Skip to main content
CMAJ : Canadian Medical Association Journal logoLink to CMAJ : Canadian Medical Association Journal
. 1986 Dec 1;135(11):1260–1268.

Chronic viral diseases.

B Berris
PMCID: PMC1491381  PMID: 3022903

Abstract

Until 20 years ago the only chronic viral diseases known were those considered to be confined to the nervous system. As a result of recent advances in epidemiology, molecular biology and immunology, new viral diseases have been recognized and their clinical features and pathogenesis elucidated. Chronic disease may result from infection with the hepatitis B and D viruses and whatever agent or agents cause hepatitis non-A, non-B, the herpesviruses, Epstein-Barr virus, cytomegalovirus and human T-lymphotropic virus type III. These diseases have common features, including long-term or even lifetime asymptomatic carriage, viremia, with virus free in the plasma or attached to circulating mononuclear cells, presence of virus in body secretions, irreversible tissue injury in target organs and oncogenic potential. New information on these diseases is reviewed. Other chronic diseases for which the cause is currently unknown may eventually prove to be due to viral infection. In addition, vaccines may be developed for prophylaxis of some chronic viral diseases and associated malignant diseases.

Full text

PDF
1260

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BLUMBERG B. S., ALTER H. J., VISNICH S. A "NEW" ANTIGEN IN LEUKEMIA SERA. JAMA. 1965 Feb 15;191:541–546. doi: 10.1001/jama.1965.03080070025007. [DOI] [PubMed] [Google Scholar]
  2. Barré-Sinoussi F., Chermann J. C., Rey F., Nugeyre M. T., Chamaret S., Gruest J., Dauguet C., Axler-Blin C., Vézinet-Brun F., Rouzioux C. Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS). Science. 1983 May 20;220(4599):868–871. doi: 10.1126/science.6189183. [DOI] [PubMed] [Google Scholar]
  3. Beasley R. P., Hwang L. Y., Lin C. C., Leu M. L., Stevens C. E., Szmuness W., Chen K. P. Incidence of hepatitis B virus infections in preschool children in Taiwan. J Infect Dis. 1982 Aug;146(2):198–204. doi: 10.1093/infdis/146.2.198. [DOI] [PubMed] [Google Scholar]
  4. Berman M., Alter H. J., Ishak K. G., Purcell R. H., Jones E. A. The chronic sequelae of non-A, non-B hepatitis. Ann Intern Med. 1979 Jul;91(1):1–6. doi: 10.7326/0003-4819-91-1-1. [DOI] [PubMed] [Google Scholar]
  5. Berris B., Wrobel D. M., Sinclair J. C., Feinman S. V. Hepatitis B antigen in families of blood donors. Ann Intern Med. 1973 Nov;79(5):690–693. doi: 10.7326/0003-4819-79-5-690. [DOI] [PubMed] [Google Scholar]
  6. Bockman J. M., Kingsbury D. T., McKinley M. P., Bendheim P. E., Prusiner S. B. Creutzfeldt-Jakob disease prion proteins in human brains. N Engl J Med. 1985 Jan 10;312(2):73–78. doi: 10.1056/NEJM198501103120202. [DOI] [PubMed] [Google Scholar]
  7. Boxall E. H. Letter: Breast-feeding and hepatitis B. Lancet. 1975 Nov 15;2(7942):979–979. doi: 10.1016/s0140-6736(75)90390-6. [DOI] [PubMed] [Google Scholar]
