HSV型特异性糖蛋白抗体检测及其意义

[目的]探讨以HSV型特异性糖蛋白gG-1和gG-2为抗原的酶免疫方法检测生殖器疱疹(GH)HSV抗体的应用价值.[方法]以确诊复发性GH38例、初发GH8例为病例组,以31例健康献血者为对照组,用ELISA方法分别检测血清标本HSVgG1-IgG抗体及HSVgG2-IgG抗体,并进行结果评价.[结果]复发性GH患者血清HSVgG2-IgG阳性率为94.7%,初发GH患者阳性率为25%,对照组阳性率为9.7%.复发性GH血清HSVgG2-IgG阳性率明显高于初发GH及对照组的阳性率(P<0.05).复发性GH与对照组血清HSVgG1-IgG抗体阳性率相近,元明显统计学差异.[结论]以HSV的型特异性糖蛋白gG-1和gG-2为抗原检测血清HSV抗体是高敏感性和特异性的新一代酶免疫实验方法.通过病毒分离培养及血清学检测均说明HSV-2是本地区GH的主要病原体,用ELISA方法检测血清HSVgG2-IgG抗体可以检测出无症状HSV感染者,有助于对不典型GH患者的诊断并可作为流行病学调查的手段.     

女性生殖器疱疹患者宫颈无症状HSV排泌的研究

目的:研究女性GH发作期和间歇期患者宫颈无症状HSV-2排泌情况.方法:发作期GH患者分别取皮疹和宫颈拭子标本;间歇期GH患者每周1次取宫颈拭子,共4次,正常对照组取宫颈拭子标本,用ELISA法检测标本中的HSV抗原.结果:GH患者宫颈HSV-2总阳性率为20.8%,明显高于正常组的3.3%(P<0.05);现症发作期GH患者宫颈HSV-2阳性率为21.2%,与复发间歇期患者宫颈HSV-2阳性率(20.4%)比较,无显著性差异(P>0.05).每年复发6次以上的GH患者宫颈HSV-2阳性率为27.4%,明显高于复发6次以下者(15.0%),且有显著性差异(P<0.05).结论:GH患者发作期及间歇期宫颈均有HSV无症状排毒.年复发频率在6次以上的GH患者HSV-2隐性排毒多于年复发频率6次以下者.     

衡阳地区性乱人群中HSV2感染的研究

目的了解性乱人群典型皮损及无皮损的生殖道分泌物中2型单纯疱疹病毒(HSV2)的感染情况.方法用PCR法对衡阳地区310例性乱者作HSV2-DNA检测.结果187例典型皮损的性乱人群中,115例检出HSV2-DNA,阳性率为61.5%,其中男性阳性率为54.9%,女性阳性率为77.8%,男女之间差异显著(P<0.05).123例无皮损性乱人群中,28例检出HSV2-DNA,HSV2-DNA检出率为22.8%,其中男性阳性率为20.9%,女性阳性率为27.0%.结论衡阳地区性乱人群中HSV2有较高的感染率,典型皮损区HSV2-DNA检出率高于无皮损的生殖道分泌物.     

HSVⅡ-DNA在生殖器疱疹检测中的应用

目的探讨HSVⅡ-DNA检测对生殖器疱疹中Ⅱ型单纯疱疹病毒（HSVⅡ）阳性检出率的应用价值。方法选取本院2010年7月～2012年7月性病门诊收治的生殖器疱疹患者135例为实验标本,分别予以荧光定量聚合酶链反应法（FQ-PCR）检测HSVⅡ-DNA和血清酶联免疫吸附法（ELISA）检测HSVⅡ抗体,再以病毒培养法评价以上两种方法的检出率。结果FO-PCR法HSVⅡ-DNA检测的HSVⅡ阳性检出率为74．1％,ELISA法HSVⅡ抗体检测的HSVⅡ阳性检出率为65．2％,作病毒培养标准检测的HSVⅡ阳性率为80．7％;FQ-PCR法检测HSVⅡ的灵敏度、阳性及阴性预测值、特异性显著高于ELISA法。结论FQ-PCR法HSVU-DNA检测的HSVⅡ阳性检出率更贴近于金标准值．并且检测上具有特异性强、灵敏度高、快速等优越性,对于临床诊断生殖器疱疹具有重要的应用价值,值得推广应用。     

