epitheliu&. !atho2enicity# +irus in,ection is spread %ia respiratory droplets. 7he %irus particles -inds to cells o, the respiratory epitheliu& 1hich are rich in %iral receptors. $eura&inidase present on the %irus particles aid the in,ectious process -y releasin2 %irus particles 1hich ha%e -een -ound -y the &ucous present on the sur,ace o, epithelial cells. 8ecause o, the 2eneralized sy&pto&s present, %irae&ic spread ,or& the respiratory tract has -een suspected, althou2h there is no conclusi%e e%idence. Class I+# ss >$A D !ositi%e !icorna%iruses# !olio%irus Characteristics# $aked icosahedral particles 2(n& in dia&eter Clinical i&portance# Ene o, a 2roup o, entero%iruses co&&on in the 2ut o, hu&ans. 7he pri&ary site o, &ultiplication is the ly&phoid tissue o, the ali&entary tract. Enly rarely do they cause syste&ic in,ections or serious neurolo2ical conditions like encephalitis or polio&yelitis. !atho2enicity# !olio is an interestin2 disease in that F)6F30 o, those 1ho -eco&e in,ected re&ain asy&pto&atic, allo1in2 the %irus to circulate silently throu2hout a co&&unity -e,ore an apparent case o, paralytic polio is seen. I, the polio%irus ne%er e'tends -eyond the s&all intestine, it does no apparent da&a2e. "o1e%er, it is 1hen the polio%irus enters the -loodstrea& that it tar2ets ner%e cells and -e2ins to do

serious da&a2e. 7he %irus replicates in the ly&ph tissue o, the pharyn' and e'tends to the central ner%ous syste&. 7he %irus tar2ets the &otorneurons o, the anterior horn cells o, the spinal cord and -rainste&. It is its &ultiplication and lytic in,ection o, these neurons that leads to apoptosis o, the a,,ected neuron. 7hese ner%e cells cannot -e re2enerated, and the a,,ected &uscles no lon2er ,unction. 7he &uscles o, the lo1er e'tre&ities are a,,ected &ore o,ten than the upper e'tre&ities. 7he li&-s -eco&e li,eless and ,loppy. In e'tre&e cases, paralysis o, the thora' and a-do&en can lead to :uadriple2ia. In the &ost se%ere cases, the polio%irus attacks the &otor neurons o, the -rain ste&, inhi-itin2 the a-ility to -reak, speak, and s1allo1. 7his ,or& o, paralytic polio is re,erred to as -ul-ar polio&yelitis. !olio &ainly a,,ects youn2er children, -ut the disease can ha%e increasin2ly drastic e,,ects as a2e increases. *e%eral ,actors ha%e -een identi,ied to e'plain 1hy such a s&all percenta2e o, inCections lead to paralysis, includin2 i&&une de,iciency, pre2nancy, tonsillecto&y, inCury, strenuous e'ercise, and intra&uscular inCections. or the re&ainin2 30, &ost su,,er &inor ,e%er and &alaise, and only a-out 10 su,,er a &aCor aseptic &enin2itis phase 1here the &enin2es o, the -rain -eco&es in,la&ed. 7he indi%idual &ay su,,er headache, %o&itin2, ,e%er, and sti,,ness o, the -ack or le2s. 7hese sy&pto&s typically last ,ro& ten to t1o days and are ,ollo1ed -y a co&plete reco%ery. 9ess than 10 o, polio patients, a-out one in t1o hundred in,ections, result in paralysis, -ut the risk o, per&anent da&a2e &ade polio one o, the &ost dreaded childhood diseases o, the 2)th century. 7his paralysis can ran2e ,ro& a sin2le &uscle to the entire -ody, and in e'tre&e cases 1here respiration is i&paired, the use o, arti,icial %entilation is re:uired to i&pro%e the chance o, sur%i%al. 3 to 1)0 o, polio patients die ,ro& the i&&o-ilization o, respiratory &uscles. E, the patients 1ho de%elop paralytic sy&pto&s, a-out 230 sustain se%ere, per&anent disa-ility, another 230 reco%er 1ith only &ild disa-ilities, and 3)0 reco%er co&pletely. !har&aceutically usedGaltered# 7he purpose o, ad&inisterin2 any attenuated, li%e %irus %accine is to sti&ulate the i&&une syste& to produce an acti%e i&&unity -y sti&ulatin2 natural in,ection 1ithout producin2 clinical sy&pto&s o, the disease. 7o acco&plish this 1ith li%e polio%irus %accine, it is necessary ,or the %irus to &ultiply in the