  8. Bréchot C., Degos F., Lugassy C., Thiers V., Zafrani S., Franco D., Bismuth H., Trépo C., Benhamou J. P., Wands J. Hepatitis B virus DNA in patients with chronic liver disease and negative tests for hepatitis B surface antigen. N Engl J Med. 1985 Jan 31;312(5):270–276. doi: 10.1056/NEJM198501313120503. [DOI] [PubMed] [Google Scholar]
  9. Chu C. M., Karayiannis P., Fowler M. J., Monjardino J., Liaw Y. F., Thomas H. C. Natural history of chronic hepatitis B virus infection in Taiwan: studies of hepatitis B virus DNA in serum. Hepatology. 1985 May-Jun;5(3):431–434. doi: 10.1002/hep.1840050315. [DOI] [PubMed] [Google Scholar]
  10. Dienstag J. L. Non-A, non-B hepatitis. I. Recognition, epidemiology, and clinical features. Gastroenterology. 1983 Aug;85(2):439–462. [PubMed] [Google Scholar]
  11. Drew W. L., Conant M. A., Miner R. C., Huang E. S., Ziegler J. L., Groundwater J. R., Gullett J. H., Volberding P., Abrams D. I., Mintz L. Cytomegalovirus and Kaposi's sarcoma in young homosexual men. Lancet. 1982 Jul 17;2(8290):125–127. doi: 10.1016/s0140-6736(82)91092-3. [DOI] [PubMed] [Google Scholar]
  12. Epstein M. A., Morgan A. J., Finerty S., Randle B. J., Kirkwood J. K. Protection of cottontop tamarins against Epstein-Barr virus-induced malignant lymphoma by a prototype subunit vaccine. Nature. 1985 Nov 21;318(6043):287–289. doi: 10.1038/318287a0. [DOI] [PubMed] [Google Scholar]
  13. Fauci A. S., Masur H., Gelmann E. P., Markham P. D., Hahn B. H., Lane H. C. NIH conference. The acquired immunodeficiency syndrome: an update. Ann Intern Med. 1985 Jun;102(6):800–813. doi: 10.7326/0003-4819-102-6-800. [DOI] [PubMed] [Google Scholar]
  14. Feinman S. V., Berris B., Rebane A., Sinclair J. C., Wilson S., Wrobel D. Failure to detect hepatitis B surface antigen (HBsAg) in feces of HBsAg-positive persons. J Infect Dis. 1979 Sep;140(3):407–410. doi: 10.1093/infdis/140.3.407. [DOI] [PubMed] [Google Scholar]
  15. Feinman S. V., Krassnitski O., Sinclair J. C., Wrobel D. M., Berris B. Hepatitis B surface antigen in saliva of HB-SAg carriers. J Lab Clin Med. 1975 Jun;85(6):1042–1048. [PubMed] [Google Scholar]
  16. Fiala M., Payne J. E., Berne T. V., Moore T. C., Henle W., Montgomerie J. Z., Chatterjee S. N., Guze L. B. Epidemiology of cytomegalovirus infection after transplantation and immunosuppression. J Infect Dis. 1975 Oct;132(4):421–433. doi: 10.1093/infdis/132.4.421. [DOI] [PubMed] [Google Scholar]
  17. Fournier J. G., Tardieu M., Lebon P., Robain O., Ponsot G., Rozenblatt S., Bouteille M. Detection of measles virus RNA in lymphocytes from peripheral-blood and brain perivascular infiltrates of patients with subacute sclerosing panencephalitis. N Engl J Med. 1985 Oct 10;313(15):910–915. doi: 10.1056/NEJM198510103131502. [DOI] [PubMed] [Google Scholar]
  18. Fujinami R. S., Oldstone M. B. Amino acid homology between the encephalitogenic site of myelin basic protein and virus: mechanism for autoimmunity. Science. 1985 Nov 29;230(4729):1043–1045. doi: 10.1126/science.2414848. [DOI] [PubMed] [Google Scholar]
  19. Gajdusek D. C. Unconventional viruses and the origin and disappearance of kuru. Science. 1977 Sep 2;197(4307):943–960. doi: 10.1126/science.142303. [DOI] [PubMed] [Google Scholar]
