زائر
Hepes Vises
* Imptane t dentisty.
* Pimay infetin, ateny and eativatin.
* HHV infetins in the immnmpmised.
* assifiatin f Hman Hepes Vises.
* Temingy.
* Individa HHV infetins f eevane t dentisty.
* A age nmbe f hepes vises have been desibed.
* At east 8 f these, the Hman Hepes Vises (HHVs), infet hmans and an ase inia disease (HHV1-8). De t histia easns, HHV1-HHV5 ae as knwn by the names:
HHV1Hepes Simpex Vis 1 (HSV1)HHV2Hepes Simpex Vis 2 (HSV2)HHV3Vaiea Zste Vis (VZV)HHV4Epstein Ba Vis (EBV)HHV5ytmegavis (MV)
Imptane t Dentisty
* Six HHVs ase hman diseases f eevane t the patie f dentisty (HHV1-5 & HHV8).
* HHVs ae we-adapted t thei (hman) hst and infetin ates ae high in mst ppatins.
* As a dentist y wi be expeted t diagnse, initiate management and knw when t apppiatey efe f a speiaist pinin, patients with HHV infetins.
* It is patiay imptant that apppiate ss Infetin nt meases ae empyed t pevent nneessay spead f HHV infetins in the denta patie.
Pimay Infetin, ateny & eativatin
* HHV infetins have thee phases: pimay infetin, ateny and eativatin. Vaiatin in eah phase exist between the diffeent HHVs, bt thee ae shaed feates.
Pimay infetin: Ding pimay infetin thee is via epiatin and the patient is infetis. In immnmpetent individas pimay infetin is msty eithe sbinia (asymptmati) ases a mid iness and ny a sma pptin f patients devep fid inia iness. Pimay infetin is sef-imiting in immnmpetent patients. By ntast, pimay HHV infetin in immnmpmised patients is assiated with high mbidity and an be fata.
ateny: Eah HHV entes a atent state as the pimay infetin esves. It emains in speifi e types f ife and annt be eiminated by hst defenes (i.e. infetin is ifeng). atent infetin may in a diffeent e type fm that invved in the pimay infetin. In the atent state the HHV des nt ase disease, thee is n via epiatin and the patient is nt infetis.
eativatin: eativatin fm the atent state s peidiay. It is assiated with fthe via epiatin and the patient bemes infetis ne again. Hweve, eativatin is msty asymptmati and it is nt bvis whethe a patient is in eithe a atent eativated state. This is f patia eevane t ss infetin nt. Sme patients d expeiene symptmati eativatin. In immnmpetent patients this is typiay mid, wheeas in the immnmpmised, eativatin an be sevee and even fata. The inia disease assiated with eativatin may be diffeent fm that seen with pimay infetin. Adingy, a singe HHV is abe t ase me than ne inia iness. F exampe, VZV ases hikenpx (pimay infetin) and shinges (eativatin). Fats nting eativatin ae py ndestd.
HHV Infetins in the Immnmpmised Patient
* In immne mpetent patients any inia iness tends t be mid and sef-imiting.
* HHVs ase sevee and atypia inia iness in immnmpmised patients.
* Patients may be immnmpmised f many diffeent easns, mst f whih ae aqied athe than ngenita. These inde:
* Iatgeni - the nseqene f pesibed dgs sh as tisteids the immnsppessants.
* ane - ften assiated with dysegatin f the immne system.
* Infetin - patients with T-e immndefiieny (e.g. AIDS) geneay have me sevee and pesistent HHV infetins.
* It is as imptant t emembe that the immne system hanges thgh ife:
* Nenates have an immate immne system and ae patiay sseptibe t sevee HHV pimay infetin that may be fata.
* Pimay HHV infetin in pegnany an be sevee
* HHV infetin f the deveping fets an ase sevee ngenita abnmaities assiated with mtaity and high mbidity.
* Pegnant wmen ae at ineased isk f deveping sevee pimay HHV infetin that an be fata.
* The immne system bemes ess effiient with ineasing age.
* In patia, T-ymphyte immnity is ess effetive in d age.
assifiatin f Hman Hepes Vises
HHVs ae assified int ne f thee gps that ae f eevane t ndestanding f the pathgenesis f HHV infetins:
Apha-hepes vises
· HSV1, HSV2 & VZV.
· epiate apidy in many diffeent e types, bt espeiay statified sqams epitheim.
· atent in neve es (netphi) whee they ae nabe t epiate.
Beta-hepes vises
· MV, HHV6 & HHV7.
· epiate swy - infeted es typiay beme age.
Gamma-hepes vises
· EBV & HHV8.
· epiate swy - infetin ften assiated with ymphytes (ymphtphi).
· Abe t inde e-pifeatin, whih may be nepasti (e.g. EBV & ymphmas).
Temingy
* 'Hepes' means 't eep' and efets hw HHV infetins spead fm an infeted e t adjaent heathy es whih then beme infeted themseves.
* 'Hepeti aphths eatin' is NT eated t HHV infetin, bt identifies a speifi fm f aphths eatin f whih the ase if nknwn. nftnatey, this nfsing temingy has beme embedded in the iteate.