intestinal tract. A pri&ary series o, this %accine is desi2ned to produce an anti-ody response to polio%irus types 1, 2 and ?. 7his i&&une response is co&para-le to that induced -y natural disease. 7he anti-odies thus ,or&ed help protect the indi%idual a2ainst clinical polio&yelitis in,ection -y any one o, the ? types o, polio%irus. 7he i&&une response to !olio%irus +accine 9i%e Eral 7ri%alent <E!+= is si&ilar to that induced -y natural in,ection 1ith polio%irus and includes the de%elop&ent o, secretory anti-ody 1ithin the intestinal tract. 7his is -elie%ed to pre%ent su-se:uent in,ection 1ith H1ildH polio%iruses and their disse&ination -y the ,ecal6oral route to suscepti-le indi%iduals in the co&&unity. E!+ also inter,eres 1ith si&ultaneous in,ection 1ith H1ildH polio%irus and is thus o, particular %alue in the control o, epide&ics. 7he %irus persists in the throat ,or 1 to 2 1eeks. it is e'creted in the ,eces ,or se%eral 1eeks, and, rarely, ,or &ore than 2 &onths. 7his &ay lead to in,ection o, close contacts 1hich is re2arded as lar2ely -ene,icial since it results in protection o, &ore indi%iduals than the nu&-er actually %accinated. In a %ery s&all nu&-er o, in,ected contacts, especially adults, paralytic disease &ay occur. Class +# ss >$A D $e2ati%e !ara&y'o%iruses# Measles %irus Characteristics# En%eloped particles %aria-le in size, 12) D 23) n& in dia&eter, helical capsids Clinical i&portance# +ery co&&on childhood ,e%er, i&&unity is li,elon2 and second attacks are %ery rare. !atho2enicity# Measles ,irst 2ains access to the -ody %ia the upper respiratory tract or the conCuncti%a. 7he %irus :uickly spreads to the i&&ediate ly&ph nodes. Destruction o, the ly&phoid tissues leads to a pro,ound leucopenia. A pri&ary %irae&ia ensues 1hich is responsi-le ,or spreadin2 the %irus throu2hout the rest o, the >6E syste& and the respiratory syste&. A secondary %irae&ia ,ollo1s 1here-y the %irus is ,urther spread to

in%ol%e the skin, the %iscera, kidney and -ladder. 7he Koplik;s spots and the rash in &easles are thou2ht to result ,ro& a delayed hypersensiti%ity reaction, the %irus anti2en -ein2 a-sent ,ro& the lesion itsel,. 1. Acute measles panencephalitis - It is likely that C$* in%ol%e&ent, e%en in unco&plicated &easles, is co&&on. 7ransient EEI a-nor&alities are detected in 3)0 o, patients. Measles %irus is rarely isolated ,ro& the -rain o, a patient 1ith acute &easles panencephalitis. 7here,ore, current theories ,a%our an autoi&&une reaction as the possi-le cause o, C$* da&a2e. 2. Subacute measles encephalitis 6 arise only in patients 1ith se%ere i&&une disorder. 7here,ore it is not usually acco&panied -y the ,or&ation o, anti-odies in the C* . In,ectious %irus has not -een isolated -y con%entional &ethods, su22estin2 de,ects in replication. >ecently -iolo2ical studies on -rain tissue ,ro& a case o, *ME re%ealed that the en%elope proteins 1ere &issin2 ,ro& the -rain tissue and only the $ and the ! protein 1ere consistently detected. ?. SSPE 6 in **!E, the %irus is ,irst thou2ht to 2ain entry to the C$* durin2 the %irae&ia. Ence there, it esta-lishes a lo162rade persistent in,ection. It is not kno1n 1hether %iral replication itsel,, or i&&unopatholo2ical &echanis&s are responsi-le ,or the de%elop&ent o, lesions. In **!E, ,ree in,ectious %irus particles ha%e ne%er -een isolated ,ro& the -rain or the C* , althou2h so&e %iral anti2ens &ay -e ,ound. Iiant cells 1hich are characteristic o, acute &easles in,ection are also a-sent. "o1e%er, %iral nucleocapsids are present in the cytoplas&. 7here,ore, so&e de,ect &ust e'ist in the %irus replication process that pre%ents &aturation. In the a-sence o, ,ree in,ectious particles, the in,ection &ay spread slo1ly -y in,ectious nucleocapsids ,ro& cell to cell. Anti-odies in the C* are oli2oclonal as opposed to the polyclonal response seen in the sera. 7his su22ests that anti-ody in the C* is &ade locally -y a &uch s&aller population o, ly&phocytes 1hich ha%e in%aded this co&part&ent. 7he M6protein is not reco2nized -y the anti-odies present in the C* . **!E -rain lesions ha%e M, $ and ! proteins present in in,ected cells 1hereas the en%elope proteins are &issin2. 7he &easles &>$As