性病门诊无症状女性患者单纯疱疹病毒2型的检测及其意义

［摘 要］ 目的:探讨性传播疾病（STD）门诊无症状女性患者血清单纯疱疹病毒2型（HSV2）的感染情况, 为预防和控制生殖器疱疹传播提供依据。方法：STD门诊732例女性患者分为无症状组（n=355）、疑似生殖器疱疹（GH）组（n=132）及不典型症状组（n=245）,同时设健康对照组（n=260）,采用ELISA法检测血清HSV2抗体。结果: 无症状组患者HSV2抗体检出阳性率为55.8%（198/355）;疑似GH组、不典型症状组及健康对照组HSV2抗体检出阳性率分别为62.9%（83/132）、57.1%（145/245）和11.9%（31/260）。无症状组HSV2抗体检出阳性率显著高于健康对照组（P<0.05),但与疑似GH组和不典型症状组比较差异无统计学意义(P>0.05)。在355例无症状的患者中, STD患者HSV2感染率显著高于非STD患者（P<0.05）,本组感染HSV2的患者主要以20～40岁为主。结论：STD门诊女性HSV2隐性感染的比率较高,HSV2隐性感染在STD患者中更常见。     

FQ-PCR技术评价乙型肝炎不同血清型传染性的研究

为探讨HBV -DNA定量聚合酶链反应技术在不同血清型乙型肝炎的传染性中的意义和临床实用性 ,采用先进的FQ -PCR技术对 377例常见不同组合乙型肝炎免疫标志物阳性血清HBV -DNA作定量检测。结果显示 :检测出阳性2 6 8例 ,总阳性率为 71.1%。单纯HBsAg(+ )患者的检测阳性率为 5 4.9% (2 8/ 5 1)。认为运用FQ -PCR技术对乙型肝炎不同血清型HBV -DNA定量分析是评价其传染性的可靠方法。     

生殖器疱疹患者血清IgM抗体和皮损抗原检测的意义

目的 :评价生殖器疱疹 (GH)患者血清单纯疱疹病毒 (HSV)IgM抗体和皮损HSV抗原检测的临床意义。方法 :用酶联免疫吸附实验 (ELISA)方法对 5 2例GH患者在皮损发作期同时检测血清IgM抗体和局部皮损中HSV抗原。结果 :5 2例患者血清HSVIgM抗体阳性 7例 ,阳性率为 13.4 6 % (7/ 5 2 ) ,IgM阳性组疱疹复发平均间隔时间与IgM阴性组比较 ,无显著性差异 (P >0 .0 5 )。皮损HSV抗原阳性 31例 ,阳性率 5 9.6 2 % (31/ 5 2 ) ,其中丘疹、丘疱疹、水疱性损害阳性率 10 0 % (13/ 13) ,糜烂或浅表溃疡性损害阳性率 6 3.6 4 % (14 / 2 2 ) ,结痂性损害阳性率 2 3.5 3% (4 / 17)。皮损HSV抗原检测阳性率显著高于血清HSVIgM抗体阳性率 (P <0 .0 5 )。结论 :血清HSVIgM抗体检测对GH诊断和判断复发价值不大 ,皮损HSV抗原检测对诊断GH活动性感染具有更重要的临床意义。     

HPV、HSV2感染及C-erbB-2表达与宫颈癌关系

目的 :探讨汕头地区宫颈癌的发生与HPV、HSV2感染以及C erbB 2表达的相关性。方法 :采用PCR技术检测宫颈癌(84例 )组织与正常宫颈 (13例 )组织的HPV DNA、HSV2 DNA ,并用免疫组化SP法检测同一宫颈癌组织标本与正常宫颈组织标本的C erbB 2表达情况。结果 :①宫颈癌组织HPV DNA ,HSV2 DNA阳性率分别为 4 7 6 % ,4 6 4 % ,正常宫颈组织则为7 7% ,15 4 %。宫颈癌组织的HPV、HSV2感染率均显著高于正常宫颈组织 (P <0 0 1,P <0 0 5 )。②宫颈癌组织中 ,HPV、HSV2双阳性 2 4例 ,经统计学处理 ,HPV和HSV2间的感染有显著相关性 (P <0 0 5 )。③宫颈癌组织的C erbB 2表达率为34 5 % ,显著高于正常宫颈组织 (0 /13,P <0 0 5 )。④ 75 9%的C erbB 2阳性患者 (2 2 /2 9)与HPV和 (或 )HSV2同时呈现阳性。结论 :汕头地区宫颈癌的发生与较高的HPV、HSV2感染率和C erbB 2表达率密切相关 ,三者的共同作用可能是宫颈癌发生发展的重要因素     

