酶联免疫吸附试验检测单纯疱疹病毒抗体在生殖器疱疹筛查中的应用

目的:探讨酶联免疫吸附试验检测单纯疱疹病毒(HSV)抗体对生殖器疱疹筛查的意义。方法:选取50例2010年2月至2013年10月来我院治疗疑似生殖器疱疹患者,将其作为试验组,使用酶联免疫吸附试验进行HSV抗体检测,另外选择50例健康体检人员血清作为对照组。结果:在50例疑似生殖器疱疹患者HSV-I Ig M,HSV-I Ig G的检出率依次为14%,32%,HSV-ⅡIg M检出率为20%,HSV-ⅡIg G的检出率为34%;在对照组中HSV-I Ig M,HSV-I Ig G的检出率依次为0.8%,14%,HSV-ⅡIg M检出率为10%,HSV-ⅡIg G的检出率为24%,两组患者HSV抗体检测阳性率有显著的不同,二者明显的差异具有统计学意义(P0.05)。结论:疑似生殖器疱疹患者单纯疱疹病毒抗体检出率高,酶联免疫检测HSV抗原的方法可直接检测出泌尿生殖道及皮损中HSV病原体,在生殖器疱疹筛查中具有一定的优势。     

疑似生殖器疱疹患者单纯疱疹病毒抗原检测结果分析

目的了解生殖器疱疹疑似患者不同类型皮损中单纯疱疹病毒(HSV)抗原感染情况。方法应用酶联免疫吸附试验(ELISA)进行HSV抗原检测。结果不同类型皮损HSV抗原检出率有差异,水疱、溃疡、结痂、丘疹红斑和裂隙的HSV抗原检出率分别为83.1%,66.8%,34.6%,11.1%和9.8%。结论疱液阳性率最高,说明早期采样的重要性。而临床表现不典型的皮损如红斑、裂隙HSV抗原的检出率低(11.1%,9.8%),提示应加强对此类患者皮损中HSV抗原的检测。     

生殖器标本单纯疱疹病毒抗原检测及其临床评价

为评价酶联免疫吸附试验（ELISA）检测生殖器疱疹病毒的临床应用情况，我们应用ELISA法检测645例生殖器标本中HSV抗原。ELISA法检测不同类型的皮损，HSV抗原检出率有差异，水疱、溃疡、结痂、丘疹红斑和裂隙的HSV抗原检出率分别为83．7％、66．3％、34．6％、12．9％和12．6％。ELISA法检测HSV感染，其敏感性和特异性强，具有方便、快速等特点，适合大批量样本的检测，值得临床推广使用，尤其在基层医院。     

聚合酶链反应检测生殖器疱疹患者单纯疱疹病毒

近年来,生殖器疱疹(ＧＨ)在国内外的发病人数日益增多。由于其反复发作,给病人带来一定痛苦,且其病原体单纯疱疹病毒Ⅱ(ＨＳＶ2)与生殖器恶性肿瘤有密切关系[1],因此,越来越受到人们的重视。我们对64例临床诊断为ＧＨ的患者做聚合酶链反应(ＰＣＲ)检测。现报告如下。病例和方法一、病例　患者组:64例患者均为我科性病专科门诊病人。男58例,女6例。年龄21～63岁,其中21～24岁12例,25～29岁12例,30～39岁24例,40～49岁14例,大于49岁2例。已婚42例,未婚22例。病程2天～3年。初发者22例(34.38%),复发者42例(65.62%)。男性在阴茎包皮、龟头、冠状…     

对ELISA检测生殖器疱疹患者HSV及其临床应用的评价

目的评价酶联免疫吸附试验(ELISA)检测生殖器疱疹病毒的临床应用价值。方法采用ELISA和分型聚合酶链反应(分型PCR)检测生殖器标本中的单纯疱疹病毒(HSV),两种试验结果不符合者采用不分型PCR检测。结果164例受检者中,ELISA法HSV阳性96例(58.5%),其中具典型皮损者阳性84例(80.8%,84/104),非典型皮损阳性12例(20.0%,12/60);分型PCRHSV阳性98例(59.8%),其中典型皮损者HSV阳性86例(82.7%,86/104),非典型皮损者阳性12例(20.0%,12/60)。HSV1感染者占生殖器疱疹的5.1%,HSV2感染占88.7%,HSV1和HSV2混合感染者占6.1%。ELISA的敏感性和特异性分别为96.7%和94.0%。结论ELISA检测HSV感染,其敏感性高、特异性强,方便、快速,尤其适合大批量样本的检测。     