isolated ,ro& **!E patients sho1ed a hi2h rate o, &utations, the hi2hest rate o, &utation in the M 2ene, ,ollo1ed -y the , ", ! and $ 2enes. In so&e cases, in,ectious M+ particles &ay -e reco%ered i, the -rain cells are co6cultured 1ith tissue culture cells suscepti-le to &easles %irus. In other cases thou2h, the -lock is only partially o%erco&e and the a2ent re&ains cell associated. In this case, althou2h M+ en%elope &>$As are present, the en%elope proteins are not synthesized. Another hall&ark o, **!E is the hyperi&&une response to &easles anti2ens that include neutralizin2 anti-odies in the seru& and the C* . In spite o, this, the in,ection cannot -e controlled. CMI is &uch &ore i&portant than the hu&oral response in clearin2 &easles %irus in,ection. 7here is no e%idence to su22est that the CMI is i&paired in patients 1ho de%elop **!E. $atural i&&unity to &easles is kno1n to last at least A3 years. In 1B(1 &easles disappeared ,ro& the aroe islands ,ollo1in2 an epide&ic and 1as not reintroduced until 1(@A. Indi%iduals old enou2h to ha%e e'perienced the disease A3 years pre%iously 1ere still protected. 7his unusual persistence o, i&&unity su22ests that &easles %irus &ay nor&ally persist inside the -ody, possi-ly in ly&phocytes so that i&&unity is resti&ulated ,ro& 1ithin. Class +I# ss >$A 1ith D$A inter&ediate in their 2ro1th >etro%iruses# "I+ Characteristics# Di,,ers ,ro& other retro%iruses in that the core is cone shaped rather than icosahedral Clinical i&portance# "I+ is trans&itted ,ro& person to person %ia -lood or 2enital secretions. 7he principal tar2et ,or the %irus is the CD@J 76ly&phocyte cells. Depletion o, these cells induces i&&unode,iciency. !atho2enicity# 7he pro,ound i&&unosuppression seen in AID* is due to the depletion o, 7@ helper ly&phocytes. In the i&&ediate period ,ollo1in2 e'posure, "I+ is present at a hi2h le%el in the -lood <as detected -y "I+ Anti2en and "I+6>$A assays=. It then settles do1n to a certain lo1 le%el <set6point= durin2 the incu-ation period. Durin2 the incu-ation period, there is a &assi%e turno%er o, CD@ cells, 1here-y CD@ cells killed -y "I+ are replaced e,,iciently. E%entually, the i&&une syste& succu&-s and AID* de%elop 1hen killed CD@ cells can no lon2er -e replaced <1itnessed -y hi2h "I+6>$A,

"I+6Anti2en, and lo1 CD@ counts=. "I+61 "al,69i%es. Acti%ated cells that -eco&e in,ected 1ith "I+ produce %irus i&&ediately and die 1ithin one to t1o days. !roduction o, %irus -y short6li%ed, acti%ated cells accounts ,or the %ast &aCority o, %irus present in the plas&a. 7he ti&e re:uired to co&plete a sin2le "I+ li,e cycle is appro'i&ately 1.3 days. >estin2 cells that -eco&e in,ected produce %irus only a,ter i&&une sti&ulation. these cells ha%e a hal,6li,e o, at least 36A &onths. *o&e cells are in,ected 1ith de,ecti%e %irus that cannot co&plete the %irus li,e6cycle. *uch cells are %ery lon2 li%ed, and ha%e an esti&ated hal,6li,e o, appro'i&ately three to si' &onths. !har&aceutically usedGaltered# 7ypes o, "I+GAID* Antiretro%iral Dru2s. 7here are si' &aCor types o, dru2s used to treat "I+GAID*. Called antiretro%irals -ecause they act a2ainst the retro%irus "I+, these dru2s are 2rouped -y ho1 they inter,ere 1ith steps in "I+ replication <!D =. Entry inhi-itors inter,ere 1ith the %irus; a-ility to -ind to receptors on the outer sur,ace o, the cell it tries to enter. Khen receptor -indin2 ,ails, "I+ cannot in,ect the cell. usion Inhi-itors inter,ere 1ith the %irus5s a-ility to ,use 1ith a cellular &e&-rane, pre%entin2 "I+ ,ro& enterin2 a cell. >e%erse 7ranscriptase Inhi-itors pre%ent the "I+ enzy&e re%erse transcriptase <>7= ,ro& con%ertin2 sin2le6stranded "I+ >$A into dou-le stranded "I+ D$ALa process called re%erse transcription. 7here are t1o types o, >7 inhi-itors# $ucleosideGnucleotide >7 inhi-itors <$>7Is= are ,aulty D$A -uildin2 -locks. Khen one o, these ,aulty -uildin2 -locks is added to a 2ro1in2 "I+ D$A chain, no ,urther correct D$A -uildin2 -locks can -e added on, haltin2 "I+ D$A synthesis. $on6nucleoside >7 inhi-itors <$$>7Is= -ind to >7, inter,erin2 1ith its a-ility to con%ert "I+ >$A into "I+ D$A Inte2rase Inhi-itors -lock the "I+ enzy&e inte2rase, 1hich the %irus uses to inte2rate its 2enetic &aterial into the D$A o, the cell it has

