Genital Herpes Simplex Virus Infection Research Articles

Is the level of varicella-zoster virus IgG associated with symptomatic status of genital herpes simplex virus infection? A case-control study.

Herpes simplex virus (HSV) is a common infection, affecting the majority of the population by age of 50. Recurrent symptomatic outbreaks, experienced by a minority, have significant psychological and psychosexual effects. The varicella zoster virus (VZV), resembling HSV, shows potential for a functional cure via vaccination. This study seeks to investigate if there is an association between low VZV antibody levels and recurrent HSV outbreaks. A total of 110 patients with symptomatic and asymptomatic HSV were recruited during their sexual health screen. Serum samples were collected between Aug 2019 - July 2022; breaks in the study occurred due to COVID. The primary outcome measure was the serological status of HSV and VZV IgG titre level. The average age was 37.3years (range 21-65years). For people with asymptomatic genital HSV2 the average VZV IgG titre was 2373.9IU/mL (n = 17); and 1219.0IU/mL for the symptomatic group (n = 67); p ≤ 0.00001), with similar results for HSV1. There is a strong association between average higher varicella-zoster virus (VZV) IgG level and being an asymptomatic carrier of herpes simplex sirus (HSV)1&2. A feasibility study to assess the use of the VZV vaccine as a treatment of HSV is planned.

P-459 Sexually transmitted infections in women and fecundability – A prospective cohort study

Abstract Study question Does a previous infection with Chlamydia trachomatis (CT) or genital herpes simplex virus (HSV) affect fecundability, and does recency of infection play a role? Summary answer Previous infection with CT or HSV in women was not appreciably associated with fecundability. However, a recent CT infection was associated with slightly lower fecundability. What is known already Worldwide, 1 million people contract sexually transmitted infections (STIs) every day. CT and genital HSV infections are among the most common STIs. Untreated CT in women can cause pelvic inflammatory disease (PID), which can lead to scarring and narrowing of the fallopian tubes and the lower uterus, thus complicating the ability to conceive. Also, an association between genital HSV in women and PID has been suggested. However, it is uncertain to what extent CT and HSV infections in women are associated with fecundability, defined as the per-cycle probability of conception, and whether recency of the infection plays a role. Study design, size, duration We conducted a prospective cohort study of female participants included in two Danish preconception cohorts: SnartGravid.dk (‘Soon Pregnant’, 2007-2011) and SnartForældre.dk (‘Soon Parents’, 2011-ongoing). At enrollment, participants had to be non-pregnant, aged 18-45 years, in a relationship with a male partner, not using contraception or fertility treatment, and trying to conceive. Participants completed a baseline questionnaire and bimonthly follow-up questionnaires until conception or up to 12 months after study entry. Participants/materials, setting, methods We analyzed data from 10475 women. At study entry, participants reported if they had ever been diagnosed (including year of first diagnosis) with CT or HSV. Fecundability ratios (FRs) were calculated using proportional probability regression models and 95% confidence intervals (CIs). The analyses were adjusted for age, income, educational attainment, other STIs, and smoking, reported at study entry. The reference groups were either women with no CT or no HSV diagnosis. Main results and the role of chance At study entry, 2603 (24.9%) of participants reported a history of infection with CT, and 766 (7.3%) with HSV. Using life table methods, 84.7% of participants conceived within 12 cycles of follow-up. Compared with the reference group, the adjusted FR for women ever diagnosed with CT was 0.98 (CI: 0.93-1.04) and 0.96 (CI: 0.88-1.06) for women ever diagnosed with HSV. Compared with the reference group, a recent CT infection was associated with slightly lower fecundability: adjusted FRs for women diagnosed 0-2 years, 2-5 years, and more than 5 years before study entry were 0.84 (CI: 0.71-0.99), 1.01 (CI: 0.90-1.12), and 1.00 (CI: 0.93-1.07), respectively. The association between recency of a HSV infection compared to the reference group was less evident: adjusted FRs for 0-2 years, 2-5 years, and more than 5 years since study entry were 0.93 (CI: 0.72-1.21), 0.97 (CI: 0.77-1.22), and 0.91 (0.75-1.09), respectively. Limitations, reasons for caution Misclassification of exposure is possible, as CT and HSV infections are often asymptomatic and hence undiagnosed. In addition, self-report may have resulted in misclassification of infection type and year. Further, we lacked information on severity or frequency of infections. Wider implications of the findings Women diagnosed with STIs often experience psychological distress concerning their future ability to conceive. Our finding of no overall association between previous diagnoses of CT or HSV may reassure women wanting to conceive. Still, testing for STIs remains important because untreated infections can damage the female reproductive system. Trial registration number Not applicable

Seroprevalence and Molecular Detection of Symptomatic and Asymptomatic Genital Herpes Simplex Virus 2 among HIV Positive Patients: A Cross-sectional Study

Introduction: Genital Herpes Simplex Virus (HSV) infection is the most common infection in Acquired Immunodeficiency Syndrome (AIDS) patients, occurring in 60-90% according to World Health Organisation (WHO) reports. Early detection of HSV-2 infection, the introduction of chemotherapy, and prophylaxis improve the lifespan of AIDS patients. Aim: To detect the HSV-2 seroprevalence that is Immunoglobulin G (IgG) and Immunoglobulin M (IgM) antibodies in Human Immunodeficiency Virus (HIV) positive serum and molecular detection of HSV-2 Deoxyribonucleic Acid (DNA) in symptomatic HSV-2 Patients. Materials and Methods: The descriptive cross-sectional study was conducted in the Guntur Government Hospital with the help of the Antiretroviral Therapy (ART) Centre and Department of Dermatology, Venereology and Leprosy (DVL) in GGH, Guntur, Andhra Pradesh, India. A total of 100 blood samples from HIV positive individuals were collected and for those with symptoms on the external genitalia, a biopsy specimen from the ulcer and fluid from vesicles were taken. All the cases in the study group are on ART and without any antiviral treatment. A blood sample was collected for IgG (Calbiotech kit), IgM detection (Merilisa kit), and biopsy from genital ulcer for gene detection by realtime Polymerase Chain Reaction (PCR) (HELINI Biomolecules, Chennai). Statistical analysis was done by mean and percentages with p-value by calculating Chi-square test, Fisher’s-Exact test to know significance of association between HSV-2 and HIV. Results: Among the total 100 HIV positive patients, it was observed that IgG seroprevalence of HSV-2 in HIV positive individuals is 78%, while it is 19% for IgM. In the present study, 19 symptomatic cases showed DNA of HSV-2 in PCR, out of which, 17 were from genital ulcers and two from vesicle fluid. Conclusion: As HSV-2 is a lifelong infection, serological testing provides the best method, to estimate its prevalence even in asymptomatic individuals.

Tuberculosis of the Glans Penis: A Case Presentation with Review Literature

Background: Tuberculosis of the glans penis is a rare occurrence., even in developing nations. Aim and Object: To review the literature and case presentation of Tb of glans penis Methodology: Pakmedinet, Pubmed and google data were searched for Tb of glans penis. Literature Review: Tuberclosis of the penis can be primary or secondary, and it might look like penile cancer, penile ulcers (granulomatous), genital herpes simplex or HIV infection. Tb of the Penis can develop after a individual who had primary pulmonary Tb and can be spread through ejaculation, contamination of endometerium secretions or clothes, as a result of a previous pulmonary Tb or Tb somewhere else. Tb of the Penis is characterised by a tiny nodule on the penis that is either painless or painful, an ulcer, a mass that progressively increasing and be swelling. Palpation of inguinal lymph nodes and erection problems of the penis can or can not observed. