Primary cytomegalovirus and opportunistic infections. Incidence in renal transplant recipients.

Thirty-five renal allograft recipients were studied concerning the relationship between cytomegalovirus (CMV), herpes simplex virus (HSV), and opportunistic bacterial and fungal infections. The incidence of opportunistic infections was determined for patients whose tests prior to transplantation were seronegative in complement fixation and indirect hemagglutination assays of CMV antibody and for those patients whose tests were seropositive. Among the six seronegative patients with seronegative tests, four (66%) experienced active CMV infection within two months, and four died of Candida or Aspergillus infection within six months after transplantation. Among the 22 patients with seropositive tests, only one (4%) had a fungal infection and it was nonfatal (P less than .05). The increased morbidity and mortality due to fungal and bacterial infections in transplant recipients with seronegative CMV tests appears, therefore, to be related to primary CMV infection rather than to generalized immunodeficiency.     

Acyclovir prophylaxis against herpes virus infections in severely immunocompromised patients: randomised double blind trial

Twenty patients undergoing allogeneic bone marrow transplantation and 39 patients receiving remission induction chemotherapy for acute leukaemia were entered into a double blind, placebo controlled stratified trial of acyclovir prophylaxis against herpes group virus infections. Within the transplant group intravenous acyclovir 5 mg/kg twice daily given throughout the period of granulocytopenia completely prevented oropharyngeal herpes simplex virus infection compared with a 50% incidence in the placebo arm (p = 0.033). The acyclovir group also had fewer days of fever during the trial and a shorter duration of leukopenia, possibly because of the prevention of herpes simplex virus infections. There was a high incidence of herpes infections after the trial in patients who received either acyclovir or placebo. In the non-transplant group there was also a significant reduction of herpes simplex virus infection in the oropharynx and oesophagus (two out of 19 patients as compared with 10 out of 20; p = 0.018). Herpes simplex virus was isolated in the acyclovir arm within a day after starting the trial in one patient, and the other failure was due to a virus with reduced sensitivity to acyclovir in a patient who had had several previous courses of the drug. The incidence of herpes infections after stopping treatment was low. The influence of acyclovir on excretion of Epstein-Barr virus in saliva in either group was inconclusive. One patient (transplant group) developed a cytomegalovirus infection while receiving acyclovir. Acyclovir provides effective prophylaxis against oropharyngeal and oesophageal herpes simplex virus infection in severely immunocompromised seropositive (greater than or equal to 1/8) patients. In patients given bone marrow transplants this may have the additional benefit of reducing the time to recovery of an adequate blood count and the number of days of fever.     

Impact of pathogen burden on in-stent restenosis in patients after coronary stent implantation

Background Although some certain infectious pathogens could be detected in the patients with coronary artery disease, the roles of these infectious factors in the development of coronary artery diseases remain largely unknown. Since the number of infectious pathogens has been argued to be relative to the coronary artery diseases, we therefore examined whether there is a link between the number of infections and the incidence of in- stent restenosis after stent implantation. Methods One hundred and eighty-one patients were enrolled in this study. Infectious pathogens including serum anti-Chlymydia p neumoniae, cytomegalovirus, Helico pylori, human herpes simplex virus-1, human herpes simplex virus-2 antibodies and hepatitis B virus antigen were measured in all patients before coronary stent implantation. Coronary angiography was performed before, immediately after and 6 months after stent implantation. Results Restenosis rate 6 months post stent implantation was similar in patients with low pathogen burden （ 〈3 pathagens, 33.3% ） to those with high pathogen burden （ ≥3 pathogens, 29. 1% ）. Conclusions Previous infections with Chlymydia pneumoniae, cytomegalovirus, Helico pylori, human herpes simplex virus-l, human herpes simplex virus-2 and hepatitis B virus do not contribute to the incidence of restenosis after stent implantation.     

Viral infections in sudden hearing loss. Do we have enough evidence?

