Herpes simplex virus viremia during primary genital infection

Primary genital herpes simplex virus (HSV) infection is commonly associated with systemic symptoms. A systematic evaluation of HSV viremia during primary genital infection has not been performed previously. Plasma samples from adults with a first clinical episode of genital HSV infection were assayed for HSV DNA by polymerase chain reaction. One hundred sixty-four adults had confirmed primary genital HSV infection. Of these, 40 (24%) had HSV DNA detected in plasma. Thirty-seven (93%) of 40 were infected with HSV-2. Viremic participants were more likely to be women, compared with aviremic participants (83% vs. 61%; P=.01). Viremia was detected more frequently and at a higher number of copies per milliliter early in infection. We conclude that HSV viremia during primary genital HSV infection is common, especially among women.     

Herpes simplex virus infection of the adult lower respiratory tract

We have reported six adult patients with HSV infection of the lower respiratory tract diagnosed ante-mortem, and have reviewed the literature on this subject. An attempt has been made to define the natural history of the infection, and suggestions have been made regarding diagnosis and treatment. HSV can infect the lower respiratory tract in immunologically normal patients, as well as the immunocompromised host. Many patients have been burned, or intubated, or have other reasons for squamous metaplasia of the respiratory epithelium. The pathogenesis in many cases is an extension or aspiration of oropharyngeal HSV, but there is a suggestion that some cases may be hematogenously spread. The diagnosis of the site and presence of HSV infection should be based initially on cytologic findings, histologic findings, or both. Viral cultures or immunofluorescent or immunoperoxidase labeling can be used to confirm the cytologic and histologic diagnoses. Bronchoscopy is valuable for visualizing ulcerations or membranes in the respiratory tract, and for improving the sensitivity and specificity of the cytologic diagnosis. Because the process is most often focused in the tracheobronchial tree, percutaneous needle biopsy and open lung biopsy may be less sensitive than bronchoscopy. Standard serologic tests are, in general, not helpful diagnostically. They can help verify that a recent HSV infection has occurred, but do not differentiate between primary and recurrent infection, and do not help in localizing the site of infection. However, paired complement fixation or neutralizing antibody titers may be useful prognostically. If the titers do not rise in the presence of a documented HSV lower respiratory tract infection, the outcome is more likely to be fatal. The respiratory epithelium from the oral mucosa to the alveoli can be infected with HSV. The manifestations can range from a few scattered ulcers in the trachea to a severe ulcerative process resulting in an obstructing, inflammatory tracheobronchial membrane. Focal or diffuse pneumonia can also occur. No specific treatment for the illness can be recommended at this time. There is no evidence that currently available antiviral therapy is effective. The outcome of the illness seems to be largely dependent on the immunologic status of the host, complicating superinfections, and the progression of the underlying disease.     

Herpes simplex virus infection in pregnancy and its management.

Neonatal herpes simplex virus (HSV) infection is considered to be rare in the UK, affecting less than 3 per 100,000 live births, but the true incidence is probably higher due to under-reporting. In contrast, neonatal HSV infection is more common in the USA affecting 1 per 7500 live births overall. Infection in neonates is frequently serious and may be fatal.     

Herpes simplex virus type 2 infection of neonatal mice

Summary We have demonstrated that newborn mice can be infected orally with herpes simplex virus type 2. Transplacental and transvaginal transmission of herpes simplex virus type 2 did not occur in our mice. Failure to produce natural transvaginal infection in mice may be explained by the relatively short period of exposure to the virus during parturition. These experiments demonstrate that high oral doses of herpes simplex virus type 2 can produce disseminate herpes neonatal infection in mice and therefore may be useful in future investigations into the mechanism and the treatment of this disease.

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Infizierung neugeborener Mäuse mit Herpes simplex-Virus Typ 2

Zusammensetzung Wir haben nachgewiesen, daß neugeborene Mäuse oral mit Herpes simplex-Virus Typ 2 infiziert werden können. Bei unseren Mäusen trat keine transplazentäre oder transvaginale Übertragung des Herpes simplex-Virus Typ 2 auf. Das Ausbleiben einer natürlichen transvaginalen Infizierung bei Mäusen läßt sich durch die relativ kurze Expositionszeit gegenüber dem Virus während des Geburtsvorgangs erklären. Diese Versuche zeigen, daß hohe orale Dosen von Herpes simplex-Virus Typ 2 bei Mäusen eine disseminierte Neonatalinfektion bewirken können und diese Versuche daher bei künftigen Untersuchungen des Mechanismus und der Behandlung dieser Krankheit möglicherweise von Nutzen sind.