  20. Garnett H. M. Isolation of human cytomegalovirus from peripheral blood T cells of renal transplant patients. J Lab Clin Med. 1982 Jan;99(1):92–97. [PubMed] [Google Scholar]
  21. Giraldo G., Beth E., Henle W., Henle G., Mike V., Safai B., Huraux J. M., McHardy J., deThé G. Antibody patterns to herpesviruses in Kaposi's sarcoma. II. Serological association of American Kaposi's sarcoma with cytomegalovirus. Int J Cancer. 1978 Aug 15;22(2):126–131. doi: 10.1002/ijc.2910220204. [DOI] [PubMed] [Google Scholar]
  22. Giraldo G., Beth E., Huang E. S. Kaposi's sarcoma and its relationship to cytomegalovirus (CMNV). III. CMV DNA and CMV early antigens in Kaposi's sarcoma. Int J Cancer. 1980 Jul 15;26(1):23–29. doi: 10.1002/ijc.2910260105. [DOI] [PubMed] [Google Scholar]
  23. Govindarajan S., Lee S. D., Tong M. J., Tsai Y. T., Lo K. J. Prevalence of delta agent among Chinese in Taiwan and Los Angeles. J Med Virol. 1984;14(1):33–37. doi: 10.1002/jmv.1890140106. [DOI] [PubMed] [Google Scholar]
  24. Groopman J. E., Salahuddin S. Z., Sarngadharan M. G., Markham P. D., Gonda M., Sliski A., Gallo R. C. HTLV-III in saliva of people with AIDS-related complex and healthy homosexual men at risk for AIDS. Science. 1984 Oct 26;226(4673):447–449. doi: 10.1126/science.6093247. [DOI] [PubMed] [Google Scholar]
  25. Hadler S. C., De Monzon M., Ponzetto A., Anzola E., Rivero D., Mondolfi A., Bracho A., Francis D. P., Gerber M. A., Thung S. Delta virus infection and severe hepatitis. An epidemic in the Yucpa Indians of Venezuela. Ann Intern Med. 1984 Mar;100(3):339–344. doi: 10.7326/0003-4819-100-3-339. [DOI] [PubMed] [Google Scholar]
  26. Hallam N. F. Non-A, non-B hepatitis: reverse transcriptase activity? Lancet. 1985 Sep 21;2(8456):665–665. doi: 10.1016/s0140-6736(85)90027-3. [DOI] [PubMed] [Google Scholar]
  27. Handsfield H. H., Chandler S. H., Caine V. A., Meyers J. D., Corey L., Medeiros E., McDougall J. K. Cytomegalovirus infection in sex partners: evidence for sexual transmission. J Infect Dis. 1985 Feb;151(2):344–348. doi: 10.1093/infdis/151.2.344. [DOI] [PubMed] [Google Scholar]
  28. Hoofnagle J. H., Gerety R. J., Tabor E., Feinstone S. M., Barker L. F., Purcell R. H. Transmission of non-A, non-B hepatitis. Ann Intern Med. 1977 Jul;87(1):14–20. doi: 10.7326/0003-4819-87-1-14. [DOI] [PubMed] [Google Scholar]
  29. Hoofnagle J. H., Seeff L. B. Natural history of chronic type B hepatitis. Prog Liver Dis. 1982;7:469–479. [PubMed] [Google Scholar]
  30. Horwitz C. A., Henle W., Henle G., Rudnick H., Latts E. Long-term serological follow-up of patients for Epstein-Barr virus after recovery from infectious mononucleosis. J Infect Dis. 1985 Jun;151(6):1150–1153. doi: 10.1093/infdis/151.6.1150. [DOI] [PubMed] [Google Scholar]
  31. Jones J. F., Ray C. G., Minnich L. L., Hicks M. J., Kibler R., Lucas D. O. Evidence for active Epstein-Barr virus infection in patients with persistent, unexplained illnesses: elevated anti-early antigen antibodies. Ann Intern Med. 1985 Jan;102(1):1–7. doi: 10.7326/0003-4819-102-1-. [DOI] [PubMed] [Google Scholar]
