Relationship between serum anti‐varicella zoster virus antibody titer and time from onset of herpes zoster

Herpes zoster is an internal reactivation of varicella zoster virus, and its onset depends on immunity against this virus. We have previously reported that antiviral antibody titers are inversely correlated with patient numbers. In this study, we hypothesized that patients with higher titers may be late visitors to the clinic, whose antibodies were already boosted at presentation because of the time lapse between onset of zoster and measurement of antibodies. We analyzed antibody titers of patients with acute herpes zoster who visited Fukuoka University Hospital from January 2009 to May 2016 (n = 141, 62 males and 79 females). Varicella zoster virus‐specific immunoglobulin G, M and complement fixation tests were positive in 93.9%, 12.0% and 64.2% of the patients, respectively. Immunoglobulin G and complement fixation titers were strongly correlated (Spearman's r = 0.8634, P < 0.0001). Patients with high immunoglobulin G and complement fixation titers were immunoglobulin M‐negative. Unexpectedly, immunoglobulin G and complement fixation titers showed large inter‐subject variation, and were only weakly correlated with onset–measurement time lapse. Patients with consecutive tests tended to show increasing immunoglobulin G and complement fixation titers. Our data suggest that herpes zoster preferentially occurs in patients with low immunoglobulin G and complement fixation titers, and subsequently causes antibody elevation. However, the timing of elevation varies and can be as late as 10 days after zoster. The large variation in antibody titer over the time from onset to testing suggests that some mechanism exists that resists the local breakthrough of virus in the skin, and so delays the onset of blisters.     

Prevalence and impact on quality of life of post-herpetic neuralgia in French medical centers specialized in chronic pain management: The ZOCAD study

Objectives(1) We had for aim to determine the rate of patients consulting for post-herpetic neuralgia (PHN) in centers specialized in the management of chronic pain, (2) to assess the burden of PHN, (3) to compare the impact of PHN between new (newly consulting for PHN) and known (already treated by pain specialists) patients.Patients and methodsWe conducted a prospective multicenter observational study including all chronic pain outpatients consulting for 3 consecutive weeks. The impact of PHN was assessed with the ZBPI, SF12, HADS, and a non-validated disability questionnaire.ResultsAmong the patients, 4518 consulted 54 specialized centers from January 24th to July 21st 2008: 2.6% of patients (but 10.9% of patients 70 years of age or more) reported PHN. The acute herpes zoster episode had occurred more than 13.3 months before inclusion for half of the patients. 108 of the 118 PHN patients (33 new and 75 known) completed the questionnaires. Their mean scores were 3.7 (SD, 2.6) for ZBPI and 34.4 (SD, 10.9) and 55.9 (SD, 11.4) for SF12 PCS and MCS; 38% and 42% of PHN patients had HADS anxiety and depression scores > 10. Nearly all PHN patients had received antiepileptic and analgesic drugs. Tricyclic antidepressants and lidocaine patches were more frequently administered to known than to new patients. Pain relief was more effective for known than for new patients.ConclusionsPHN is a frequent cause of visit in French medical centers specialized in chronic pain management long after the rash has disappeared, and a reason for treatment with drugs that should be prescribed cautiously in elderly patients.     

The hazardous burden of Herpesviridae in inflammatory bowel disease: The case of refractory severe ulcerative colitis

BACKGROUND: Herpesviridae infection or spread may be a hazard in immunodepressed patients. In the field of inflammatory bowel disease, refractory severe ulcerative colitis is a challenging condition, closely associated to immunosuppression both for inanition due to the disease activity and for immunosuppressive treatments. Cytomegalovirus (CMV) has been proposed as a major cause of refractoriness, while other Herpesviridae may be a risk factor in the long-term follow-up. AIM OF THE STUDY: To evaluate the positivity rates of CMV, Epstein-Barr (EBV) and Human herpes virus-8 (HHV8) in a consecutive group of ulcerative colitis patients who underwent colectomy for refractoriness to medical treatment compared to a control group, using state of the art methods. PATIENTS AND METHODS: Colonic specimens from 24 consecutive patients with ulcerative colitis submitted to colectomy for refractoriness and from 20 controls (submitted to colectomy for colorectal cancer) were studied. Standard histology and immunohistochemistry (IHC) for CMV and specific polymerase chain-reaction (PCR) for CMV, EBV and HHV8 were carried out. RESULTS: Regarding CMV, 1 case (4%) was positive at histology and IHC, whereas 3 cases (13%) were positive at PCR, compared to none in the control group (p=0.239). For EBV 2 cases (8%) and 2 controls (10%) were positive at PCR. None of the cases or of controls was positive for HHV8. The only clinical characteristic independently associated to CMV positivity was the white blood cell count at admission, higher among CMV positive patients (p<0.001). At the end of the post-surgery follow-up (median 7.3 years) none of the CMV positive cases experienced pouchitis, compared to 3/21 (14%) of the CMV negative cases (p=1.000). DISCUSSION: Our data suggest that CMV is uncommon (13%), even though PCR techniques, considered to be the most sensitive tools, were used for virus detection and the study population is made by highly selected patients with definite refractoriness. EBV and HHV8 may represent a theoretical risk of immunosuppressive therapy because of their potential role as cancer triggers; however in our study, results seem to be reassuring that UC patients undergoing immunosuppressive therapy are not exposed to an excessive risk of viral infection.     

