418. Reactivation of herpes simplex virus infection in schizophrenia

Abstract

High prevalence of concurrent viral infection in schizophrenia has been reported. The effect of such infections on the clinical phenomena of schizophrenia is unknown. Eighty consecutive, consenting, DSM-IV schizophrenia patients participated in this study. All were HIV-negative. CSF and blood were sampled at baseline and at two weeks thereafter. All received standard neuroleptic therapy after first sampling. The samples were coded and analyzed for seven viral antibodies; Cytomegalovirus, HSV-1, Mumps, Measles, Rubella, Varicella Zoster, Japanese Encephalitis (ELISA). A four-fold increase in antibody titres for one or more viruses in either CSF or serum occurred in 36 patients: HSV alone in 14 (HSV-positive group), other viruses in 17 (HSV-negative group), and HSV as well as other viral infections in five. The patients were assessed at baseline, one week and two weeks on Positive and Negative Syndrome Scale (PANSS). The HSV-positive group had higher mean positive syndrome score on PANSS than HSV-negative group (18.1 ± 4.9; 13.3 ± 4.9; p = 0.01). The two groups however did not differ on other symptom dimensions, illness duration, sex and age. During the two-week treatment the scores on psychopathology decreased in both groups. However, the difference on positive syndrome score continued through the three assessment points (RMANOVA; F = 9.3; df = 1,29; p = 0.005). Herpes virus has special affinity to the temporal lobes and this may explain predominance of positive symptoms. All patients tested positive for HSV had antibody elevations only in CSF, suggesting reactivation of latent infection during the stress of psychosis.