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Sexually Transmitted Infections

(STIs)

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OBJECTIVE
- To describe the morphology and virulence factors
of Herpes simplex. Describe the laboratory
diagnosis of genital herpes.

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Introduction
Herpes simplex virus
Family : Herpesviridae
Sub-family: Alpha herpesvirinae

Types:
Herpes simplex virus type 1 ( HSV-1 )
Herpes simplex virus type 2 ( HSV-2 )

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Morphology
Envelope:
Large (150-200 nm in
diameter)
Spherical
Contains viral
glycoprotein spikes
Contains approx 11
glycoproteins
Capsid:
Icosahedral symmetry
100 nm diameter
162 capsomers
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Tegument:
Present between
envelope and capsid
Contains virally-encoded
proteins (at least 20)
Core:
Densely staining region
Within capsid
Fibrillar spool on which
the DNA is wrapped
Genome:
Linear dsDNA

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Virulence factors
Envelope glycoproteins
ICP 47 protein
ICP 34.5 protein
UL 41 and viron host shutoff protein
Latency related protein
ICP 4 protein

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Laboratory diagnosis

Sample : Vesicular fluid , scrapings of vesicular lesions,


Skin & mucosal swabs

Microscopy :
Tzanck smear- ( in light microscopy )
Ballooning of cells, multinucleated giant cells ,
ground glass nuclei , intranuclear inclusions
Electron microscopy- direct demonstration of virons

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Herpesvirus in Tzanck
smear

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Direct antigen detection :
Direct immunofluorescence test
Enzyme immunoassay

Isolation of the virus :


Culture on HeLa cells , Hep-2 cells & human embryonic
fibroblasts ---- cytopathic effects within 1-3 days
Chorioallantioc membrane--- produce different visible
lesion ( pocks )

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Serological test:
ELISA , Immunoblot test , immunofluorescence test
(antibody detection )
Others neutralization test , complement fixation test

Molecular diagnosis :
DNA probes & PCR - useful for demonstration of
viral genome

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Correlation with STIs
Genital herpes is a sexually transmitted disease.
Commonly caused by HSV-2 , less commonly by
HSV-1
Common in sexually active individual

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THANK YOU
Any questions, queries and
suggestions are highly welcomed.

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