  32. Kane M. A., Bradley D. W., Shrestha S. M., Maynard J. E., Cook E. H., Mishra R. P., Joshi D. D. Epidemic non-A, non-B hepatitis in Nepal. Recovery of a possible etiologic agent and transmission studies in marmosets. JAMA. 1984 Dec 14;252(22):3140–3145. doi: 10.1001/jama.252.22.3140. [DOI] [PubMed] [Google Scholar]
  33. Karayiannis P., Fowler M. J., Lok A. S., Greenfield C., Monjardino J., Thomas H. C. Detection of serum HBV-DNA by molecular hybridisation. Correlation with HBeAg/anti-HBe status, racial origin, liver histology and hepatocellular carcinoma. J Hepatol. 1985;1(2):99–106. doi: 10.1016/s0168-8278(85)80759-5. [DOI] [PubMed] [Google Scholar]
  34. Karayiannis P., Novick D. M., Lok A. S., Fowler M. J., Monjardino J., Thomas H. C. Hepatitis B virus DNA in saliva, urine, and seminal fluid of carriers of hepatitis B e antigen. Br Med J (Clin Res Ed) 1985 Jun 22;290(6485):1853–1855. doi: 10.1136/bmj.290.6485.1853. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Khuroo M. S. Study of an epidemic of non-A, non-B hepatitis. Possibility of another human hepatitis virus distinct from post-transfusion non-A, non-B type. Am J Med. 1980 Jun;68(6):818–824. doi: 10.1016/0002-9343(80)90200-4. [DOI] [PubMed] [Google Scholar]
  36. Kim H. C., Saidi P., Ackley A. M., Bringelsen K. A., Gocke D. J. Prevalence of type B and non-A, non-B hepatitis in hemophilia: relationship to chronic liver disease. Gastroenterology. 1980 Dec;79(6):1159–1164. [PubMed] [Google Scholar]
  37. Klein G., Klein E. The changing faces of EBV research. Prog Med Virol. 1984;30:87–106. [PubMed] [Google Scholar]
  38. Koch T. K., Berg B. O., De Armond S. J., Gravina R. F. Creutzfeldt-Jakob disease in a young adult with idiopathic hypopituitarism. Possible relation to the administration of cadaveric human growth hormone. N Engl J Med. 1985 Sep 19;313(12):731–733. doi: 10.1056/NEJM198509193131206. [DOI] [PubMed] [Google Scholar]
  39. Lang D. J., Kummer J. F. Cytomegalovirus in semen: observations in selected populations. J Infect Dis. 1975 Oct;132(4):472–473. doi: 10.1093/infdis/132.4.472. [DOI] [PubMed] [Google Scholar]
  40. Martin D. C., Katzenstein D. A., Yu G. S., Jordan M. C. Cytomegalovirus viremia detected by molecular hybridization and electron microscopy. Ann Intern Med. 1984 Feb;100(2):222–225. doi: 10.7326/0003-4819-100-2-222. [DOI] [PubMed] [Google Scholar]
  41. Miller G. The oncogenicity of Epstein-Barr virus. J Infect Dis. 1974 Aug;130(2):187–205. doi: 10.1093/infdis/130.2.187. [DOI] [PubMed] [Google Scholar]
  42. Mims C. A. Viral aetiology of diseases of obscure origin. Br Med Bull. 1985 Jan;41(1):63–69. doi: 10.1093/oxfordjournals.bmb.a072027. [DOI] [PubMed] [Google Scholar]
  43. Modlin J. F., Halsey N. A., Eddins D. L., Conrad J. L., Jabbour J. T., Chien L., Robinson H. Epidemiology of subacute sclerosing panencephalitis. J Pediatr. 1979 Feb;94(2):231–236. doi: 10.1016/s0022-3476(79)80829-x. [DOI] [PubMed] [Google Scholar]
