ViralPanelExplained

Avirustakescontrolofthecellitinfectsandforcesittomakemoreviruses(Obligateparasite),eitherbylyticorlysogenicmeans.C4A:aninflammatorymarkerlookingatinnateimmuneresponseformoldandlymesinfections.Infectioncannothidefromthispartofthecomplementsystem.The"C"inC3aandC4astandsforcomplement.Complementproteinsworkwithantibodiestodestroypathogens.Theyactivateimmunitythroughcontrolofinflammation,phagocytosis(ingestionofpathogensbywhitebloodcells)andcelldeathbylysis(breakingofthecellmembrane).HerpesThereareeightcurrentlyidentifiedmembersoftheherpesvirusfamily.Theyareubiquitousandextremelywelladaptedpathogens.ThenamecomesfromtheGreek'herpein'-'tocreep',describingthechronic,latentorrecurrentnatureofinfections.• HerpessimplextypeI(HSV-1).• HerpessimplextypeII(HSV-2).• Varicella-zostervirus(VZV/HHV-3).• Epstein-Barrvirus(EBV/HHV-4).• Cytomegalovirus(CMV/HHV-5).• Herpesvirustype6(HBLV/HHV-6).• Herpesvirustype7(HHV-7).• Kaposi'ssarcomaherpesvirus(KSHV/HHV-8).Theybelongtothefollowingthreefamilies:• Alpha-herpesviruses:HSV-1andHSV-2;VZV-thesehavearelativelyshortreproductive

cycle,variablehostrange,efficientlydestroyinfectedcellsandestablishlatentinfectionsprimarilyinsensoryganglia.

• Beta-herpesviruses:CMV,HHV-6andHHV-7-thesehavelongreproductivecyclesandarestrictedhostrange.Infectedcellsoftenenlarge.Latencycanbemaintainedinthewhitecellsoftheblood,kidneys,secretoryglandsandothertissues.

• Gamma-herpesviruses:EBVandHHV-8-thesearespecificforeitherTorBlymphocytes,andlatencyisoftendemonstratedinlymphoidtissue.

Learnmoreaboutalltheherpesviruseshere:http://patient.info/doctor/herpes-virusesEBVantibodyIgG,IgM:(HSV4)panelforEpsteinbarrvirus,commonlyknownas“mono”whenitaffectsteenager.PresenceofVCA(viralcapsidantigen)IgMindicatedrecentprimary

infection,VCAIgGshowspastinfection.Over90%ofadultpopulationhaveIgGantibodiestoVCAandEBNA

https://labtestsonline.org/understanding/analytes/ebv/tab/test/ANA:Theantinuclearantibody(ANA)testisusedasaprimarytesttohelpevaluateapersonforautoimmunedisordersthataffectmanytissuesandorgansthroughoutthebody.ApositiveANAblood test shows that your immune system ismaking an antibody (protein) that reactswithcomponentsofyourbody'scells.

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EpsteinBarrVirus(EBV)

HHV4(Herpes4)InfectiousMononucleosis“Mono”

Hodgkin’sLyphoma Burkitt’s Lymphoma Nasopharngeal CarcinomaAssociatedwiththefollowingcancers

Dermatomyositis MultipleSclerosis Sjogren’s Syndrome

Rheumatoidarthritis SystemicLupus ChronicFatigue

Associatedwiththefollowingautoimmune

Alsoimplicatedinbrainconditions(neurology.55(9):1398–401.doi:10.1212/WNL.55.9.1398.PMID11087792)

Blastomycesantibody:causedbythefungusBlastomycesdermatitidis,occursmostcommonlyinmenages20-69years.Infectionmaybetransientorleadtochronic,progressivepulmonarydisease.CommoninGreatLakesregion.

CMVantibodyIgG,IgM:Cytomegalovirus(CMV)isamemberoftheHerpesviridaefamilyofvirusesandusuallycausesasymptomaticinfectionafterwhichitremainslatentinpatients,primarilywithinbonemarrowderivedcells.PrimaryCMVinfectioninimmunocompetentindividualsmayalsomanifestasamononucleosis-typesyndrome,similartoprimaryEpstein-Barrvirusinfection,withfever,malaiseandlymphadenopathy.

ParvovirusB19IgGandIgM:alsocalledfifthdiseaseandslappedcheeksyndrome.Outbreakshappeninspringandclosecontactareas.Cancausefetaldamageandinfectionduringpregnancyriskstransfertofetuswhichcancausedeath.ParvoB19cancausepainfulorswollenjoints(polyarthropathysyndrome)inadultsbutdoesnotprogresstootherformsofarthritis

• Canalsocausethebodytotemporarilystopmakingnewredbloodcells– canleadtosevereanemia

• Associatedwiththedevelopmentofseveraldifferentautoimmunediseasesincluding

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CMV:HHV5• Afterinitialinfection,whichmaycausefewsymptoms,CMVbecomes

latent,residingincellswithoutcausingdetectabledamageorclinicalillness.– primarilywithinbonemarrowderivedcells

• PeoplewhoareinfectedwithCMVsometimesshedthevirusinbodyfluids,suchasurine,saliva,blood,tears,semen,andbreastmilk.Thesheddingofvirusmayoccurintermittently,withoutanydetectablesigns,andwithoutcausingsymptoms

• Inpeoplewhoareseverelyimmunocompromised bymedicationordisease,viralreactivationmayleadtosymptomaticdisease.– asignificantcauseofmorbidityandmortalityamongbonemarroworsolid

organtransplantrecipients,individualswithAIDSandotherimmunosuppressed patientsduetovirusreactivationorfromanewlyacquiredinfection

• Antiviraltreatmentsmayimprovetheprognosisinsomepatientswithcytomegalovirusinfections.