in,ected. !rotease Inhi-itors inter,ere 1ith the "I+ enzy&e called protease, 1hich nor&ally cuts lon2 chains o, "I+ proteins into s&aller indi%idual proteins. Khen protease does not 1ork properly, ne1 %irus particles cannot -e asse&-led. Multi6class Co&-ination !roducts co&-ine "I+ dru2s ,ro& t1o or &ore classes, or types, into a sin2le product. 7o pre%ent strains o, "I+ ,ro& -eco&in2 resistant to a type o, antiretro%iral dru2, healthcare pro%iders reco&&end that people in,ected 1ith "I+ take a co&-ination o, antiretro%iral dru2s in an approach called hi2hly acti%e antiretro%iral therapy <"AA>7=. De%eloped -y $IAID6supported researchers, "AA>7 co&-ines dru2s ,ro& at least t1o di,,erent classes. MNE*7IE$* 1. Khat is the class o, "I+ anti%iral dru2 that inhi-its the action o, an "I+ enzy&e that clea%es t1o precursor proteins into s&aller ,ra2&ents 1hich are needed ,or %iral 2ro1th, in,ecti%ity and replicationO A. usion Inhi-itors 8. !rotease Inhi-itors C. >e%erse 7ranscriptase Inhi-itors Ans1er# 8. !rotease Inhi-itors >ationale# !rotease Inhi-itors -ind to the acti%e site o, o, protease enzy&e and pre%ent the &aturation o, the ne1ly produced %irions so that they re&ain non6in,ectious. 2. Khat kind o, %accine is postponed -y until a,ter 12 &onthsO A. >a-ies +accine 8. Measles +accine C. 7etanus +accine Ans1er# 8. Measles +accine >ationale# 8ecause persistin2 passi%ely re:uired i&&uno2lo-ulins &ay inter,ere 1ith th i&&une response -e,ore 12 &onths. ?. Khat is a neurotropic %irus that displace se%eral i&portant adaptions to the ner%ous syste&O A. "erpes *i&ple' +irus 8. E-ola +irus C. >hino%irus Ans1er# A. "erpes *i&ple' +irus

>ationale# "erpes *i&ple' +irus can -e rationally e'ploited in the desi2n o, 2ene therapy %ectors 1ith re2ard to neurolo2ical applications. It possesses interestin2 ,eature to -e transported retro2radely in neurons and trans,erred across synapses and it is possi-le to take ad%anta2e o, this %irus characteristic to trace neuronal path1ays. @. Khat is the certain type o, cancer cells that the In,luenza +irus could reduceO A. 8reast cancer cells 8. 8rain cancer cells C. !rostrate cancer cells Ans1er# C. !rostrate cancer cells >ationale# In,luenza %irus induces apoptosis in !rostrate cancer cells and sensitize the& to che&otherapeutic dru2s thus &akin2 In,luenza %irus a pro&isin2 tar2et ,or 2ene therapy on !rostrate cancer. 3. Khat are the t1o %accines that &ade a hu2e decrease o, incidences o, paralytic polio and later on eli&inated it throu2hout the Nnites *tatesO A. *alk <inacti%ated= polio %accine and *a-in <oral= polio %accine 8. *alk <acti%ated= polio %accine and *a-in <oral= polio %accine C. *alk <attenuated= polio %accine and *a-in <oral= polio %accine Ans1er# A. *alk <inacti%ated= polio %accine and *a-in <oral= polio %accine >ationale# ollo1in2 licensure *alk <inacti%ated= polio %accine in 1F33, the incidence o, the disease ,ell dra&atically. 7he disease 1as ,urther reduced -y the ad%ent o, the *a-in <oral= polio %accine in 1FA1. 7he last cases o, paralytic polio in the Nnited *tates 1ere in 1FBF.