body as host test iv. – Flashcards

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virulence factors
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ways to colonize and breach host surfaces:

-loss of barrier function

-adhesion molecules

-fimbrae, pili

-motility and chemotaxis

-proteases

-surface binding proteins

-bacterial capsules

-toxic proteins

-variability of surface antigens

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other virulence factors (2)
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- evasion and resistance to antibacterial peptides

-iron acquisition compounds

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mechanisms of infectious diseases
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- acquisition of disease

-asymptomatic phase

-prodromal phase

-symptomatic phase

-healing convalescence 

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determinants of disease
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-Nature of disease: tissue target, entry site, accessibility of virus to target tissue; tissue tropism; permissiveness of viral replication ; viral strain

-severity of disease

-cytopathicity

-health status of patient

-virus innoculum

 

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cytopathicity:

3 potential outcomes of a viral infection

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1-failed infection--no infection

2-lytic infection--cell death

3-persistent infection--chronic or latent or immortalizing

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herpes virus
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-herpes viridae family (HHV)

-herpes simplex virus (HSV 1&2)

-varicella zoster virus (VZV)

 

-epstein barr virus (EBV)

-cytomegalovirus (CMV)

-HHV 6,7,8 (exanthems)

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herpes virus characteristics

 

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-ubitquitous, highly infective, small, five sides figure

-ds DNA virus

-DNA envelope has 4basic components

-classified by virulence in cell structure

-viral envelope proteins bind to host cell plasma membrane receptors, enter the cytolasma via endocytosis, virons uncoat, and viral DNA enters host's nucleus

-replication will cause mental swelling

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basic characteristics of viruses
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-lack their own metabolism!

-can replicate in both pro/eukaryotic cells

-contain 2 genomes

-coding for structural proteins

-non-coding proteins (enzymes such as RNAase and DNAase, and immune signaling proteins)

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how viruses work basically
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attachment

penetration

uncoating of viral nucleic acid

transport of viron

synthesis of mRNA

replication of viral DNA

assembly

dispersion of viron out of cell (egress)

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recurrent herpes simplex infections

(7 "phases")

;

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-reactivated virus

-prodromal symptoms

-minimal systemic symptoms

-small group of vesicles (new lesions for 1-2 days)

-viral shedding(3-5 days)

-crusting of vesicles

-healing (9-10 days)

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how a virus may get reactivated

;

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-virus hangs out in neural ganglion

-during periods of stress or compromised immune system the virus travels down teh axons like a slinky

-LAT (latency associated transcriptase) keeps virus dormant--when this gene turns off you get prodromal symptoms which are mostly neural (tingly lips, etc.)

 

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primary course of HSV infection
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-incubation of virus for about 5 days

~day "0" pt experiences systemic and local symptoms

-systemic--> tender lymph nodes

-local->pain/itching/dysuria/malaise/fever/headache

~day 2-5 you see more systemic symptoms

-vesicle, wet ulcer, crusting

-shedding virus for ten days or so!

~day 15 you begin healing

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recurrent course of HSV infection
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-prodromal symptoms for 1-2 days before day "0"

-day "0" get lesions & local symptoms; shedding virus

~day 10, start to heal

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treatment for HSV
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-mostly pallative

-hydration

-antipyretics

-prophylactic tx with acyclovir sometimes

-affects immediate early protein gene transcription and/or early protein phase gene transcription

*thus inhibits DNA elongation/synthesis

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varicella zoster virus
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-varicella-->chicken pox in kids

-longer incubation period (14-17); prodromal rare

-lesions develop over 3 days

-itchy rash persists for about 1-6 days

-crusting and shedding for about 7 days

-fever 101-105 degreese

-no live attentuated oka vaccine

-zoster-->virus reactivated to cause shingles

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shingles
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-prodrome symptoms common for 4-5 days

-vesicles develop withint 12-24 hrs and rash persists for 1-7 days

-rash forms "belt" or follows CN V1,V2,V3 on face

-pustules dry and crust and fall off

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Epstein Barr Virus
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-causes mononucleosis

-tx: supportive

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cytomegalovirus
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-opportunistic pathogen activated by immunosuppression

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viral exanthems
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-hand-foot-mouth disease

-highly contagious spread by oral fecal route

-herpangia (coxsackie virus)

-vesicles on soft palate

-measles (rubeola)

-vaccine

-german measles (rubella)

-vaccine

-fifth disease (parvovirus B19)

-"slapped cheeks"

-respiratory

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hepatitis
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-inflammation of the liver

-toxic

-infectious

Types A, B, C, D, E

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Hepatitis A
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-infectious