性病门诊836例患者单纯疱疹Ⅰ,Ⅱ型检测结果分析

目的探讨性病专科门诊患者中HSV-Ⅰ,Ⅱ型病毒的感染情况及在典型和非典型生殖器疱疹(GH)患者中的分布。方法采用荧光定量聚合酶链反应技术(FQ-PCR)对836例性病专科门诊患者进行HSV-Ⅰ,Ⅱ型DNA的检测。结果836例患者中,HSV-Ⅰ型感染38例(4.54%),男性阳性率5.20%,女性为3.36%,二者差异无显著性;HSV-Ⅱ型感染380例(45.45%),男性阳性率39.96%,女性为55.37%,二者差异有显著性(P<0.05)。具有典型GH或高度可疑GH症状者369例,HSV感染者218例;无明显GH症状者467例,HSV感染者198例,二者差异有显著性(P<0.05)。结论HSV在本地区具有较高感染率,以HSV-Ⅱ型为主。在非典型GH患者中,HSV的检出率较高,须引起临床注意。     

疑似生殖器疱疹患者标本中单纯疱疹病毒的检测

生殖器疱疹的典型症状为水疱和溃疡,但症状不典型的生殖器疱疹患者也不少,亦有女性宫颈感染单纯疱疹病毒(HSV)的报道。国内实验室诊断生殖器疱疹的方法有细胞培养法、血清抗体测定,而HSV抗原检测的报道甚少,为了解疱疹感染情况及特征,我们对疑似生殖器疱疹患者进行HSV抗原检测。     

177例可疑生殖器疱疹患者HSV-ⅡIgM/IgG抗体检测结果分析

目的:探讨Ⅱ型单纯疱疹病毒抗体(HSV-ⅡIgM/IgG)与生殖器疱疹的相关性,辅助临床诊断。方法:应用酶联免疫吸附试验(ELISA)检测血清中HSV-ⅡIgM/IgG抗体,并用PCR荧光定量法检测分泌物的HSV-Ⅱ抗原(HSV-Ⅱ-DNA)进行对比。结果:177例可疑生殖器疱疹患者检出HSV-Ⅱ抗原131例,阳性率为74.0%;检出HSV-ⅡIgM和(或)IgG共144例,阳性率为81.4%,两者没有显著性差异(2=2.96,P>0.05)。其中19例为结痂型的患者中,HSV-Ⅱ抗原阳性4例,阳性率21.1%;而HSV-Ⅱ抗体阳性14例,阳性率为73.7%。结论:同时检测血清中HSV-ⅡIgG和HSV-ⅡIgM作为生殖器疱疹筛查试验,有利于症状不典型的HSV-Ⅱ感染者的检出,提高诊断率。     

性病门诊患者单纯疱疹病毒血清型特异性抗体的检测

目的了解本地区性病门诊患者单纯疱疹病毒感染的血清学特征。方法用酶联免疫吸附试验法对864例性病患者及100例健康对照人群进行血清HSV1及HSV2抗体检测。结果性病患者血清HSV1IgM,HSV1IgG,HSV2IgM,HSV2IgG抗体阳性率分别为13.8%,90.3%,15.4%,42.4%,明显高于健康对照者的5.0%,82.0%,0,4.0%。女性患者HSV1型和2型IgM抗体阳性率分别为17.3%和23.0%,明显高于男性患者的11.0%和9.0%;男女患者HSV1型和2型IgG抗体阳性率均无统计学差异。结论性病门诊患者HSV感染严重,尤其是HSV2感染。对血清HSV2抗体阳性者采取行为干预及预防性治疗,对降低HSV传播的危险性及复发频率具有十分重要的意义。     

