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Title

Viral Infections, Part 2: Herpes and Hepatitis Viruses (1 credit hours)

Abstract

This course focuses on the biology, transmission and pathogenesis of two large families of viruses. Herpesviruses include herpes simplex, varicella-zoster, cytomegalovirus and Epstein-Barr. Of the seven hepatotropic viruses, hepatitis B and C are given greatest emphasis because they are transmitted by serum and are of most concern to health care providers. Principles of immunization and post-exposure considerations are described.

This activity is approved for Category A credits by the ASRT/Expiration August 1, 2010.

This activity may be available in multiple formats or from different sponsors. The ARRT does not allow CE activities such as internet courses, home study programs or directed readings to be repeated for CE credit in the same or any subsequent biennium.

Author

Dan Becker, DDS

Dr. Becker received his bachelor of science in zoology from Ohio University in 1968 and his doctor of dental surgery from Ohio State University in 1972. Although Dr. Becker is a dentist, his interest always centered on academia and he began teaching biology at Sinclair Community College (Dayton, OH) as a part-time instructor in the autumn of 1972. He accepted a full-time faculty position in the Dental Hygiene department in 1976, but continued his teaching within the Biology department as well.

Dr. Becker's interest in pharmacology and anesthesia attracted him to Miami Valley Hospital where he became involved with their dental residency instructing dental residents and learning from mentors during rotations within departments of anesthesia and emergency medicine. During this time, he developed and taught courses in pharmacology and pathophysiology for nursing and other allied health programs until his teaching at Sinclair became entirely devoted to these subject areas. Currently he is a full professor at Sinclair Community College and Associate Director of Education at Miami Valley Hospital. He has published in numerous scientific journals and textbooks, and lectures extensively throughout the United States and Canada.

Objectives

After studying the information presented, the reader should be able to:

Describe general features of herpesviruses including structure and biology of infection.
Explain the pathogenesis and clinical features of herpes simplex infection.
Explain the pathogenesis and clinical features of varicella-zoster infection, distinguishing primary and recurrent infection.
Compare the pathogenesis and clinical features of cytomegalovirus and Epstein-Barr virus infections.
Describe the pathogenesis and clinical phases of viral hepatitis.
Describe components of the hepatitis B virus and the biology of infection.
Identify the serological markers associated with HBV infection and the basis for diagnosis of the carrier state and its degree of infectivity.
Explain active and passive immunization strategies against HBV.
Compare infection with hepatitis C to hepatitis B in terms of transmission and chronic infection.

Resources

Brooks GF, Carroll KC, Butel JS, Morse SA, Eds. Jawetz, Melnick, & Adelberg's Medical Microbiology, 24th Ed. New York, NY: McGraw Hill; 2007.

Brunell PA. Varicella (Chickenpox, Shingles). In: Goldman L, Ausiello D Editors. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: W.B. Saunders; 2008.

Center for Disease Control. Department of Health and Human Services. Exposure to Blood: What healthcare personnel need to know. Public Health Foundation. July 2003. http://bookstore.phf.org.

Drew WL. Cytomegalovirus. In: Goldman L, Ausiello D Editors. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: W.B. Saunders; 2008.

Center for Disease Control. Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis MMWR 2001; 50(RR11;-43.

Dienstag JL, Isselbacher KJ. Acute Viral Hepatitis. In: Kasper DL, Braunwald E, Fauci AS, et al, eds. Harrison's Textbook of Internal Medicine. 16th ed. New York, NY: McGraw Hill; 2005.

Ganem D, Prince AM. Hepatitis B Virus Infection- Natural History and Clinical Consequences. N Engl J Med 2004;350:1118-29.

Hoofnagle JH. Acute Viral Hepatitis.. In: Goldman L, Ausiello D Editors. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: W.B. Saunders; 2008.

Kimberlin DW, Whitley RJ. Varicella-Zoster vaccine for the prevention of herpes zoster. N Engl J Med 2007;356(13):1338-43.

Lauer GM, Walker BD. Hepatitis C virus infection. N Engl J Med 2001;345:41-52.

Poland GA, Jacobson RM. Prevention of Hepatitis B with the Hepatitis B Vaccine. N Engl J Med 2004;351:2832-8.

Schooley RT. Epstein-Barr Virus Infection. In: Goldman L, Ausiello D Editors. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: W.B. Saunders; 2008.

Seef LB, Miller RN, Rabkin CS, et al. 45-year followup of hepatitis C virus infection in healthy young adults. Ann Intern Med 2000; 132:105-11.

Wong T, Lee SS. Hepatitis C: a review for primary care physicians. CMAJ 2006; 174(5):649-59.

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