-picornavirus

-capsid RNA

-oral- fecal route

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Hepatitis  B
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-serum

-hepadnavirus

-enveloped DNA

-sexual contact

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Type C
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-NonA/NonB

-flavivrus

-enveloped RNA

-sexual contact

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Type D
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-Delta agent

-viroid like 

-enveloped circular RNA

-sexual contact

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type E
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-enteric

-calicovirus

-capsid RNA

-oral fecal route

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serum components and indications
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-IgM anti HAV or IgM antiHBc indicate recent or active hepatitis infection

-Anti HAV; AntiHbs; Antidelta indicate a past ifnection with hepatitis

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Hep B structure
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-enveloped virion

-very stable and resistant to low pH and temperature extremes

-easy to transmit 

-envelope consists of Hep B surface antigens

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Hep B replication
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-virus binds to hepatocyte

-enters cell endocytotically

-carried to nucleus

-uncoats

-replicates

-goes into membrane vacuole and makes nucleid capsid

-excess capsid particles are released when virus exocytoses

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manifestations of Hep B (3)
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-Acute

-Chronic

-Fulminant

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acute hepatitis B
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-90% of cases 

-cell mediated immune response shuts down virus and yields resolution

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acute hep B manifestations
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-subclinical, mild, or severe symptoms

-severe classified as having jaundice for 4-5 wks

-incubation period of 4-26 wks

-preicteric phase-prodromal symptoms

-icteric phase-jaundice and dark urine results from build up of bilirubin which liver can't break down

 

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acute Hep B serotology
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-over period of months

-damage to liver causes spike in liver enzymes

-at beginning you see HBsAg so you know virus is replicating

-towards end you will see anti-HBsAg IgG and yhou know virus is resolved

-between those two stages you have the antigen Hep B window where neither are present in serum bc they are binding each other up.

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chronic Hepatitis B
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-9% of cases

-cell mediated immune system doesn't clear virus, but does slow down virus development over span of 6 months +

-half of these cases resolve 

-half of these cases are chronic and active and may cause ultimate damage (cirrhosis and carcinoma)

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chronic Hepatitis B manifestations
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-in chronic persistant hepatitis, one is asymptomatic, but still sheds the virus

-in chronic active hepatitis, there can be development of carcinoma, cirrhosis, or liver failure but symptoms prior to this point are more mild than acute

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chronic hepatitis B serology
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-over span of years

-redundancy in liver may cause enzyme levels to fall

-trace the HbsAg & antiHbsAg to detect infectious status

 

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chronic Hepatitis B vaccine
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-inactivated HBsAg from human serum (old)

-recombinant DNA vaccine with HBsAg gene inserted into plasmid (current)

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hepatitis A
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-picornavirus

-very stable in environment for long periods of time and can be frozen for months

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hepatitis A replication
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-liver cell receptors 

-classic RNA replication/cytoplasmic replication

-uncoats and replicates in the cytoplasm

-causes cell to lyse

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hepatitis A transmission
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-usually via oral-fecal route/contaminated food & water

-after ingestion, virus survives low pH of stomach and crosses intestinal wall into blood stream causing transient viremia

-virus gets dumped into liver and the virus causes cell lysis there

-virus is dumped into bile where it still survives and gets dumped back into the intestine

-virus is excreted in fecal matter to start process again

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clinical syndromes of Hep A
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-much shorter incubation period than B

-abrupt onset of symptoms

-children tend to be asymptomatic bc of highly responsive cell mediated immune system]

-virus is small and will stay in circulation even when you see presence of antibodies and virus may deposit elsewhere (cell walls and joints)

-rash and arthritis are rare though

-tx: interupt contamination and give immune serum Ig during incubation phase 

-this is 80-90% effective

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hepatitis C
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-short or long incubation period (avg is about 6-9 wks)

-milder symptoms then Hep A/B

-icteric phase seldome develops

-still see chronic damage though

-10-50% of cases become chronic

-chronic case increases risk of recurrence in liver transplant

-fulminate decreases risk of infectio nof liver transplant

-tx: none; but 10-40% cases respond to interferon and ribivinn tx

-diagnosis: eliminate possibility of other two types

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delta agent
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-defective satellite virus

-can't replicate unless Hepatitis B is suprainfected or Co-infected in same cell

-coinfection increases risk of fulminate hepatitis and slightly increases the risk of cirrhosis and carcinoma

-complicates but does not cause hepatitis by itself

 

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Hep E
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-enterically transmitted (oral-fecal route)