口服脊髓灰质炎疫苗治疗复发性生殖器疱疹临床疗效观察

目的　评价口服脊髓灰质炎减毒活疫苗 (OPV)治疗复发性生殖器疱疹的临床效果。方法　所有研究对象为复发性生殖器疱疹患者 ,治疗方案为OPV每月 1次 ,每次 4粒 ,连续口服 3次 ,观察 1年。资料经SPSS 10 .0进行统计分析。结果　 76例复发性生殖器疱疹患者治疗前平均复发频率为 5 .39次 (SD =3.78) ,治疗后平均复发频率为 0 .4 7次 (SD =0 .74 ) ,经u检验 ,治疗前后平均复发率差异有非常显著的统计学意义 (u =11.13,P <0 .0 0 1)。 6 4 .5 %的患者在观察期内未复发 ,35 .5 %的患者复发 ,但复发频率减少 ,间期延长。结论　OPV治疗复发性生殖器疱疹患者是一种可行、经济、有效的方法。     

Herpes virus infected spermatozoa following density gradient centrifugation for IVF purposes

Studies have documented the presence of herpes viruses in semen. The aim of our study was to determine whether they persist in semen samples following two-density gradient centrifugation for IVF purposes. Semen samples were collected from 109 men seeking fertility evaluation, prior to IVF treatment. Routine semen analysis was performed according to WHO guidelines. Each sample was treated in a two-density gradient centrifugation using PureSperm (PS). Both untreated and treated samples were screened for the presence of herpes viruses, using PCR. Kruskal-Wallis, chi-square and binomial statistical tests were used; P ≤ 0.05 was considered statistically significant. No statistically significant associations were observed between semen parameters and viral presence. Viral DNA was detected in 54% of semen samples: HSV1/2 in 32 samples, EBV in 49, CMV in 47, HHV6 in 9, HHV7 in 4 and VZV in none. PS gradient failed to remove CMV in 89.36%, HSV1/2 in 59.38% and EBV in 22.45% of samples, while HHV6 and 7 were completely removed. Especially HSV1/2 and CMV seem to persist even following PS treatment. These observations indicate the possible risk of oocyte becoming infected during insemination, by IVF or intracytoplasmic sperm injection, with unknown sequelae. Further studies are required to determine whether any correlation exists between their presence, implantation rate and the outcome of pregnancy.     

Long-Term Clinical Outcomes of Peritoneal Dialysis Patients: 9-Year Experience of a Single Center from North India