OBJECTIVE: The aetiology of sudden deafness remains unknown even though some evidences suggest that it could be viral in origin. This study aimed to find out the relationship between viral infections and sudden sensorineural hearing loss. METHODS: 32 patients presenting with sudden deafness and 10 healthy controls were included in the study. IgM antibodies to varicella zoster virus, measles, cytomegalovirus and herpes simplex virus were detected using micro ELISA. RESULTS: Overall, 7(21.8%) patients showed seropositivity to one or more viruses. Virus specific IgM antibodies against measles and varicella zoster could be demonstrated in 4 (12.5%) and 3 (9.4%) patients respectively. None of the samples were found to be positive for herpes simplex virus (HSV) and human cytomegalovirus (HCMV) specific IgM antibodies. Controls were negative for all the viruses tested. The difference in seropositivity between the patient and control group was not statistically significant (p>0.05). CONCLUSION: Thus, this study suggests that sudden deafness is not commonly associated with a systemic viral infection.     

通用引物检测儿童血和脑脊液的6种疱疹类病毒

目的:通过PCR-RFLP、DNA克隆和测序分析来检测和区分6种疱疹类病毒,探讨其在临床上的应用价值.方法:在疱疹类病毒高度同源序列DNA多聚酶基因中设计两对通用引物,一对扩增单纯疱疹病毒1型和2型、爱泼斯坦-马尔病毒、人巨细胞病毒4种病毒,另一对扩增水痘-带状疱疹病毒和人类疱疹病毒6型2种病毒,经DNA PCR扩增,并对扩增产物进行分子克隆、序列分析后,选择BamHⅠ或BstUⅠ酶切扩增产物进行鉴别.最后,对临床38份脑脊液(CSF,临床诊断为病毒性脑炎的病例)和49份血标本(其中27份为确诊病例,22份为临床诊断病例)进行疱疹病毒的检测.结果:38份CSF标本中13份阳性(34.2%),27份确诊病例标本均阳性(100%),22份临床诊断病例标本16份阳性(72.7%).这些阳性标本通过BamHⅠ或BstUⅠ两种酶切后能明确系何种疱疹类病毒.68例正常健康儿童的血和9份非病毒感染的脑脊液标本6种疱疹类病毒DNA均为阴性.结论:聚合酶链反应加限制性内切酶片段长度多态性分析为疱疹类病毒感染的临床诊断提供了一种有效的手段.     

Oral acyclovir for treatment of first-episode herpes simplex virus proctitis

Twenty-nine patients with first-episode rectal herpes simplex virus infection were enrolled in a double-blind trial of oral acyclovir, 400 mg five times daily, vs placebo treatment. Eighty percent of those receiving acyclovir compared with 25% of placebo recipients no longer had herpes simplex virus isolated from their rectal lesions three days after onset of therapy. The median duration of rectal lesions and viral excretion from rectal lesions (median, five and zero days, respectively) was significantly shorter in patients treated with acyclovir than in placebo-treated patients (14 and 11 days, respectively). Durations of local signs and symptoms of proctitis, such as rectal pain, discharge, and friability, were shorter in acyclovir recipients than in placebo recipients, but these differences were not statistically significant. Daily administration of 2 g of oral acyclovir for ten days alleviates some of the clinical signs of herpes simplex virus rectal infection.     

重庆地区TORCH感染的血清学调查

本研究对重庆地区正常人群的TORCH感染进行了血清学调查。共收集160份成人血清,多数为育龄期妇女者,以及100份脐带血清。对上述标本以IFA法检测了弓形体抗体(IgS和IgM),以ELISA法检测巨细胞病毒(CMV)抗体(CMV-IgG和CMV-IgM),以乳胶凝集法检测风疹抗体,以及以补体结合试验(CF)检测单纯疱疹抗体。成人的弓形体、CMV、风疹、单纯疱疹感染率各为32.6％、72.0％、89.4％和79.4％;脐带血清的阳性率则各为21.4％、79.3％、78.9％和90.7％。作者讨论了以上结果的重要性     

延吉市单纯疱疹病毒抗体的间接血球凝集试验法检测

用间接血球凝集试验法验测延吉市282例健康人的血清中单纯疱疹病毒1型抗体。检查结果表明:10岁以下年龄组抗体阳性率为48.0％,其他年龄组抗体阳性率为97.8％,两者有显著性差异(P<0.01)。10岁以上的儿童几乎都感染过HSV-1毒,汉族儿童的抗体阳性率为58.1％,朝鲜族儿童的抗体阳性率为35.1％,两者有显著性差异(P<0.01)。     