• Alsoresponsibleforcongenitaldiseaseamongnewbornsandis1oftheTORCHinfections(toxoplasmosis,otherinfectionsincludingsyphilis,rubella,CMV,andherpessimplexvirus)

https://www.cdc.gov/cmv/clinical/features.html

– dematomyositis,– mixedconnectivetissuediseases– alupus-likeillness– serologicallynegative(negativeRAfactortest)formofarthritis– granulomaannulare– autoimmunethyroiddisease(91%ofHashimotospts+forParvo)– autoimmuneschizophrenia– variousformsofvasculitis,includingHenochSchonleinpurpura,Kawasakidisease,

Wegener’sgranulomatosis,andpolyarteritisnodosa.ThyroglobulinAntibody

HSV1IgG:HSV-1isahighlycontagiousinfection,whichiscommonandendemicthroughouttheworld.MostHSV-1infectionsareacquiredduringchildhood,andinfectionislifelong.

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Thyroglobulin Antibody

• Theantibodiesthatshowuponthyroidtestsarepresentbecausethere’sabattlegoingoninyourthyroidbetweenvirusesandyourimmunesystem

• Yourimmunesystemisproducingtheantibodiestoseekoutanddestroythevirusthat’scausingthyroiddamage

• TBGab isshowingusinfection

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Herpes:HSV

– “Appearstobeparticularlydamagingtothenervoussystem”NeurobiologyAging20(4)

– highlycontagiousinfection

– Mostpeoplehaveasilentinfectionandperiodicallyshedthevirus

– Verycommonandendemicthroughouttheworld

– MostHSV-1infectionsareacquiredduringchildhood,andinfectionislifelong

– MajorityofHSV-1infectionsareoralbutsomeofHSV-1infectionsaregenitalherpes(infectionsinthegenitaloranalarea)

Herpes1(coldsores)

HVS2IgG:HSV-2infectioniswidespreadthroughouttheworldHSV-2isthemaincauseofgenitalherpes,whichcanalsobecausedbyherpessimplexvirustype1(HSV-1).

HSVigM:Apositiveresult(ie,thepresenceofIgMclassherpessimplexvirus[HSV]1and/or2antibodies)indicatesrecentinfection.ThepresenceofHSV1and/or2antibodiesmayindicateaprimaryorreactivatedinfection,butcannotdistinguishbetweenthem.HHV6igG:HHV-6Binfectsnearly100%ofhumanbeings.Althoughrare,thisinitialinfectionHHV-6Binfectioncanalsocausefebrileseizures,encephalitisorintractableseizures.LittleisknownabouttheprevalenceofHHV-6Aorhowitisacquired,butonesmallstudyfoundverylowlevelsofHHV-6Ainthesalivaofhalfofhealthyadults.HHV6Tendstohibernateinthetissuesratherthancirculateintheblood,itisverydifficulttofindviralDNAintheblood.UnlikevirusessuchasherpessimplexwhereitisveryeasytodetectviralDNA in theblood,HHV-6 is considereda “lowcopynumber” virus.Almost100%of thepopulationhaslatentvirusandHHV-6antibodies.Theimportantquestionis:areyourantibodylevelsabnormallyelevated?

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Herpes:HSV

– Widespreadthroughouttheworld– About1outof6adultsintheUnitedStateshaveantibodiestoHSV-2

– Canbereactived bycommonillnesseslikecoldandinfluenza,eczema,emotional/physicalstress,GIissues,fatigue,injury,menstruationandexposuretosunlight

– almostexclusivelysexuallytransmittedHSV-2isthemaincauseofgenitalherpes,whichcanalsobecausedbyherpessimplexvirustype1(HSV-1)

– InfectionwithHSV-2islifelongandincurable

Herpes2(Genital)

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HHV6• SetoftwocloselyrelatedherpesvirusesknownasHHV-6AandHHV-6B

• Infectiontypicallybeforetheageof3andoftenresultsinfever,diarrhea,arashknownasroseola.– canalsocausefebrileseizures,encephalitisorintractableseizures

– LittleisknownabouttheprevalenceofHHV-6Aorhowitisacquired,butonesmallstudyfoundverylowlevelsofHHV-6Ainthesalivaofhalfofhealthyadults

• HHV-6establisheslife-longlatencyandcanbecomereactivatedlaterinlife.Canpersistasachronicinfection,nearlyundetectablebymostcurrentdiagnostictests

HHV-6Binfectsnearly100%ofhumanbeings