     

Herpes simplex virus infections

Herpes simplex virus (HSV) is a member of the herpesviridae family. Recognised since ancient Greek times, the virus frequently infects human beings, causing a range of diseases from mild uncomplicated mucocutaneous infection to those that are life threatening. In the past 50 years, substantial advances in our knowledge of the molecular biology of HSV have led to insights into disease pathogenesis and management. This review provides a contemporary interpretation of the biological properties, function, epidemiology, and treatment of HSV diseases.     

Herpes simplex virus infections

There are two serological types of herpes simplex virus, HSV-1 and HSV-2. The types can be differentiated by different methods. After a primary infection HSV reaches the sensory ganglions by the way of peripheral nervous tracts. The virus remains for life in the ganglion as virus genome. After activation and return movement a new infection can appear. A lot of various diseases are caused by primary infection, reactivation or reinfection. The diagnosis in herpes virus diseases includes the detection of virus or viral antigens and the demonstration of specific antibodies against HSV. Effective antiviral drugs are available for chemotherapy of HSV-infection. Acyclovir is a beneficial drug without toxic secondary effects. The prevalence of HSV-antibodies in the population is very high.     

Herpes simplex virus DNA in amniotic fluid without neonatal infection.

Twenty-one pregnant women were studied to determine the distribution of herpes simplex virus (HSV): 10 had symptomatic genital herpes, including 1 with primary cervical HSV infection, and 11 had asymptomatic genital herpes. Samples from vesicles, the cervix, and amniotic fluid (AF) were analyzed with 2 separate polymerase chain reaction (PCR) tests and with viral culture. For newborns, clinical examinations and pharyngeal HSV cultures were performed, and cord blood IgM antibodies to HSV were measured. HSV DNA was present in the AF of 3 women with symptomatic HSV infection, but all cultures were negative. HSV was detected more often with PCR than with culture, in both vesicle and cervical samples. For the asymptomatic group, all AF samples were negative, whereas 4 cervical samples were positive by PCR (none were positive by culture). All isolates were HSV type 2. All infants were healthy, and none had cord blood IgM antibodies to HSV, including those with PCR-positive AF.     

单纯疱疹病毒感染与冠心病急性心肌梗死相关性研究

目的探讨单纯疱疹病毒(HSV)感染与冠心病心肌梗死的关系。方法测定51例急性心肌梗死(AMI)和42例陈旧性心肌梗死(OMI)患者及31例冠脉造影正常者(NC)的HSV1抗体水平及脱氧核糖核酸(DNA),同时观测纤维蛋白原(Fg)、6酮前列环素F1α(6Keto PGF1a)、血栓素B2(TXB2)、P选择素(GMP140)变化。结果AMI组HSV1免疫球蛋白G(IgG)阳性率及水平高于NC组(P<0.05),HSV1DNA检测结果与之吻合。校正冠心病危险因素前、后,HSV1IgG阳性与AMI均有相关关系(OR4.266,P=0.019;OR3.321,P=0.032)。AMI组中HSV1( )组Fg、TXB2、GMP140高于,而6Keto PGF1a低于HSV1(-)组(P均<0.05);并且IgG与TXB2、GMP140呈正相关,与6Keto PGF1a呈负相关,调整冠心病的危险因素前、后,IgG与Fg均呈正相关。结论HSV1感染与AMI之间存在明显的相关性,与Fg、TXB、6-Keto-PGF及GMP也存在相关性。     

Herpes simplex virus infection as a risk factor for human immunodeficiency virus infection in heterosexuals.

