Clarifications (Long)(was Re: T-helper etc., etc.) 
Author Message
 Clarifications (Long)(was Re: T-helper etc., etc.)

Hello All,

Thanks for all the questions, I hope I can cover all of them to your
satisfaction.

First of all, in my post where I responded to Paul's question about the
immune system and viruses "hiding" I used the example of latency which a
frequent feature of members of the the herpes group viruses.

FYI there are numerous viruses which belong to the herpesvirus family -
each has its own diseases and target tissues for replication. A severly
abridged listing would be:

herpes simplex viruses type 1 and 2 - type one is associated with cold
sores while type 2 is more associated with {*filter*} lesions.

Varicella zoster virus (aka herpes zoster) - causes chickenpox as a
primary infection in children and {*filter*}s and later in life causes the
painful skin condition known as shingles.

Cytomegalovirus (CMV) - a really bad bug - is associated with severe
pneumonia in immunocompromised patients (eg. AIDS).

Epstein-Barr virus (EBV) - this virus causes infectious mononucleosis
("kissing disease") and has been linked to chronic fatigue syndrome.

Human herpesvirus type 8 - strongly associated with Kaposi's sarcoma (a
form of cancer with a characteristic purplish skin manefestation) in
immunocompromised patients (eg. AIDS).

I've missed a number of members of this family of viruses but I hope I
have revealed the breadth of different diseases which they cause.

Unfortunately many of your posts reveal that this response was taken as
being linked with HCV. This was not my intention. I'll leave it at that
and address some of the other specific queries.

Quote:
>I *think* I recall reading something in the past couple of years o\in
>this group about co-infection with both hepC and herpes making it harder
>to clear the hepC virus (or cause periodic flare-ups of the hep. virus)
>- but I could be mistaken, it was quite a long time ago.

Hmmm...to be honest I don't recall this particular point because both
viruses have preferences for different tissues/organs systems.

Quote:
>I'm now wondering how unusual it is for a child to have shingles, and
>... if herpse zoster can hide out in the body and mutate later into
>herpes simplex.

It is a bit unusual since shingles is usually associated with older people
but if for some reason you were transiently immunocompromised this might
have brought virus out of its latent hiding state.

Just to clarify a misconception here - these viruses do not mutate from
one virus TYPE into another. Herpes zoster virus cannot mutate into herpes
simplex or vice versa; these viruses are distinctly different genetic
entities.

Quote:
>Would the presence of herpes simplex stimulate hepC replication, and if
>so, in what way?

Don't really understand what you're driving at here, Leola? Do you mean in
terms of immune system or some interaction between the viruses at the
molecular level?

Leola -I just checked my MedLine resources for the past 3 years and there
is really nothing about an association of herpesviruses and HCV. Sorry.

Quote:

>Am I wrong in believing that approximately 95% of all [U.S. citizens anyway]
>of us are infected with herpes?

If you mean "have been infected with herpes simplex type 1", the answer is
yes. The sniggly bit is that while most have had a primary infection at
some time in our lives, only a proportion have an episode of recurrence
(ie. the virus reactivates from the nerves where it was latent and it
starts another infection).

Quote:
>Can herpes be transmitted through {*filter*}?

Only if the person has a systemic infection - these people would be in no
shape to donate {*filter*} if the herpes simplex virus was in their
{*filter*}stream.

Members of the herpesvirus family can infect the liver and cause hepatitis
but in those cases the patients are those who are profoundly
immunocompromised due to chemotherapy and radiation therapy,
transplantation (eg. bone marrow) or other infections (eg. AIDS).

Quote:
>If you didn't already have it, could
>the transfusion, iv drug use, etc. co-infect you with both HCV and herpes
>or HBV and herpes?

Unlikely in the extreme. As indicated above, if herpes simplex virus was
present in the {*filter*}stream it probably would cause herpes encephalitis - a
rapid and often fatal infection of the central nervous system. An IVDU
with this probably wouldn't live long enough to score a spitball nevermind
share his/her rig.

Quote:
>She still has frequent ulcers in her mouth/lip area.  In her case
>I don't think they are necessarily associated with stress, but I certainly
>could be wrong.

Other things can activate the virus and rouse it from its latent state.
Hormone imbalance, emotional stress , environmental stress (windburn,
sunburn) are some of the best known activators.

If this is a concern for Wilda, because of frequency of occurence, you
might wish to talk with your physician about getting some topical
acyclovir (Zovirax). This is not a cure but when applied at the first
indication of a breakout (usually a tingling or numbness precedes the
formation of the lesions) this antiviral will decrease the size of the
lesion and speeds up the healing process.

Quote:

>I was also wondering if zoster is NOT the same as simplex?

Zoster is not simplex; these are two distinct and different viruses.