Viral opportunistic infections in HIV-infected adults

Despite the development of highly active antiretroviral therapy (HAART), opportunistic infections continue to be seen in HIV-infected patients throughout the world. The primary reason for this is the lack of access to HAART for most people living with HIV/AIDS. For patients that have access to HAART, some may not have an effective response to therapy, due to reasons such as medication toxicity, poor adherence, or drug-resistant strains of HIV. Viral infections, in particular, are a major cause of opportunistic infections in HIV-infected adults, and can lead to significant morbidity and mortality. We have reviewed the epidemiology, clinical manifestations, diagnosis, and treatment of the most common viral opportunistic infections, including cytomegalovirus, JC virus, varicella-zoster virus, herpes simplex virus, and human papillomavirus.     

中枢神经系统感染性疾病的病原学研究

目的 :探讨中枢神经系统感染性疾病的病原学特点。方法 :分别用双抗体夹心ELISA法和传统的细菌及真菌培养等方法检测患者血清IgM ,IgG抗体和脑脊髓液中病原体。结果 :82 3例中枢神经系统急症患者中有 12 6例 (15 .3%)单纯疱疹病毒IgM和 /或IgG阳性 ,其中 10岁以下年龄为高峰。 10 (1.2 %)例巨细胞病毒特异性IgM和 /或IgG阳性 ;8(0 .97%)例水痘 带状疱疹病毒特异性IgM和 /或IgG阳性 ;7(0 .85 %)例为结核性脑膜炎 ;6 (0 .72 %)例为新生隐球菌性脑膜炎 ;1(0 .12 %)例为脑膜炎球菌性脑膜炎。结论 :病毒 ,特别是单纯疱疹病毒 ,是中枢神经系统感染性疾病的常见病原 ;结核杆菌和新生隐球菌感染也占一定比例。     

中枢神经系统感染性疾病的病原学研究

目的：探讨中枢神经系统感染性疾病的病原学特点。方法：分别用双抗体夹心ELISA法和传统的细菌及真菌培养等方法检测患者血清IgM，IgG抗体和脑脊髓液中病原体。结果：823例中枢神经系统急症患者中有126例(15．3％)单纯疱疹病毒IgM和／或IgG阳性，其中10岁以下年龄为高峰。10(1．2％)例巨细胞病毒特异性IgM和／或IgG阳性；8(0.97％)例水痘-带状疱疹病毒特异性IgM和／或IgG阳性；7(0．85％)例为结核性脑膜炎；6(0．72％)例为新生隐球菌性脑膜炎；1(0.12％)例为脑膜炎球菌性脑膜炎。结论：病毒，特别是单纯疱疹病毒，是中枢神经系统感染性疾病的常见病原：结核杆菌和新生隐球菌感染也占一定比例。     

病毒感染性眼病病原学诊断的研究进展

多种病毒可导致眼部疾病，包括腺病毒、人类疱疹病毒、人类T淋巴细胞白血病病毒1型（HTLV-1）及新发现的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）等。这类疾病的鉴别诊断较困难，容易被误诊和漏诊，导致严重的组织损伤和视觉损伤。腺病毒、单纯疱疹病毒1型和水痘-带状疱疹病毒相关眼病的诊断中，病原学诊断可作为一种强有力的辅助诊断工具；而在单纯疱疹病毒2型、巨细胞病毒、EB病毒、人类疱疹病毒6型和7型、人类疱疹病毒8型、HTLV-1和SARS-CoV-2相关眼病的诊断中，病原学诊断则发挥着主导作用。病毒培养、免疫组织化学或免疫荧光法及以PCR为代表的病毒基因诊断法是三种主要的病原检测手段，其中PCR技术检测快速、操作便捷、敏感度和特异度高，成为眼科病毒学诊断中最重要的工具。     

Seminal fluid excretion of cytomegalovirus related to immunosuppression in homosexual men

Seminal fluid samples from 84 Danish homosexual men were successfully cultured to determine the prevalence of cytomegalovirus excretion. Ten (15%) out of 66 men positive for the antibody were found to be excreting the virus. Although the proportion excreting was inversely related to age (p less than 0.01), three men aged over 30 and with many years of homosexual experience excreted the virus. In addition, a 50 year old man with Kaposi's sarcoma excreted the virus. A further study of the ratio of T cell helpers to suppressors in the men aged over 30 and a series of age matched non-excreting homosexual control or heterosexual men showed that those excreting cytomegalovirus in their seminal fluid had statistically lower ratios (all less than 0.77) than the controls (p less than 0.05). Excretion of cytomegalovirus may be related to re-emergence of latent infection in immunosuppressed homosexual men.     