衡阳地区性乱人群中HSV2感染的研究

目的：了解性乱人群典型皮损及无皮损的生殖道分泌物中2型单纯疱疹病毒（HSV2）的感染情况。方法：用PCR法对衡阳地区310例性乱者作HSV2－DNA检测。结果：187例典型皮损的性乱人群中,115例检出HSV2－DNA,阳性率为61．5％,其中男性阳性率为54．9％,女性阳性率为77．8％,男女之间差异显著（P＜0．05）。123例无皮损性乱人群中,28例检出HSV2－DNA,HSV2－DNA检出率为22．8％,其中男性阳性率为20．9％,女性阳性率为27．0％。结论：衡阳地区性乱人群中HSV2有较高的感染率,典型皮损区HSV2－DNA检出率高于无皮损的生殖道分泌物。     

电视阴道镜HPV16,18HSVⅡ诊断早期宫颈癌的价值

目的:探讨电视阴道镜,人类乳头瘤病毒(HPV16,18),Ⅱ型单纯疱疹病毒(HSVⅡ)诊断宫颈癌及癌前病变的价值.方法:对87例可疑宫颈病变的妇女常规行电视阴道镜检查,并对可疑病变行多点活组织检查,同时采用聚合酶链反应技术(PCR)检测HPV16,18 -DNA,HSVⅡ-DNA.结果:HPV16,18-DNA随着病变程度的加重,检出率逐渐升高,差异有统计学意义(P＜0.05),HSVⅡ在癌变组与非癌变组差异有统计学意义(P＜0.05).结论:电视阴道镜指引下能准确选择活检部位,阴道镜检查辅以HPV16,18,HSVⅡ检测,可以提高宫颈癌的确诊率.     

Effect of serologic status and cesarean delivery on transmission rates of herpes simplex virus from mother to infant

CONTEXT: Neonatal herpes most commonly results from fetal exposure to infected maternal genital secretions at the time of delivery. The risk of transmission from mother to infant as it relates to maternal herpes simplex virus (HSV) serologic status and exposure to HSV in the maternal genital tract at the time of labor has not been quantified. Furthermore, no data exist on whether cesarean delivery, the standard of care for women with genital herpes lesions at the time of delivery, reduces HSV transmission. OBJECTIVE: To determine the effects of viral shedding, maternal HSV serologic status, and delivery route on the risk of transmission of HSV from mother to infant. DESIGN: Prospective cohort of pregnant women enrolled between January 1982 and December 1999. SETTINGS: A university medical center, a US Army medical center, and 5 community hospitals in Washington State. PATIENTS: A total of 58 362 pregnant women, of whom 40 023 had HSV cultures obtained from the cervix and external genitalia and 31 663 had serum samples tested for HSV. MAIN OUTCOME MEASURE: Rates of neonatal HSV infection. RESULTS: Among the 202 women from whom HSV was isolated at the time of labor, 10 (5%) had neonates with HSV infection (odds ratio [OR], 346; 95% confidence interval [CI], 125-956 for neonatal herpes when HSV was isolated vs not isolated). Cesarean delivery significantly reduced the HSV transmission rate among women from whom HSV was isolated (1 [1.2%] of 85 cesarean vs 9 [7.7%] of 117 vaginal; OR, 0.14; 95% CI, 0.02-1.08; P =.047). Other risk factors for neonatal HSV included first-episode infection (OR, 33.1; 95% CI, 6.5-168), HSV isolation from the cervix (OR, 32.6; 95% CI, 4.1-260), HSV-1 vs HSV-2 isolation at the time of labor (OR, 16.5; 95% CI, 4.1-65), invasive monitoring (OR, 6.8; 95% CI, 1.4-32), delivery before 38 weeks (OR, 4.4; 95% CI, 1.2-16), and maternal age less than 21 years (OR, 4.1; 95% CI, 1.1-15). Neonatal HSV infection rates per 100 000 live births were 54 (95% CI, 19.8-118) among HSV-seronegative women, 26 (95% CI, 9.3-56) among women who were HSV-1-seropositive only, and 22 (95% CI, 4.4-64) among all HSV-2-seropositive women. CONCLUSION: Neonatal HSV infection rates can be reduced by preventing maternal acquisition of genital HSV-1 and HSV-2 infection near term. It can also be reduced by cesarean delivery and limiting the use of invasive monitors among women shedding HSV at the time of labor.     