  44. Moniz E., Feldman F., Newkirk M., Feinman S. V., Berris B. Removal of hepatitis B surface antigen from a contaminated applanation tonometer. Am J Ophthalmol. 1981 Apr;91(4):522–525. doi: 10.1016/0002-9394(81)90243-9. [DOI] [PubMed] [Google Scholar]
  45. Mosley J. W., Redeker A. G., Feinstone S. M., Purcell R. H. Mutliple hepatitis viruses in multiple attacks of acute viral hepatitis. N Engl J Med. 1977 Jan 13;296(2):75–78. doi: 10.1056/NEJM197701132960204. [DOI] [PubMed] [Google Scholar]
  46. Padgett B. L., Rogers C. M., Walker D. L. JC virus, a human polyomavirus associated with progressive multifocal leukoencephalopathy: additional biological characteristics and antigenic relationships. Infect Immun. 1977 Feb;15(2):656–662. doi: 10.1128/iai.15.2.656-662.1977. [DOI] [PMC free article] [PubMed] [Google Scholar]
  47. Prince A. M., Huima T., Williams B. A., Bardina L., Brotman B. Isolation of a virus from chimpanzee liver cell cultures inoculated with sera containing the agent of non-A, non-B hepatitis. Lancet. 1984 Nov 10;2(8411):1071–1075. doi: 10.1016/s0140-6736(84)91509-5. [DOI] [PubMed] [Google Scholar]
  48. Prusiner S. B. Novel proteinaceous infectious particles cause scrapie. Science. 1982 Apr 9;216(4542):136–144. doi: 10.1126/science.6801762. [DOI] [PubMed] [Google Scholar]
  49. Resnick L., diMarzo-Veronese F., Schüpbach J., Tourtellotte W. W., Ho D. D., Müller F., Shapshak P., Vogt M., Groopman J. E., Markham P. D. Intra-blood-brain-barrier synthesis of HTLV-III-specific IgG in patients with neurologic symptoms associated with AIDS or AIDS-related complex. N Engl J Med. 1985 Dec 12;313(24):1498–1504. doi: 10.1056/NEJM198512123132402. [DOI] [PubMed] [Google Scholar]
  50. Resnick R. H., Stone K., Antonioli D. Primary hepatocellular carcinoma following non-A, non-B posttransfusion hepatitis. Dig Dis Sci. 1983 Oct;28(10):908–911. doi: 10.1007/BF01317042. [DOI] [PubMed] [Google Scholar]
  51. Rickinson A. B., Yao Q. Y., Wallace L. E. The Epstein-Barr virus as a model of virus-host interactions. Br Med Bull. 1985 Jan;41(1):75–79. doi: 10.1093/oxfordjournals.bmb.a072030. [DOI] [PubMed] [Google Scholar]
  52. Rizzetto M., Purcell R. H., Gerin J. L. Epidemiology of HBV-associated delta agent: geographical distribution of anti-delta and prevalence in polytransfused HBsAg carriers. Lancet. 1980 Jun 7;1(8180):1215–1218. doi: 10.1016/s0140-6736(80)91678-5. [DOI] [PubMed] [Google Scholar]
  53. Rizzetto M. The delta agent. Hepatology. 1983 Sep-Oct;3(5):729–737. doi: 10.1002/hep.1840030518. [DOI] [PubMed] [Google Scholar]
  54. Schrier R. D., Nelson J. A., Oldstone M. B. Detection of human cytomegalovirus in peripheral blood lymphocytes in a natural infection. Science. 1985 Nov 29;230(4729):1048–1051. doi: 10.1126/science.2997930. [DOI] [PubMed] [Google Scholar]
  55. Seto B., Coleman W. G., Jr, Iwarson S., Gerety R. J. Detection of reverse transcriptase activity in association with the non-A, non-B hepatitis agent(s). Lancet. 1984 Oct 27;2(8409):941–943. doi: 10.1016/s0140-6736(84)91163-2. [DOI] [PubMed] [Google Scholar]