TORCH检查的意义及应对措施

目的：为有效贯彻落实优生优育政策,临床探究孕妇产前TORCH检查的意义并根据结果分析相对应对措施。方法方便选取并回顾性分析该院2014年7月—2015年7月期间300例入院进行产检的孕妇,对49例出现不良妊娠以及60名正常者TORCH检查进行比照。结果不良妊娠组与正常组孕妇在年龄、孕周、孕次上差异无统计学意义,P>0.05;正常组弓形虫感染、风疹病毒、巨细胞病毒、乙肝检查、单纯疱疹病毒Ⅰ、梅毒螺旋体检查、单纯疱疹病毒Ⅱ分别为0.0%、0.0%、1.7%、1.7%、3.3%、1.7%,不良妊娠组依次为6.1%、10.2%、8.2%、12.2%、6.1%、14.3%,两组在乙肝检查异常率上差异无统计学意义,P>0.05,不良妊娠组较正常组在弓形虫感染、风疹病毒、巨细胞病毒、单纯疱疹病毒Ⅰ、单纯疱疹病毒Ⅱ异常率高,P<0.05。结论孕妇产前TORCH检查对避免不良妊娠、胎儿先天缺陷、畸形、死胎等情况均有重要意义。     

Genital herpes and public health: addressing a global problem

Genital herpes can be caused by herpes simplex virus 2 (HSV-2) or, less commonly, by herpes simplex virus 1 (HSV-1). With a seroprevalence of antibodies to HSV-2 of 22% in the general population, genital herpes is 1 of the 3 most prevalent sexually transmitted diseases (STDs) in the United States. A central issue in the public health problem of genital herpes is the high proportion of genital HSV infections that are unrecognized by both patients and clinicians. Persons who are HSV-2 seropositive may be symptomatic but nevertheless fail to recognize genital herpes; they serve as reservoirs for transmission. Physicians and patients must be aware of the subclinical presentation of genital herpes and the potential these patients have for transmitting HSV. Serious consequences of HSV infection include neonatal herpes and increased risk of human immunodeficiency virus transmission. Recommendations to physicians for prevention include using type-specific tests for HSV when screening for other STDs and testing for HSV when evaluating patients with genital ulcers. Researchers must evaluate the performance of type-specific tests and strategies to prevent transmission.     

Vidarabine therapy for severe herpesvirus infections. An unusual syndrome of chronic varicella and transient immunologic deficiency.

Six patients with severe herpesvirus infections were successfully treated with vidarabine. One patient had a previously undescribed syndrome of chronic cutaneous varicella infection of eight months' duration, associated with transient but complete duppression of lymphocyte response to conconavalin A. Other diagnoses were severe varicella pneumonia, progressive cytomegalovirus pneumonia associated with acute lymphocytic leukemia, herpes simplex encephalitis, severe zoster associated with stage IV lymphoma, and disseminated herpes simplex in a patient receiving high doses of steroids. All patients showed cessation of new lesions or abrupt clinical improvement between days 2 and 4 after initiation of therapy, and all were cured of their clinical infection. Dramatic improvement in all of our patients and the minimal toxicity observed make vidarabine suitable for use in severe herpesvirus infections.     

366例患者单纯疱疹Ⅱ型病毒感染的分析

目的:了解单纯疱疹Ⅱ型病毒(HSV2)感染与性传播疾病(性病)、流产、死(畸)胎和不孕不育等疾病的关系。方法:应用酶联免疫吸附试验(ELISA)检测HSV2-IgMI、gG抗体,对366例患者和80例健康对照者HSV2感染状态进行调查分析。结果:HSV2-IgMI、gG抗体阳性率患者组:13.1%、49.2%(48/366、180/366);对照组2.5%、25.0%(2/80、20/80),两组阳性率比较,差异非常显著(χ2=7.431,15.519;P<0.01,P<0.01)。结论:HSV2感染与性病、流产、死(畸)胎和不孕不育等疾病的部分患者的发病有关。     