278例单纯疱疹病毒检测分析

目的:了解生殖器溃疡患者中单纯疱疹病毒(HSV)感染情况。方法:采用免疫酶技术对278例、6个病种生殖器溃疡标本作HSV检测。结果:278例生殖器溃疡患者HSV检出率36.70%(102/278)。其中男性HSV检出率34.86%(76/218),女性HSV检出率43.33%(26/60)。糜烂性龟头炎125例,不典型硬下疳50例,药物性皮炎27例,接触性皮炎40例,糜烂性扁平苔癣8例,机械性损伤28例,HSV检出率分别为16.20%(45/278),7.20%(20/278),3.20%(9/278),5.40%(15/278),1.10%(3/278)和3.50%(10/278)。结论:生殖器溃疡的HSV感染率升高。女性HSV检出率明显高于男性,加强对女性患者的HSV主动检测是防治生殖器溃疡的重要环节。并提示对高危人群的不典型生殖器溃疡,及时做HSV检测是早期诊断和鉴别生殖器疱诊的重要手段之一。     

间接免疫荧光法检测生殖器疱疹病毒

目的:评价间接免疫荧光试验(IFA)在生殖器疱疹(GH)诊断中的应用价值。方法:采用以单纯疱疹病毒(HSV)型共同性单克隆抗体为夹心的IFA法,检测了120例临床诊断为GH患者皮疹中的HSV,并与病毒培养法进行比较。结果:IFA检测HSV的总阳性率为85.8%,高于病毒培养法的阳性率(70.8%,χ2=12.04,P<0.01)。两种方法检测GH水疱内的HSV阳性率分别为93.3%和90.0%,无明显差异(χ2=1.96,P>0.05);而检测糜烂和结痂性皮疹内的HSV时,IFA的阳性率分别为92.6%和69.4%,均分别高于病毒培养法(75.9%,χ2=5.82,P<0.05;47.2%,χ2=14.17,P<0.01)。结论:IFA法具有简单、快速、敏感性高的优点,适于检测GH患者皮疹内HSV,有临床实用价值。     

抗原捕获聚合酶链反应分型检测妇女生殖器单纯疱疹病毒

目的 :　建立直接分型检测妇女生殖器单纯疱疹病毒 (HSV)的抗原捕获聚合酶链反应 (AC -PCR)。方法 :　用抗HSV型共同性糖蛋白单克隆抗体 ,包被聚苯乙烯离心管 ,捕获HSV ,同时加入 3个引物 :HSV - 1 HSV - 2型共同性上游引物及HSV - 1和HSV - 2型特异性下游引物 ,进行PCR扩增。结果 :HSV - 1和HSV - 2标准病毒株均分别扩增出与设计大小相符的 4 77bp和 399bpDNA条带。AC -PCR可检测到 10PFUHSV - 1和 1PFUHSV - 2。用AC -PCR检测了 36 5份妇女生殖器拭子标本 ,阳性 10 1例(2 7.7% ) ,2 3例为HSV - 1(占 2 2 .8% ) ,78例为HSV - 2 (占 77.2 % ) ;其中 112份标本同时用AC -PCR和分离培养法检测 ,AC -PCR的阳性率为 2 6 .8% (30 112 ) ,分离培养法的阳性率为 2 0 .5 % (2 3 112 ) ,两者差异有显著性 (χ2 =4 .5 ,P <0 .0 5 )。结论 :　AC -PCR是特异、敏感、快速分型检测妇女生殖器HSV感染的方法     

生殖器疱疹病毒感染检测方法的临床应用

目的 :　评价检测生殖器疱疹病毒实验方法的临床应用价值。方法 :　同时采用细胞培养法、定量PCR法、间接免疫荧光法 (IIF)对 5 3例生殖器疱疹 (GH)感染患者进行了HSV检测。结果 :　细胞培养、定量PCR检测HSV阳性率明显高于IIF法 (P <0 .0 1) ,细胞培养与定量PCR比较无显著性差异 (P >0 .0 5 )。三种方法检测GH患者皮疹水疱内的阳性率无明显差异 (P >0 .0 5 )。IIF法检测糜烂结痂的阳性率仅为 2 8.6 %。结论 :　三种方法均适用GH水疱期患者标本的检查。而定量PCR、细胞培养检测GH糜烂结痂患者标本较IIF法敏感     

