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34 - Herpesvirus infections

Published online by Cambridge University Press:  23 December 2009

By
Richard M. Rutstein  and
Stuart E. Starr
Edited by
Steven L. Zeichner  and
Jennifer S. Read
Richard M. Rutstein
Affiliation:
Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA
Stuart E. Starr
Affiliation:
(Formerly): Division of Allergy, Immunologic and Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA
Steven L. Zeichner
Affiliation:
National Cancer Institute, Bethesda, Maryland
Jennifer S. Read
Affiliation:
National Institutes of Health, Bethesda, Maryland
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Summary

Introduction

Herpesviruses share a common structure: double-stranded DNA, surrounded by a protein capsid and a lipid and glycoprotein envelope. Primary infection typically occurs during childhood or early adult years. Beyond neonates, infection rarely results in serious illness in immunocompetent hosts. Herpesvirus infections are usually controlled by the cellular immune system (see Chapter 1): immunocompromised patients can develop serious, life-threatening herpesvirus infections. In normal hosts herpesviruses establish lifelong, latent infection, which may reactivate. Sites harboring latent infection are sensory autonomic ganglia, for herpes simplex virus (HSV) and varicella-zoster virus (VZV); for cytomegalovirus (CMV), Epstein–Barr virus (EBV) and human herpesvirus 6 (HHV-6), lymphocytes are latent reservoirs. A complex interplay exists between herpesviruses and HIV [1]. In some in vitro systems, infection with CMV or HSV may increase susceptibility of cells to HIV infection. In HIV-infected cells, infection with CMV or HSV can upregulate HIV expression. Co-infection with HIV and CMV enhances CMV replication.

In immunocompromised hosts, primary herpesviruse infections may be more severe than in healthy children. Reactivation infections occur more frequently and severely in HIV-infected children. CMV, HSV, VZV, and Epstein–Barr virus (EBV), HHV-6, and human herpesvirus-8 (HHV-8 or Kaposi's sarcoma-associated herpesvirus, KSHV) cause significant morbidity in HIV-infected individuals.

Cytomegalovirus (CMV)

Epidemiology

CMV is transmitted via blood, urine, saliva, tears, breast milk, stool, and genital secretions. CMV may be transmitted in utero, perinatally, or postnatally. In children, infection usually occurs through saliva or urine. In young adulthood, CMV seropositivity rates rise secondary to sexual activity.

Type
Chapter
Information
Handbook of Pediatric HIV Care , pp. 721 - 739
Publisher: Cambridge University Press
Print publication year: 2006

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  • Herpesvirus infections
    • By Richard M. Rutstein, Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, Stuart E. Starr, (Formerly): Division of Allergy, Immunologic and Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA
  • Edited by Steven L. Zeichner, National Cancer Institute, Bethesda, Maryland, Jennifer S. Read
  • Book: Handbook of Pediatric HIV Care
  • Online publication: 23 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544781.036
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  • Herpesvirus infections
    • By Richard M. Rutstein, Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, Stuart E. Starr, (Formerly): Division of Allergy, Immunologic and Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA
  • Edited by Steven L. Zeichner, National Cancer Institute, Bethesda, Maryland, Jennifer S. Read
  • Book: Handbook of Pediatric HIV Care
  • Online publication: 23 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544781.036
Available formats
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To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Herpesvirus infections
    • By Richard M. Rutstein, Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, Stuart E. Starr, (Formerly): Division of Allergy, Immunologic and Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA
  • Edited by Steven L. Zeichner, National Cancer Institute, Bethesda, Maryland, Jennifer S. Read
  • Book: Handbook of Pediatric HIV Care
  • Online publication: 23 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544781.036
Available formats
×