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Table 1 Comparison of HSV and VZV with illustrations of differences and similarities

From: Herpes simplex virus and varicella zoster virus, the house guests who never leave

Sections

 

HSV-1

VZV

Viral

Genes

~80: 4 diploid (ICP4, 0, 34.5, LAT)

68: 3 diploid (ORFs 62, 63, 64)

Genome

Size

~152kbp

~125kbp

G + C content

−67%

−47%

Repeats

-Large repeats for both UL and US

-Large on US only; 88.5 bp on UL

Isomers

4

Mostly 2 with UL region fixed

miRNA

From LAT region- role not yet clear

No known miRNAs

Viral Proteins

regulation

Regulated Cascade –defined as

Likely similar, but difficult to define experimentally

Immediate Early differences

  

α, β1, β2, γ1, γ2-six genes (ICP0, ICP4, ICP27, ICP22, ICP1.5, ICP47.

-Three genes reported to date

-All have TAATGARAT motif in IE promoters

-ORF/IE62(ICP4 Eeq) ORF/IE4(ICP27 eq) and ORF/IE63 (ICP22 eq)

-No ortholog of ICP47.

-Only IE62 has TAATGARAT in promoter

Short Region differences

-gD, an essential protein involved in receptor & entry

-No gD, is essential-

-gE not required in culture

-gE is key receptor binding protein

 

-Missing several HSV equivalents

Tegument differences

-UL48 (VP16) required in culture:

-ORF10(VP16 Eq) not required in culture:

-UL49 not required

-ORF9 (UL49 eq) required

Primary Infection

Route of Infection

Spread through direct contact.

Spread via aerosol and inhalation.

Location of 1o infection

-Epithelia in mucosa, cornea or in epidermal layers of the skin

-Epithelial and immune cells in respiratory lymphoid tissues, tonsils

-Usually no viremia

-Cell associated viremia

-Secondary infection at the sub-dermis

Spread to neurons

-Usually local only

-Systemic across entire neuraxis

-Accesses neuronal axon termini in skin

-Same as HSV; may also access neurons during viremia thrugh immune cells

Innate

TLR-2,3,9 respond to infection

Thought to be the same, but not known

IFN regulates infection

IFN regulates infection

NO helps retard viral replication

Role of NO not known

ICP0 degrades PML and ND10 proteins

Susceptible to PML caging.

ORF61 modifies ND10, does not degrade PML

Innate and adaptive immunity

Adaptive T cell response

CD4 and CD8 encounter antigen on DCs and respond to infection

-T cells infected by VZV leading to viral spread.

-CD4 and CD8 T cells are VZV specific

 

DC

Can infect and reduce presentation to T cells by DCs

-Can infect and reduce presentation to T cells by DCs

Humoral Response

Elicit antibodies against broad viral antigens. IgA, IgG and IgM

-Elicit antibodies against broad viral antigens. IgA, IgG and IgM.

-Antibodies are used in high risk patients to treat VZV

-Antibody has less role on control of infection/ latency and reactivation

 

Immune Evasion

ICP47 blocks TAP function.

-Does not block TAP function.

-Still blocks MHCI and II expression.

-Blocks MHCI by ORF66 kinase

Inhibit IFN responses thru VHS, ICP0, and γ34.5

-Inhibit IFN responses by IE63, IE62

-ORF61 blocks NFkB signaling

gC blocks complement deposition

No equivalent activity for gC

Fc binding ability of gE

VZV gE and gI complex to bind Fc

ICP22, Us5, Us3 and LAT inhibit apoptosis by NK and CD8+ cell mediated lysis

ORF63 blocks apoptosis

Models and Neuronal Latency

Animal modeling

-Most animal models replicate virus

-Guinea pig only small natural animal model that replicates virus

-Most show similar disease to humans

-No natural model of varicella

-No model of reactivated disease

Location of latency

Sensory ganglia, especially trigeminal ganglia

-Most sensory and autonomic ganglia

-Distributed across entire neuraxis

Load

Generally higher genome load than VZV

About one magnitude lower genome load

Maintenance latency

 

-Endless Circular episome.

-Endless circular episome.

-Heterochromatinated state

-Assumed to be Heterochromatinated state

Latent Gene Expression

-Abundant transcripts from LAT region

-RNAs for ORFs 4,21,61,10,29,62,63, and 66. --Reported protein expression is controversial

-LATs processed into miRNAs

-ORF63 most often reported as expressed

-LATs block apoptosis

-Rare protein expression without virus

Immune Component

-Drives ganglionic CD8+ immune infiltrate

-No Immune infiltrate yet reported

-CD8 may control reactivation events

-Cellular immunity maintains latency

Reactivation and disease

Occurrence

-May Reactivate frequently

-Reactivated disease usually never or once

-Incidence drops with age

-Incidence rises with age and declining cellular immunity.

-Disease similar to primary infection

-Occurs anywhere on body

-At same site as 1o infection

-Disease clinically different from 1o Infection

Ganglionic Spread

Involves 1 or few neurons

-Usually intraganglionic spread

-Large lesions covering a dermatome.

Causes of reactivation

Multiple environmental and physiological factors

-Mainly immune senescence or suppression.

  

-Environmental and physiological factors may contribute

Pain upon reactivation

-Not usually

-Nearly always neurological involvement

-Some sensory loss with repeated recurrence

−90% of zoster has pain

-May develop to post herpetic neuralgia