生殖器溃疡中单纯疱疹病毒的检测和分型

目的：了解性病门诊生殖器溃疡患者中单纯疱疹病毒（HSV）感染情况，并评价聚合酶链反应（PCR）－微孔板反向杂交检测和分型方法在生器疱疹诊断中的意义。方法：采用病毒分离培养、普通PCR和PCR－微孔板反向杂交法同时对200份生殖器溃疡标本作了HSV检测与分型。结果：PCR－微孔板反向杂交法的敏感性和特异性分别为98．1％和95．9％，PCR－微孔板杂交法分型结果与病毒分离培养法和普遍PCR的分型结果完全相符。生殖器溃疡中HSV检出率为30％（60／200），其中HSV－2感染占96．7％（58／60）。结论：HSV－2是性病门诊患者生殖器溃疡的主要病因之一，PCR－微孔板反向杂交法是一种适用生殖器溃疡标本中HSV的检测与分型的快速、敏感和特异的诊断方法。     

Seroprevalence of herpes simplex virus type 1 and type 2 in Turkey

BACKGROUND: Herpes simplex virus (HSV) infections are among the most common infectious diseases in humans. The prevalence of herpes simplex viruses type 1 (HSV-1) and type 2 (HSV-2) varies widely across the world. HSV-2 infection is the primary cause of genital herpes. It is highly prevalent in human populations in many parts of the world, and is the most common cause of genital ulcer disease worldwide. In spite of the large prevalence and growing incidence of herpes simplex infection (HSV-1 and HSV-2), relatively few data have been published regarding the seroprevalence of herpes simplex infection, while no data exist regarding the Turkish population. METHODS: We aimed to investigate the prevalence of HSV-1 and HSV-2 in selected populations in Turkey. A cross-sectional study was conducted involving 2082 serum samples of 725 adults, 300 pregnant women, 200 blood donors, 483 sex workers and 110 patients with genital warts and 264 hotel staff in Istanbul, Turkey. All serum samples were assessed for HSV1 and HSV-2 IgG antibodies using an HSV-type specific, enzyme-linked immunosorbent assay (ELISA). RESULTS: The prevalence of HSV-2 and HSV-1 antibodies was 4.8 and 85.3% in sexually active adults; 5.5 and 96% in blood donors; 5 and 98% in pregnant women, 17.3 and 93.6% in patients with genital warts; 8.3 and 97.3% in hotel staff; and 60% and 99% in sex workers. CONCLUSION: These results confirm a higher prevalence of HSV infection than estimated, especially in high risk groups in Turkey. The high prevalence of HSV infection underlines the need for education among these populations.     

Peculiar vegetative tumor-like genital herpes simplex nodules with brisk tissue eosinophilia in patients with human immunodeficiency virus infection

Genital herpes simplex virus (HSV) infection in a human immunodeficiency virus (HIV) patient can present as a vegetative nodule. Clinical differential diagnoses of the nodule include condyloma latum, condyloma acuminatum, viral or fungal infection, and cutaneous neoplasms. Histological examination of herpetic nodules has been reported to show thick pseudoepitheliomatous hyperplasia with dense dermal lymphoplasmacytic infiltrate and multifocal multinucleated cells with herpetic viral cytopathic changes. We report two patients with HIV presenting with vegetative tumor-like HSV nodules with distinctive histopathologic pattern of inflammation that has not been described in the literature before. All samples displayed slightly acanthotic epidermis with focal ulceration, dense dermal sclerosis, scattered plasma cells, and a brisk lymphoeosinophilic infiltrate found dissecting between dense collagen bundles. This pattern of inflammation is an important clue that can guide the pathologist to look for focal herpetic viral changes in the epidermis, as patients with HIV possibly tend to amount a predominantly eosinophilic immune response in inflammatory skin conditions.     