-diagnose by excluding other Hep viruses

-similar to HAV clinically

-short incubation time

-abrupt onset of symptoms

-no chronic form

-no tx or prevention

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virus characteristics
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-filterable, small agents

-non living

-require host cell's machinery to replicate

-have either RNA or DNA genome, but not both

-are naked capsid type or enveloped

-must encode any required processes not provided by host cell and package specialized proteins and nuclear binding proteins and enzymes

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naked vs enveloped virus
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Naked

DNA/RNA+structural proteins+nuclear binding proteins and enzymes=nucleocapsid

nucleocapsid+envelop (membrane and glycoproteins)=envelope

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DNA viruses

name and differentiate between ds or ss, and enveloped or naked

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-enveloped: Pox, Herpes, hepadna

-Naked: polyoma, papilloma, adeno and parvo (ss)

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viral attachment
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-virus has tissue tropism

-attaches to target cell via glycoproteins to bind

-immn syst recognizes these glycoproteins when in circulation after cell lyses

-we use these glycoproteins to create vaccines

-glycoproteins fuse cell membranes to make gigantic cells withe several nuclei

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RNA viruses (15)

define if ds or ss; and if + or - stranded

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ds: reo

ss+ : picorna, corona, noro, toga, flavi, hepatitis, retro

ss - : orthomyxo, paramyxo, rhabdo, filo, borna, bunya, arena, 

 

* negative indicates that it is enveloped

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places where drugs can interact to stop viral infection
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-Antibodies prevent virus from attaching

-drugs could stop viral uncoating

-drugs could stop viral transcription and replication

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steps in viral replication
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1-recognition and attachment

2-penetration

3-uncoating

4-macromolecule synthesis (mRNA & nonstructural proteins; genome replciation; late mRNA & structural proteins; modification of proteins)

5-assembly

6-budding of enveloped virus OR lysis of non enveloped virus

7-release of virus

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viral protein synthesis and protein replication of ds DNA 

 

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-DS DNA makes mRNA and proteins via host machinery
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viral protein synthesis and genome replication of ss DNA
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-make complement strand of DNA

-make mRNA

-make proteins

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viral protein synthesis and genome replication of positive stranded RNA
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-positive stranded RNA is like the mRNA that binds to ribosomes and makes one polyprotein that is then cleaved

-the mRNA makes a template of - RNA to create +mRNA progenies

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viral proteins synthesis and genome replication of - stranded RNA
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-RNA is transcribed into mRNA segments and then proteins are made

-RNA is also made into a full length +RNA template to make (-) RNA progenies by RNA polymerase

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viral protein synthesis and genome replication of ds RNA
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-acts like (-) stranded RNA 

-transcribed to make mRNA segments by RNA polymerase in capsid

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viral protein synthesis and genome replication of retrovirus
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- (+) stranded RNA are converted to complementary DNA by reverse transcriptase carried in a virion
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-immediate early and early phase viral proteins are _____1________ for ______2__________ ____________ are produced. an example is ________3_______ carried with virus
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1-necessary

2-DNA synthesis

3-RNA dependent RNA polymerase

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late genes most encode viral ____________ proteins which requires viral DNA synthesis
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-structural
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papilloma virus characteristics and pathology
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-small, nonenveloped icosahedral virus; ds DNA

-encode proteins that promote cell growth

-may oncogenetically transfer a cell that is non permissive

-causes warts and human cervical carcinoma

-infects squamous epithelium & mucosal membrane

-virus accesses the basal cell layer through breaks in skin causing basal cell to grow and cell # increases

-this leads to thickenings and causes the wart/papilloma

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HPV proteins
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-E1 protein binds to DNA @ origin to promote replication

-E6 and E7 are immortalizing genes 

-E6 binds w p53 protein and targets it for degradation

-E7 deactivates p105RB; thus NO BRAKES on cell growth

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polyomaviridae
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-like HPV

-T antigen analogous to E6&E7

-JC virus establishes kidney infection

-BK virus establishes latent kidney infection

-respiratory tract-->viremia-->kidney inf.-->viremia-->

-immunocompetent patients experience latency

-reactivation of BK virus causes hemmorrhagic cystitis in urinary tract

-reactivation of JC virus is in the CNS

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adenovirus structure characteristics and replication
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-capsid made of capsidmeres

-spikes protrude as ligand receptors and are made of glycoproteins

-nonenveloped icosadeltahedron

-potential to become oncogenic

-replication:

-requirements for transcription of early proteins: E1 gene transcription; process of primary transcript; translate immediate early E1A transactivator protein (controll/growth supressor)

-end result is host cell death

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