  56. Shafritz D. A., Lieberman H. M. The molecular biology of hepatitis B virus. Annu Rev Med. 1984;35:219–232. doi: 10.1146/annurev.me.35.020184.001251. [DOI] [PubMed] [Google Scholar]
  57. Shafritz D. A., Shouval D., Sherman H. I., Hadziyannis S. J., Kew M. C. Integration of hepatitis B virus DNA into the genome of liver cells in chronic liver disease and hepatocellular carcinoma. Studies in percutaneous liver biopsies and post-mortem tissue specimens. N Engl J Med. 1981 Oct 29;305(18):1067–1073. doi: 10.1056/NEJM198110293051807. [DOI] [PubMed] [Google Scholar]
  58. Shimizu Y. K., Feinstone S. M., Purcell R. H., Alter H. J., London W. T. Non-A, non-B hepatitis: ultrastructural evidence for two agents in experimentally infected chimpanzees. Science. 1979 Jul 13;205(4402):197–200. doi: 10.1126/science.451589. [DOI] [PubMed] [Google Scholar]
  59. Shimizu Y. K., Oomura M., Abe K., Uno M., Yamada E., Ono Y., Shikata T. Production of antibody associated with non-A, non-B hepatitis in a chimpanzee lymphoblastoid cell line established by in vitro transformation with Epstein-Barr virus. Proc Natl Acad Sci U S A. 1985 Apr;82(7):2138–2142. doi: 10.1073/pnas.82.7.2138. [DOI] [PMC free article] [PubMed] [Google Scholar]
  60. Sixbey J. W., Nedrud J. G., Raab-Traub N., Hanes R. A., Pagano J. S. Epstein-Barr virus replication in oropharyngeal epithelial cells. N Engl J Med. 1984 May 10;310(19):1225–1230. doi: 10.1056/NEJM198405103101905. [DOI] [PubMed] [Google Scholar]
  61. Snider W. D., Simpson D. M., Nielsen S., Gold J. W., Metroka C. E., Posner J. B. Neurological complications of acquired immune deficiency syndrome: analysis of 50 patients. Ann Neurol. 1983 Oct;14(4):403–418. doi: 10.1002/ana.410140404. [DOI] [PubMed] [Google Scholar]
  62. Tobi M., Morag A., Ravid Z., Chowers I., Feldman-Weiss V., Michaeli Y., Ben-Chetrit E., Shalit M., Knobler H. Prolonged atypical illness associated with serological evidence of persistent Epstein-Barr virus infection. Lancet. 1982 Jan 9;1(8263):61–64. doi: 10.1016/s0140-6736(82)90210-0. [DOI] [PubMed] [Google Scholar]
  63. Weil M. L., Itabashi H., Cremer N. E., Oshiro L., Lennette E. H., Carnay L. Chronic progressive panencephalitis due to rubella virus simulating subacute sclerosing panencephalitis. N Engl J Med. 1975 May 8;292(19):994–998. doi: 10.1056/NEJM197505082921903. [DOI] [PubMed] [Google Scholar]
  64. Weller T. H. The cytomegaloviruses: ubiquitous agents with protean clinical manifestations. II. N Engl J Med. 1971 Jul 29;285(5):267–274. doi: 10.1056/NEJM197107292850507. [DOI] [PubMed] [Google Scholar]
  65. Wildy P., Gell P. G. The host response to herpes simplex virus. Br Med Bull. 1985 Jan;41(1):86–91. doi: 10.1093/oxfordjournals.bmb.a072032. [DOI] [PubMed] [Google Scholar]
  66. Wong-Staal F., Gallo R. C. The family of human T-lymphotropic leukemia viruses: HTLV-I as the cause of adult T cell leukemia and HTLV-III as the cause of acquired immunodeficiency syndrome. Blood. 1985 Feb;65(2):253–263. [PubMed] [Google Scholar]

Articles from CMAJ: Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association

RESOURCES