生殖器疱疹患者尿道和宫颈HSV感染的研究

目的：了解生殖器疱疹（GH）患者伴发宫颈和男性尿道单纯疱疹病毒（HSV）感染情况，进一步探讨HSV和非淋菌性尿道炎／官颈炎（NGU）的关系。方法：用HSV聚合酶链反应（PCR）方法检测了56例GH患者的宫颈和男性尿道拭子标本。结果：56例患者中HSV PCR检测阳性共5例，阳性率为8．93％（5／56）。20例女性生殖器疱疹患者宫颈HSV PCR检测阳性率为25．0％（5／20）；36例男性GH患者尿道HSV PCR检测结果均为阴性。结论：生殖器疱疹患者伴发女性宫颈HSV感染更为常见，而伴发男性尿道HSV感染相对少见。HSV感染可能是非淋菌性尿道炎／宫颈炎的一个致病因子，在女性宫颈炎的发病中可能更有意义。     

Incidence of serum antibody titers against herpes simplex virus in Japanese patients

Herpes simplex virus (HSV) establishes latency in the sensory neuronal ganglia after primary infection, and occasionally causes recurrent infection, mainly on the lips or genitalia. Previous reports revealed an age‐related increase in HSV‐immunoglobulin G seropositive subjects in a hospital‐based study and the general population in Japan. In this report, we retrospectively analyzed the results of serological tests against HSV, in which subjects were diagnosed with or suspected as having HSV infection. A total of 1216 subjects with at least one complement fixation (CF) result were included. Of these, 771 subjects (63.4%) were positive at first visit. When stratified by age, incidence of positive patients linearly increased with age from teenagers (44.9%) to those in their 80s (88.9%). Positivity in women was higher than in men overall; significantly higher incidence was observed in women aged in their 30s, 40s and 60s. When observing changing HSV‐CF titers over time in 81 initially negative patients, 18 (22%) seroconverted during the 2121‐day observation period. In this study, we clearly show that distribution of HSV‐CF titers is similar to previous HSV‐immunoglobulin G results. This correlation is probably caused by the continual subclinical proliferation of HSV, thus maintaining CF titers. Our observations provide current data on the incidence of HSV, reconfirming that serological examination is unreliable in diagnosing recurrent herpes, and the majority of infected subjects are asymptomatic.     

The psychosocial impact of serological diagnosis of asymptomatic herpes simplex virus type 2 infection

OBJECTIVES: To evaluate the impact of a positive herpes simplex virus type 2 (HSV-2) serological test on psychosocial functioning among people with no known history of genital herpes. METHODS: Individuals (age 14-30 years) without a history of genital herpes were recruited from an urban university setting and sexually transmitted diseases (STD), primary care, and adolescent clinics. Participants completed a questionnaire addressing psychological functioning, psychosocial adjustment, and perceived quality of sex and were offered free HSV-2 antibody testing. 33 HSV-2 positive people and 60 HSV-2 negative people demographically matched from the same source of recruitment were re-evaluated at a 3 month follow up visit. HSV-2 positive participants also completed a genital herpes quality of life (GHQOL) measure. RESULTS: Of the 33 who were HSV-2 seropositive, four did not recall their diagnosis. In comparing those who were HSV-2 positive with those who were negative, repeated measures analysis of variance indicated there were no significant differences over time on any of the measures. None the less, many HSV-2 positive individuals indicated that the diagnosis had a notable impact on their quality of life. Also, among the HSV-2 positive people, lower GHQOL at the 3 month follow up was predicted by higher interpersonal sensitivity (r = -0.44, p<0.05), lower social support (r = 0.40, p<0.05), and quality of sex (r = 0.62, p<0.01) at baseline. CONCLUSIONS: A diagnosis of asymptomatic HSV-2 infection does not appear to cause significant lasting psychological difficulties. Those for whom the diagnosis had the greatest impact were interpersonally vulnerable before the diagnosis. These results suggest that assessment of interpersonal distress may be important to include as part of pretest and post-test counselling.     

126例生殖器疱疹的临床和病毒学检查的分析

为了探讨生殖器疱疹的临床和病毒学特征,对126例生殖器疱疹患者的临床资料和病毒检测与分型结果作了分析。结果：皮损为典型的集簇性水疱、脓疱、水溃疡及结痂者占71.4%(90/126),为裂隙、非特异性红斑等不典型损害者占28.6%(36/126)。HSV-2感染占91.3%（115/126）,HSV-1感染占7.1%(9/126),混合感染占1.6%（2/126）;男性初发病例中HSV-1感染占17.2%(5/29)。结果表明生殖器疱疹的临床表现多种多样;我国的生殖器疱疹主要由HSV-2引起,但男性初发病例中HSV-1感染较常见。