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.     

Neonatal herpes simplex virus infection occurring in second twin of an asymptomatic mother. Failure of a modern protocol

A case of neonatal herpes that occurred after vaginal delivery in the absence of genital lesions is presented. The mother had a history of drug addiction and genital herpes. Asymptomatic shedding of herpes simplex virus type 2 from the cervix was noted in the second trimester of pregnancy. Despite being followed with a protocol of close surveillance and serial culturing of the genital tract, the patient gave birth to twins, one of whom developed herpes simplex virus type 2 in the postpartum period. This report presents discussion of this case and herpes surveillance protocols.     

Transmission of genital herpes by donor insemination

This report describes a donor in a therapeutic donor insemination program who asymptomatically acquired a primary herpes simplex virus type 2 (HSV-2) infection from his long-standing sexual partner. His fresh semen was used to inseminate two HSV-seronegative recipients; in one a primary HSV-2 infection developed, and in one it did not. Direct evidence of transmission from donor to recipient was documented by restriction enzyme analysis of the HSV-2 isolates obtained from the donor's semen and from the recipient's cervix. Because of the possibility of asymptomatic acquisition and transmission of HSV-2, semen donors and their sexual partners should undergo serologic screening for genital herpes using new, type-specific HSV serologic techniques.     

The association between genital ulcer disease and acquisition of HIV infection in homosexual men

We analyzed the association of herpes simplex virus (HSV) infection and syphilis, the two most common causes of genital ulceration in homosexual men, with human immunodeficiency virus (HIV) infection in 200 men enrolled between 1983 and 1986 into a study evaluating the microbial causes of acute proctitis. Infection with HIV was independently associated with a history of syphilis, serologic evidence of syphilis, a history of HSV infection, and antibody to HSV-2. Antibody to HIV was not associated with a history of other genital infections or with antibody to Chlamydia trachomatis or HSV-1. Similar associations were observed in 111 asymptomatic homosexuals seen for HIV screening. Men who presented with primary HSV proctitis had a lower prevalence of HIV antibody than those with preexisting HSV-2 antibody (44% vs 68%); this suggests that HSV-2 infection antedated HIV infection. These data suggest that genital ulcerative diseases are an important risk factor for the acquisition of HIV infection in homosexual men; measures directed at control of these diseases may reduce the transmission of HIV in this population.     

PCR检测生殖器疱疹患者HSV-2

目的：用聚合酶链反应（ｐｏｌｙｍ ｅｒａｓｅｃｈａｉｎ ｒｅａｃｔｉｏｎ, Ｐ Ｃ Ｒ）检测生殖器疱疹患者单纯疱疹病毒（ｈｅｒｐｅｓｓｉｍ ｐｌｅｘ ｖｉｒｕｓ ２, Ｈ Ｓ Ｖ２）。方法：对１０１ 例生殖器疱疹和糜烂患者及２０ 例对照组用 Ｐ Ｃ Ｒ法检测 Ｈ Ｓ Ｖ１、 Ｈ Ｓ Ｖ２。结果： Ｈ Ｓ Ｖ２ 检出阳性率占 ６０４％ （６１／１０１）, Ｈ Ｓ Ｖ２ 和 Ｈ Ｓ Ｖ１ 双重感染占４％ （４／１０１）。对照组均为阴性,并且年龄轻者感染阳性率高于年龄长者。结论： Ｐ Ｃ Ｒ 具有操作较易、快速、敏感的特点,为临床对生殖疱疹的诊断和鉴别诊断提供了理想的新方法。     