Quote:

>the nerve endings were messed up for quite awhile

Some patient's nerve endings are so sensitized they describe a sensation
like someone is pouring liquid fire over there skin...very scary.

Good thing there is an {*filter*}antiviral available called valciclovir (aka
famciclovir) which has shown very good activity clinically in reducing the
duration and severity of a shingles episode.

My father had shingles this fall and it flared over his torso. There was
more constant irritation than actual pain. Three days of therapy and he
was back to his old self again though still a bit itchy.

Quote:
>I also had mononucleosis one year in high school, was very fatigued and
>sick for several months  

Some years back a classmate of mine developed mono in October and missed
the remainder of the academic year...all that tuition and partying wasted.

Well I think that covers most of the points to date.

Egads it's 12:45 am.
Time to get home and dream of busty and lusty Swedish scientists ("Take
off your labcoat...slowly...more....and the glasses")  ;-)

Cheers

Karl



Sat, 02 Jun 2001 03:00:00 GMT
 Clarifications (Long)(was Re: T-helper etc., etc.)
Aloha Karl,

Thanks for this wonderful response. I'll snip parts of it, and respond
to certain portions:

Quote:

> Hello All,

> Thanks for all the questions, I hope I can cover all of them to your
> satisfaction.

<snip>

Quote:
> Unfortunately many of your posts reveal that this response was taken as
> being linked with HCV. This was not my intention. I'll leave it at that
> and address some of the other specific queries.

I believe some of that may have been due to my post about what I read
about those who are co-infected (coincidentally, not causally) with both
HCV and herpes simplex 2.

Quote:
> >I *think* I recall reading something in the past couple of years o\in
> >this group about co-infection with both hepC and herpes making it harder
> >to clear the hepC virus (or cause periodic flare-ups of the hep. virus)
> >- but I could be mistaken, it was quite a long time ago.

> Hmmm...to be honest I don't recall this particular point because both
> viruses have preferences for different tissues/organs systems.

Again, the co-infection item I read was referring to a *coincidental*
co-infection with both, not suggesting a causal co-infection.

Quote:
> >I'm now wondering how unusual it is for a child to have shingles, and
> >... if herpse zoster can hide out in the body and mutate later into
> >herpes simplex.

> It is a bit unusual since shingles is usually associated with older people
> but if for some reason you were transiently immunocompromised this might
> have brought virus out of its latent hiding state.

I never was a real normal kid anyway, no doubt I was immunocompromised
from one thing or another. Laughing now, but it was an interesting
childhood, having many medical things "children don't get", etc.

Quote:
> Just to clarify a misconception here - these viruses do not mutate from
> one virus TYPE into another. Herpes zoster virus cannot mutate into herpes
> simplex or vice versa; these viruses are distinctly different genetic
> entities.

Thank you, that clears up that question for me.

Quote:
> >Would the presence of herpes simplex stimulate hepC replication, and if
> >so, in what way?

> Don't really understand what you're driving at here, Leola? Do you mean in
> terms of immune system or some interaction between the viruses at the
> molecular level?

I meant in terms of the immune system - during a flare-up of Herpes
Simplex 2, the immune system having to work harder to try and fight it
off possibly causing a temporary flare-up of the HCV, too, because of
the compromised, overworked immune system at these times? I don't
believe there is mollecular level interaction between the 2 viruses (but
what do I know?). I wondered if the imune system is normally busy
fighting off the HCV, but then it has to sort of divert some attention
(energy) to fighting a herpes flare-up, thus allowing the HCV to
replicate a bit while the immune system is busy fighting the herpes?

Quote:
> Leola -I just checked my MedLine resources for the past 3 years and there
> is really nothing about an association of herpesviruses and HCV. Sorry.

Thanks anyway, Karl, one of these days I'll run across it again
somewhere and will post it. Not sure if it was an abstract, a study, an
article, or just what (I seem to recall it was an article, it may not
even have been on the 'net).

Quote:

> >the nerve endings were messed up for quite awhile

> Some patient's nerve endings are so sensitized they describe a sensation
> like someone is pouring liquid fire over there skin...very scary.

Excellent description of what my poor sensitized nerves felt like, for
months!

Quote:
> Good thing there is an {*filter*}antiviral available called valciclovir (aka
> famciclovir) which has shown very good activity clinically in reducing the
> duration and severity of a shingles episode.

Too bad they didn't have that when I was 9 years old and had it!

<snip>

Quote:
> Some years back a classmate of mine developed mono in October and missed
> the remainder of the academic year...all that tuition and partying wasted.

Exactly!!  {g}

Quote:
> Well I think that covers most of the points to date.

> Egads it's 12:45 am.
> Time to get home and dream of busty and lusty Swedish scientists ("Take
> off your labcoat...slowly...more....and the glasses")  ;-)

LMAO!!!  Karl!! =Oo

?? Sung to the tune of Randy Newman's "You Can Leave Your hat On"????