♦ Objective: There is a paucity of published data on the outcome of maintenance peritoneal dialysis (PD) since the initiation of continuous ambulatory PD (CAPD) in India in 1991. The purpose of this study is to report long-term clinical outcomes of PD patients at a single center.♦ Design: Retrospective study.♦ Setting: A government-owned tertiary-care hospital in North India.♦ Patients: Patients who were initiated on CAPD between October 2002 and June 2011, and who survived and/or had more than 6 months’ follow-up on this treatment with last follow-up till December 31, 2011, were studied.♦ Results: A total of 60 patients were included in the analysis. The mean age of the patients was 60.2 ± 9.2 years. The majority (65%) of the patients lived in rural areas. A high proportion (47%) were diabetic and 62% had ≥ 2 comorbidities. Total duration on peritoneal dialysis treatment was 1,773 patient-months (148 patient-years) with a mean duration of 29.6 ± 23 patient-months and median duration of 25 patient-months (range 6 - 110 patient-months). Overall patient and technique survival at 1, 2, 3, 4 and 5 years was 77%, 53%, 25%, 15%, and 10% respectively. Patient survival of diabetics vs non-diabetics at 1, 2, 3, 4, and 5 years was 68% vs 84%, 54% vs 53%, 14% vs 34%, 11% vs 19%, and 11% vs 13%, respectively. The mortality in non-diabetics (16/32) was less than that in diabetic (18/28) patients (p = not significant). The main cause of mortality in these patients was cardiac followed by sepsis. There were 58 episodes of peritonitis. The rate of peritonitis was 1 episode per 30.6 patient-months or 0.39 episodes per patient-year. Furthermore, the total number of episodes of peritonitis and number of episodes of peritonitis per patient were higher in the non-survival group (p < 0.05). The incidence of tuberculosis (TB), herpes zoster (HZ) and hernias was 15%, 10% and 5% respectively.♦ Conclusion: The study reports long-term outcomes of the PD patients, the majority of whom were elderly with a high burden of comorbidities. There was a high proportion of diabetics. The survival of diabetic vs non-diabetic and elderly vs non-elderly PD patients was similar in our study. The mortality in non-diabetics was less than that in diabetic patients. TB and HZ were common causes of morbidity. Peritonitis was associated with mortality in these patients.     

改良Trizol-SiO2法在咽拭子及疱疹液EV71-RNA提取中的应用

目的 研究改良Trizol-SiO2法在咽拭子及疱疹液EV71-RNA提取中相对于目前常用的Trizol-氯仿-二氧化硅提取法的优势.方法 选取2010年6月-2013年1月传染科及发热门诊300例手足口病患儿咽拭子和（或）疱疹液拭子标本分别采用Trizol-氯仿-二氧化硅提取法和改良Trizol-SiO2法进行实验结果统计学分析.结果 采用Trizol-氯仿-二氧化硅提取法的232例EV71-RNA阳性标本,采用改良Trizol-SiO2法所获得的定性结果均为阳性;采用Trizol-氯仿-二氧化硅提取法的68例EV71-RNA阴性标本,采用改良Trizol-SiO2法所获得的定性结果均为阴性,两种方法差异无统计学意义（P=0.993）.同时所获的EV71-RNA在进行荧光定量PCR扩增后的扩增曲线Ct值,两种方法差异无统计学意义（P=0.874）.结论 与目前实验室常用的提取EV71-RNA Trizol-氯仿-二氧化硅法相比较,改良Trizol-SiO2法剔除了氯仿试剂并延长了SiO2吸附核酸物质的时间,此方法实现了EV71-RNA的快速提取,适用于大样本量的操作,具有很好的临床应用价值.     

In vitro antiviral activity of dermaseptin S4 and derivatives from amphibian skin against herpes simplex virus type 2

Herpes simplex virus (HSV) infections have become a public health problem worldwide. The emergence of acyclovir‐resistant viral strains and the failure of vaccination to prevent herpetic infections have prompted the search for new antiviral drugs. Accordingly, the present study was undertaken to synthesize chemically and evaluate Dermaseptin S₄ (S₄), an anti‐microbial peptide derived from amphibian skin, and its derivatives in terms of anti‐herpetic activity. The effects of biochemical modifications on their antimicrobial potential were also investigated. The peptides were incubated together with HSV‐2 on target cells under various conditions, and the antiviral effects were examined via a cell metabolic labeling method. The findings revealed that DS₄ derivatives elicited concentration‐dependent antiviral activity at micromole concentrations. The biochemical modifications of S₄ allowed for the reduction of peptide cytotoxicity without altering antiviral activity. Dermaseptins were added at different times during the viral cycle to investigate the mode of antiviral action. At the highest non‐cytotoxic concentrations, most of the tested derivatives were noted to exhibit high antiviral activity particularly when pre‐incubated with free herpes viruses prior to infection. Among these peptides, K₄K₂₀S₄ exhibited the highest antiviral activity against HSV‐2 sensitive and resistant strains. Interestingly, the antiviral activity of K₄K₂₀S₄ was effective on both acyclovir‐resistant and ‐sensitive viruses. The findings indicate that K₄K₂₀S₄ can be considered a promising candidate for future application as a therapeutic virucidal agent for the treatment of herpes viruses. J. Med. Virol. 85:272–281, 2013. © 2012 Wiley Periodicals, Inc.