The Viral Load of Epstein-Barr Virus in Blood of Children after Hematopoietic Stem Cell Transplantation

ObjectiveTo detect the Epstein-Barr virus (EBV) viral load of children after hematopoietic stem cell transplantation (HSCT) using chip digital PCR (cdPCR).MethodsThe sensitivity of cdPCR was determined using EBV plasmids and the EBV B95-8 strain. The specificity of EBV cdPCR was evaluated using the EBV B95-8 strain and other herpesviruses (herpes simplex virus 1, herpes simplex virus 2, varicella zoster virus, human cytomegalovirus, human herpesvirus 6, and human herpesvirus 7). From May 2019 to September 2020, 64 serum samples of children following HSCT were collected. EBV infection and the viral load of serum samples were detected by cdPCR. The epidemiological characteristics of EBV infections were analyzed in HSCT patients.ResultsThe limit of detection of EBV cdPCR was 110 copies/mL, and the limit of detection of EBV quantitative PCR was 327 copies/mL for the pUC57-BALF5 plasmid. The result of EBV cdPCR was up to 121 copies/mL in the EBV B95-8 strain, and both were more sensitive than that of quantitative PCR. Using cdPCR, the incidence of EBV infection was 18.75% in 64 children after HSCT. The minimum EBV viral load was 140 copies/mL, and the maximum viral load was 3,209 copies/mL using cdPCR. The average hospital stay of children with EBV infection (184 ± 91 days) was longer than that of children without EBV infection (125 ± 79 days), P = 0.026.ConclusionEBV cdPCR had good sensitivity and specificity. The incidence of EBV infection was 18.75% in 64 children after HSCT from May 2019 to September 2020. EBV cdPCR could therefore be a novel method to detect EBV viral load in children after HSCT.     

Frequency of asymptomatic shedding of herpes simplex virus in women with genital herpes

Twenty-seven women with recurrent genital herpes simplex virus infection underwent daily home culturing to detect asymptomatic genital herpes simplex virus shedding. Asymptomatic herpes simplex virus shedding was documented on 1% of the days on which cultures were obtained. Asymptomatic shedding from the vulva was as frequent as asymptomatic cervicovaginal shedding, and 45% of asymptomatic episodes were identified only by positive results from vulvar cultures. All women who obtained samples on more than 100 days and 80% of women who obtained samples on more than 50 days had documented asymptomatic viral shedding, compared with only 6% of those who obtained samples for fewer than 25 days. Asymptomatic shedding was not related to contraceptive use or menstrual cycle. These data suggest that all women with recurrent genital herpes simplex virus infection should be instructed about the possible risk, albeit infrequent, of asymptomatically shedding virus from the genital tract.     

疱疹性口炎与疱疹性咽峡炎的病原学检测

目的 研究临床诊断疱疹性口炎与疱疹性咽峡炎病例的病原学特点,并进行比较。 方法 选择2015年3月1日—8月31日临床诊断为疱疹性口炎病例60例和疱疹性咽峡炎50例纳入本次研究,胶体金法检测EV71、CoxA16两种肠道病毒,ELISA法检测疱疹病毒Ⅰ型、Ⅱ型,RT-PCR法检测肠道病毒5’-UTR基因片段、EV71 VP1及CoxA16 VP1基因片段,PCR法检测疱疹病毒Ⅰ型和Ⅱ型糖蛋白基因片段,比较2种疾病病原学的差异。 结果 疱疹性口炎病原学PCR结果显示:疱疹病毒检测阳性例数38例,肠道病毒检测阳性例数18例,另有4例未明确病原;IgM结果显示:疱疹病毒阳性例数35例,肠道病毒阳性例数11例。疱疹性咽峡炎病原学PCR结果显示:疱疹病毒检测阳性例数2例,肠道病毒检测阳性例数38例;IgM结果显示:疱疹病毒阳性例数2例,肠道病毒阳性例数35例。临床诊断为疱疹性口炎与疱疹性咽峡炎的病例,部分病原学结果存在交互。 结论 疱疹性口炎和疱疹性咽峡炎的临床诊断可能存在一定的混淆,通过ELISA法和胶体金法,可快速确定病原,而PCR检测方法在部分难以明确病原的病例可进一步检验。