Quote:
> Cheers

> Karl

Sweet dreams, Karl, and mahalos,

Leola <~~~ still chuckling



Sat, 02 Jun 2001 03:00:00 GMT
 Clarifications (Long)(was Re: T-helper etc., etc.)
Karl, being a student still, do you feel there are
any questions that are unanswerable.  I don't
think they were all directed to you.  Nice of you
to try answering them though.

Nan

Quote:

> Hello All,

> Thanks for all the questions, I hope I can cover all of them to your
> satisfaction.

> First of all, in my post where I responded to Paul's question about the
> immune system and viruses "hiding" I used the example of latency which a
> frequent feature of members of the the herpes group viruses.

> FYI there are numerous viruses which belong to the herpesvirus family -
> each has its own diseases and target tissues for replication. A severly
> abridged listing would be:

> herpes simplex viruses type 1 and 2 - type one is associated with cold
> sores while type 2 is more associated with {*filter*} lesions.

> Varicella zoster virus (aka herpes zoster) - causes chickenpox as a
> primary infection in children and {*filter*}s and later in life causes the
> painful skin condition known as shingles.

> Cytomegalovirus (CMV) - a really bad bug - is associated with severe
> pneumonia in immunocompromised patients (eg. AIDS).

> Epstein-Barr virus (EBV) - this virus causes infectious mononucleosis
> ("kissing disease") and has been linked to chronic fatigue syndrome.

> Human herpesvirus type 8 - strongly associated with Kaposi's sarcoma (a
> form of cancer with a characteristic purplish skin manefestation) in
> immunocompromised patients (eg. AIDS).

> I've missed a number of members of this family of viruses but I hope I
> have revealed the breadth of different diseases which they cause.

> Unfortunately many of your posts reveal that this response was taken as
> being linked with HCV. This was not my intention. I'll leave it at that
> and address some of the other specific queries.

> >I *think* I recall reading something in the past couple of years o\in
> >this group about co-infection with both hepC and herpes making it harder
> >to clear the hepC virus (or cause periodic flare-ups of the hep. virus)
> >- but I could be mistaken, it was quite a long time ago.

> Hmmm...to be honest I don't recall this particular point because both
> viruses have preferences for different tissues/organs systems.

> >I'm now wondering how unusual it is for a child to have shingles, and
> >... if herpse zoster can hide out in the body and mutate later into
> >herpes simplex.

> It is a bit unusual since shingles is usually associated with older people
> but if for some reason you were transiently immunocompromised this might
> have brought virus out of its latent hiding state.

> Just to clarify a misconception here - these viruses do not mutate from
> one virus TYPE into another. Herpes zoster virus cannot mutate into herpes
> simplex or vice versa; these viruses are distinctly different genetic
> entities.

> >Would the presence of herpes simplex stimulate hepC replication, and if
> >so, in what way?

> Don't really understand what you're driving at here, Leola? Do you mean in
> terms of immune system or some interaction between the viruses at the
> molecular level?

> Leola -I just checked my MedLine resources for the past 3 years and there
> is really nothing about an association of herpesviruses and HCV. Sorry.


> >Am I wrong in believing that approximately 95% of all [U.S. citizens anyway]
> >of us are infected with herpes?

> If you mean "have been infected with herpes simplex type 1", the answer is
> yes. The sniggly bit is that while most have had a primary infection at
> some time in our lives, only a proportion have an episode of recurrence
> (ie. the virus reactivates from the nerves where it was latent and it
> starts another infection).

> >Can herpes be transmitted through {*filter*}?

> Only if the person has a systemic infection - these people would be in no
> shape to donate {*filter*} if the herpes simplex virus was in their
> {*filter*}stream.

> Members of the herpesvirus family can infect the liver and cause hepatitis
> but in those cases the patients are those who are profoundly
> immunocompromised due to chemotherapy and radiation therapy,
> transplantation (eg. bone marrow) or other infections (eg. AIDS).

> >If you didn't already have it, could
> >the transfusion, iv drug use, etc. co-infect you with both HCV and herpes
> >or HBV and herpes?

> Unlikely in the extreme. As indicated above, if herpes simplex virus was
> present in the {*filter*}stream it probably would cause herpes encephalitis - a
> rapid and often fatal infection of the central nervous system. An IVDU
> with this probably wouldn't live long enough to score a spitball nevermind
> share his/her rig.

> >She still has frequent ulcers in her mouth/lip area.  In her case
> >I don't think they are necessarily associated with stress, but I certainly
> >could be wrong.

> Other things can activate the virus and rouse it from its latent state.
> Hormone imbalance, emotional stress , environmental stress (windburn,
> sunburn) are some of the best known activators.