To determine if infection with herpes simplex virus (HSV) type 2 is associated with human immunodeficiency virus (HIV) type 1 infection among patients attending sexually transmitted diseases clinics, a case-control study was done on coded sera from 179 HIV-1-infected patients and 367 age-, race-, and gender-matched HIV-1-seronegative patients. Although only 13 (2.3%) of 546 patients had a history of genital herpes treatment, 72% and 56.6%, respectively, had serologic evidence of prior infection with HSV-1 and -2. HSV-1 antibody prevalence was similar among both patient groups; however, HSV-2 antibodies were more common among those infected with HIV-1. Among heterosexual men, 62.7% of those infected with HIV-1 had HSV-2 antibodies compared with 46.7% of those not infected (P less than .01). The HSV-2 seroprevalence among women with or without HIV infection was 78.1% and 57.7%, respectively (P less than .02). A history of intravenous drug use and a reactive serologic test for syphilis were each independently associated with HIV-1 infection in heterosexuals. These data suggest that the two most common causes of genital ulcerative disease in the United States, genital herpes and syphilis, may contribute to increased risk for HIV-1 infection among heterosexuals.     

Herpes simplex virus and the rheumatic diseases

Summary A viral aetiology for rheumatoid arthritis and inflammatory connective tissue diseases has been sought in general terms first, by studying viral growth patterns in lymphocytes from the blood and lesions of patients affected second, by analysing lymphocyte concentrations of the interferon-induced enzyme 2–5 oligo-adenylate synthetase (2–5 A); and third, by probing Southern blots of lymphocyte DNA with viral probes. Indirect evidence consistent with a viral aetiology has been found in several such diseases, but direct proof has been difficult to adduce. There is some suggestion that herpes simplex viral (HSV) DNA is present in Behcet's blood lymphocytes, but the findings are inconsistent. It is also plausible that viruses such as HSV do not induce these diseases through classic immunopathological mechanisms, but as promoters of abnormal lymphoproliferation in individuals with predisposing defects, possibly related to selective DNA repair defects.     

Herpes simplex virus and the alimentary tract

Herpes simplex virus (HSV) infection is well known as a sexually transmitted disease. However, relatively little has been published concerning the presentations and treatment of HSV infection within the gastrointestinal tract, where HSV most commonly affects the esophagus in both immunocompromised and immunocompetent patients. HSV proctitis is not uncommon and occurs primarily in males having sex with males. In patients with normal immune systems, gastrointestinal HSV infections are generally self-limited and rarely require antiviral therapy. Treatment of infection is suggested for immunocompromised patients, though no large randomized controlled trials have been performed. This article reviews the manifestations of HSV infection within the luminal gastrointestinal tract and options for diagnosis and treatment.     

Herpes simplex virus infection of the hand. A profile of 79 cases

Seventy-nine cases of herpes simplex (HSV) infection of the hand were documented by viral culture over a 40-month period. A marked bimodal age distribution was found with 32 cases occurring in adults aged 21 to 30 years and 16 occurring in children less than 10 years old. The infection most commonly occurred on the fingers (69 percent) and thumb (21 percent). All 20 herpes simplex type 2 (HSV-2) isolates came from patients over 20 years old. All of the 13 specimens that were typed after isolation from patients under 20 years old were herpes simplex type 1 (HSV-1). Only seven of the 49 adult cases were identified in health care professionals. In this series, HSV infection of the hand occurred in 2.4 cases per 100,000 population per year. In adults, women with recurrent infections from HSV-2 and a history compatible with genital herpes predominated. In children, a primary HSV-1 infection associated with gingivostomatitis was common.     

Herpes simplex virus and facial palsy

An 8-year-old boy developed acute herpes simplex virus stomatitis followed by transient facial palsy. The possible relationship between this virus and Bell's palsy is discussed.     

Herpes simplex virus vaccines: perspectives

PURPOSE: Despite effective antiviral therapy, infection with herpes simplex virus (HSV) is a critical public health issue, particularly genital herpes by its social and psychological burden and its contribution to the neonatal herpes and possibly to the HIV/AIDS pandemic. CURRENT KNOWLEDGE: Many prophylactic and therapeutic vaccination approaches have been explored but no effective vaccine is presently available. In fact, as members of the Herpesviridae family, both HSV-1 and 2 types have genes involved in immune evasion. FUTURE PROSPECTS: Further research is needed to define determinants of immunity in order to design more effective vaccines.