Comparison of nested-polymerase chain reaction and virus culture for the diagnosis of genital herpes simplex virus infection

INTRODUCTION: This study was performed to compare nested-polymerase chain reaction (PCR) with viral culture as a diagnostic tool for genital herpes simplex virus (HSV) infection in a sexually transmitted infection (STI) clinic in Singapore. METHODS: 103 consecutive patients presenting with clinical features suggestive of genital herpes were enrolled in the study. Two swabs were obtained from each patient. On one swab, cell culture and typing was performed, and on the second swab, nested-PCR was performed and the infecting viral type was determined by using type-specific primers. RESULTS: 63 patients (61.2 percent) had a positive PCR test for HSV. Of these, 13 patients (20.6 percent) had HSV type 1 (HSV-1), 50 patients (79.4 percent) had HSV type 2 (HSV-2). HSV-1 and HSV-2 were detected by viral culture in only six patients and 24 patients, respectively. The sensitivity of cell culture compared to PCR was 46.1 percent for HSV-1 infection and 48 percent for HSV-2 infection. PCR further detected an additional 52.4 percent of HSV cases. The specificity of PCR was 100 percent. CONCLUSION: Nested-PCR has been shown in this study to be an effective diagnostic and typing method for HSV infection in a STI clinic in Singapore with its higher sensitivity and specificity to routine viral isolation in cell culture.     

Shedding of herpes simplex virus type 1 into saliva after surgery for oral and genital or urological cancer patients

The shedding of herpes simplex virus type-1 (HSV-1) into the saliva was compared in 28 patients with oral cancer and 26 patients with genital or urological cancer. All subjects tested positive for HSV-1 specific antibody. A statistically significant (p less than 0.001) difference was found: infectious viruses were isolated from 12 (39.8%) of the oral cancer patients versus only 2 (7.6%) of the genital or urological patients. This indicates that direct stimulation of peripheral nerves during surgery was responsible for the greater reactivation of HSV-1.     

Prevalence and correlates of herpes simplex infections. The population-based AIDS in Multiethnic Neighborhoods Study.

OBJECTIVE. To examine the extent and correlates of infection with herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) in an inner-city community, we studied the prevalence of antibodies to these viruses and their association with risk behaviors in a representative sample of unmarried white, black, and Hispanic adults living in San Francisco, Calif. DESIGN. Cross-sectional, community-based, random household survey. PARTICIPANTS. In 1988 and 1989, we surveyed 1770 unmarried men and women aged 20 to 44 years from three San Francisco neighborhoods of varying geographic and cultural characteristics. MAIN OUTCOME MEASURES. HSV-1 and HSV-2 antibodies based on an immunodot assay using type-specific glycoproteins gG-1 and gG-2. RESULTS. Of blood samples from 1212 participants available for testing, 750 (62%) had HSV-1 antibodies and 400 (33%) had HSV-2 antibodies. After controlling for other variables, HSV-1 antibody was significantly correlated (P less than .05) with older age (in heterosexual men, women, and homosexually active men), less education (in heterosexual men and women), and Hispanic (especially those not born in the United States) or black race. HSV-2 antibody was significantly correlated (P less than .05) with female gender, number of lifetime sexual partners and older age (in heterosexual men and women), and low levels of education and black or Hispanic race (in women). Among those with antibody to HSV-2, only 28 (19%) of 149 men and 32 (13%) of 251 women reported a history of genital herpes. However, most men (62%) and women (84%) who reported a history of genital herpes had HSV-2 antibodies. We observed a similar pattern (low sensitivity and moderate specificity) for a history of facial herpes and the presence of HSV-1 antibodies. After controlling for other variables, HSV-2 antibodies were associated with a lower frequency of HSV-1 antibodies among homosexual men infected with the human immunodeficiency virus. CONCLUSIONS. HSV-1 antibodies were found in nearly two thirds of single urban adults and were most common among Hispanics not born in the United States. HSV-2 antibodies were found in one third of this population and were associated with risk behaviors for sexually transmitted diseases. For both facial and genital herpes infections, self-reporting of infection was very insensitive and moderately specific.