Herpes virus Infections

Department of Pediatric Dentistry
Lutheran Medical Center

Name: Craig Elice Date: February 26, 2010
Article title: Herpes virus Infections
Author(s): Greenberg MS.
Journal: Dental Clinics of North America
Volume (number): 40:2 pages 359-368
Month, Year: April 1996
Major topic: summary of herpes viruses
Type of Article: Review of Literature
Main Purpose: The article provided an overview of the herpes viruses that infect human beings.
Of the 80 known viruses, only 7 Herpes viruses infect humans: HSV I and 2, Varicella Zoster (VSV), Cytomegalovirus (CMV), Epstein- Barr (EBV), HHV 6 and HHV 7. Characteristics that they share include: All viruses cause a primary infection upon first patient exposure and become latent within nuclei of certain body cells for the life of the patient. HSV I, 2, and VZV become dormant in sensory nerve ganglia, CMV in lymphocytes and salivary glands, EB in B-lymphocytes and salivary gland tissues, HHV 6 and 7 in CD4 lymphocytes. They recur as localized symptomatic or asymptomatic recurrent infection., Are transmitted by direct contact via saliva or genital secretions. The EBV can transform cells into maligniancy like nasopharyngeal carcinoma Burkitts lymphomaor B cell lymphoma. HSV 1 and 2: HSV 1 is primarily transmitted by saliva and causes most oral, pharyngeal, eye and CNS infections, while HSV 2 is transmitted by genital secretions and casues genital and anal infections. The incidence of primary infections for HSV 1 is after 6 months of age and peakes between 2-3 years of age. Primary infections are often subclinical but can be characterized by fever, chills, nausea, and lymphadenopathy and followed in 1-2 days by vesicles and ulcers of oral tissues and gingivitis. 20-40% of patients develop recurrent infections which are activated by local trauma or systemic fever or menstrual cycle. Diagnosis is made clinically but viral culture and cytology smears and serology can confirm the diagnosis. CMV is mostly asymptomatic in humans except as a congenital infection called Cytomegalovirus inclusion disease. It is transmitted via birth canal secretions, breast milk, saliva in young children, contaminated blood transfusions, and sexual contact. It is a cause of disease in immunocompromised patients like transplant and AIDs patients. Diagnosis is made by histopathologic studies sowing enlarged owl eye cells. VSV: In 0.3-0.5% of the infected patients, the virus becomes activated presenting as herpes zoster. C-3, T-5, L-1 and 2, are the nerves tracts most commonly infected, but can infect the trigeminal. The symptoms include pain, tenderness and paresthsia along the course of the infected nerve which often precedes vesicles. These vesicles along the nerve tract are a diagnostic sign. In immunocompromised patients, the disease can be life threatening. Acyclovir is effective in shortening the duration and accelerates healing. EBV: Although mild in children, in adolescents and young adults, it can lead to infective mononucleosis. Mono has an incubation period of up to 8 weeks and presents as fever, malaise, pharyngitis, and lymphadenopathy. Diagnosis is based on clinical signs and detection of large lymphocytes in the peripheral blood. Oral lesions include hairy leukoplakia HHV 6: The virus infects CD$ lymphocytes and other white blood cells causing roseola which is self limiting. HHV 7: Usually transmitted by saliva and is found in 80% of adults and 70% if children. NO clinical disorder have been associated with it.
Key points/Summary: Describes 7 human herpes viruses.
Assessment of article: Good article but may need an update.