* Imptane t dentisty.
* Pimay infetin, ateny and eativatin.
* HHV infetins in the immnmpmised.
* assifiatin f Hman Hepes Vises.
* Temingy.
* Individa HHV infetins f eevane t dentisty.
* A age nmbe f hepes vises have been desibed.
* At east 8 f these, the Hman Hepes Vises (HHVs), infet hmans and an ase inia disease (HHV1-8). De t histia easns, HHV1-HHV5 ae as knwn by the names:
HHV1Hepes Simpex Vis 1 (HSV1)HHV2Hepes Simpex Vis 2 (HSV2)HHV3Vaiea Zste Vis (VZV)HHV4Epstein Ba Vis (EBV)HHV5ytmegavis (MV)
Imptane t Dentisty
* Six HHVs ase hman diseases f eevane t the patie f dentisty (HHV1-5 & HHV8).
* HHVs ae we-adapted t thei (hman) hst and infetin ates ae high in mst ppatins.
* As a dentist y wi be expeted t diagnse, initiate management and knw when t apppiatey efe f a speiaist pinin, patients with HHV infetins.
* It is patiay imptant that apppiate ss Infetin nt meases ae empyed t pevent nneessay spead f HHV infetins in the denta patie.
Pimay Infetin, ateny & eativatin
* HHV infetins have thee phases: pimay infetin, ateny and eativatin. Vaiatin in eah phase exist between the diffeent HHVs, bt thee ae shaed feates.
Pimay infetin: Ding pimay infetin thee is via epiatin and the patient is infetis. In immnmpetent individas pimay infetin is msty eithe sbinia (asymptmati) ases a mid iness and ny a sma pptin f patients devep fid inia iness. Pimay infetin is sef-imiting in immnmpetent patients. By ntast, pimay HHV infetin in immnmpmised patients is assiated with high mbidity and an be fata.
ateny: Eah HHV entes a atent state as the pimay infetin esves. It emains in speifi e types f ife and annt be eiminated by hst defenes (i.e. infetin is ifeng). atent infetin may in a diffeent e type fm that invved in the pimay infetin. In the atent state the HHV des nt ase disease, thee is n via epiatin and the patient is nt infetis.
eativatin: eativatin fm the atent state s peidiay. It is assiated with fthe via epiatin and the patient bemes infetis ne again. Hweve, eativatin is msty asymptmati and it is nt bvis whethe a patient is in eithe a atent eativated state. This is f patia eevane t ss infetin nt. Sme patients d expeiene symptmati eativatin. In immnmpetent patients this is typiay mid, wheeas in the immnmpmised, eativatin an be sevee and even fata. The inia disease assiated with eativatin may be diffeent fm that seen with pimay infetin. Adingy, a singe HHV is abe t ase me than ne inia iness. F exampe, VZV ases hikenpx (pimay infetin) and shinges (eativatin). Fats nting eativatin ae py ndestd.
HHV Infetins in the Immnmpmised Patient
* In immne mpetent patients any inia iness tends t be mid and sef-imiting.
* HHVs ase sevee and atypia inia iness in immnmpmised patients.
* Patients may be immnmpmised f many diffeent easns, mst f whih ae aqied athe than ngenita. These inde:
* Iatgeni - the nseqene f pesibed dgs sh as tisteids the immnsppessants.
* ane - ften assiated with dysegatin f the immne system.
* Infetin - patients with T-e immndefiieny (e.g. AIDS) geneay have me sevee and pesistent HHV infetins.
* It is as imptant t emembe that the immne system hanges thgh ife:
* Nenates have an immate immne system and ae patiay sseptibe t sevee HHV pimay infetin that may be fata.
* Pimay HHV infetin in pegnany an be sevee
* HHV infetin f the deveping fets an ase sevee ngenita abnmaities assiated with mtaity and high mbidity.
* Pegnant wmen ae at ineased isk f deveping sevee pimay HHV infetin that an be fata.
* The immne system bemes ess effiient with ineasing age.
* In patia, T-ymphyte immnity is ess effetive in d age.
assifiatin f Hman Hepes Vises
HHVs ae assified int ne f thee gps that ae f eevane t ndestanding f the pathgenesis f HHV infetins:
Apha-hepes vises
· HSV1, HSV2 & VZV.
· epiate apidy in many diffeent e types, bt espeiay statified sqams epitheim.
· atent in neve es (netphi) whee they ae nabe t epiate.
Beta-hepes vises
· MV, HHV6 & HHV7.
· epiate swy - infeted es typiay beme age.
Gamma-hepes vises
· EBV & HHV8.
· epiate swy - infetin ften assiated with ymphytes (ymphtphi).
· Abe t inde e-pifeatin, whih may be nepasti (e.g. EBV & ymphmas).
Temingy
* 'Hepes' means 't eep' and efets hw HHV infetins spead fm an infeted e t adjaent heathy es whih then beme infeted themseves.
* 'Hepeti aphths eatin' is NT eated t HHV infetin, bt identifies a speifi fm f aphths eatin f whih the ase if nknwn. nftnatey, this nfsing temingy has beme embedded in the iteate.