> If this is a concern for Wilda, because of frequency of occurence, you
> might wish to talk with your physician about getting some topical
> acyclovir (Zovirax). This is not a cure but when applied at the first
> indication of a breakout (usually a tingling or numbness precedes the
> formation of the lesions) this antiviral will decrease the size of the
> lesion and speeds up the healing process.


> >I was also wondering if zoster is NOT the same as simplex?

> Zoster is not simplex; these are two distinct and different viruses.


> >the nerve endings were messed up for quite awhile

> Some patient's nerve endings are so sensitized they describe a sensation
> like someone is pouring liquid fire over there skin...very scary.

> Good thing there is an {*filter*}antiviral available called valciclovir (aka
> famciclovir) which has shown very good activity clinically in reducing the
> duration and severity of a shingles episode.

> My father had shingles this fall and it flared over his torso. There was
> more constant irritation than actual pain. Three days of therapy and he
> was back to his old self again though still a bit itchy.

> >I also had mononucleosis one year in high school, was very fatigued and
> >sick for several months

> Some years back a classmate of mine developed mono in October and missed
> the remainder of the academic year...all that tuition and partying wasted.

> Well I think that covers most of the points to date.

> Egads it's 12:45 am.
> Time to get home and dream of busty and lusty Swedish scientists ("Take
> off your labcoat...slowly...more....and the glasses")  ;-)

> Cheers

> Karl



Sat, 02 Jun 2001 03:00:00 GMT
 Clarifications (Long)(was Re: T-helper etc., etc.)

Quote:

> Karl, being a student still, do you feel there are
> any questions that are unanswerable.

Hmmm...can't tell if that was a kick or a kudo.

Unanswerable questions? Sure - How do they get the caramilk into the
caramilk bar? Why do studios continue to make Pauly Shore movies when
he's..just..not..funny??

Seriously though - Yes - there are lots of *currently* unanswerable
questions in the realm of hepatotropic viruses. Some which come to mind
are:

Why is it so difficult for a person with chronic HBV to develop an HBsAb
response even if the viraemia and liver-associated virus is profoundly
suppressed by antiviral therapy for more than 12-18 months?

Why do people who recover from HBV infection still have viral sequences in
their circulating lymphocytes more than 5 years after resolution of the
infection?

What is the measurable fidelity of the HBV polymerase?

Is it possible to determine the crystal structure of HBv polymerase?

What are the features of the HCV virus genome that allow it to be
faithfully copied into minus strand RNA from the 3'UTR (untranslated
region)?

What are the mechanisms of transmission in cryptogenic HCV infections?

Does TTV actually cause pathology? Does HGV?

Will we ever have a non-primate animal model for HCV infection (we already
have several for HBV)?

Regards

Karl



Sun, 03 Jun 2001 03:00:00 GMT
 Clarifications (Long)(was Re: T-helper etc., etc.)

Quote:

> > >Would the presence of herpes simplex stimulate hepC replication, and if
> > >so, in what way?
> I meant in terms of the immune system - during a flare-up of Herpes
> Simplex 2, the immune system having to work harder to try and fight it
> off possibly causing a temporary flare-up of the HCV, too, because of
> the compromised, overworked immune system at these times? I don't
> believe there is mollecular level interaction between the 2 viruses (but
> what do I know?). I wondered if the imune system is normally busy
> fighting off the HCV, but then it has to sort of divert some attention
> (energy) to fighting a herpes flare-up, thus allowing the HCV to
> replicate a bit while the immune system is busy fighting the herpes?

Even though the infections overlap I don't think a localized infection
like cold sores due to HSV would affect a more systemically expressed
disease like chronic HCV infection. OTOH if you came down with a second
systemic infection then the double "punch" might have a more pronounced
effect on the underlying HCV infection.

Quote:
> ?? Sung to the tune of Randy Newman's "You Can Leave Your hat On"????

Only if Joe{*filter*}er is singing it.

Regards

karl



Sun, 03 Jun 2001 03:00:00 GMT
 Clarifications (Long)(was Re: T-helper etc., etc.)

Quote:

> Even though the infections overlap I don't think a localized infection
> like cold sores due to HSV would affect a more systemically expressed
> disease like chronic HCV infection. OTOH if you came down with a second
> systemic infection then the double "punch" might have a more pronounced
> effect on the underlying HCV infection.

Well, I've never had a cold sore in my life, (knocking on wood). Thanks
for clarifying this issue, as with others. Us lay folks wonder about so
many things, good we have people like you we can go to for a reality
check sometimes.

Quote:
> > ?? Sung to the tune of Randy Newman's "You Can Leave Your hat On"????

> Only if Joe{*filter*}er is singing it.

Absolutely - *very* funky!!!  ;)

Quote:
> Regards

> karl

Warm aloha from the land of bananas bearing year 'round

Leola



Mon, 04 Jun 2001 03:00:00 GMT
 
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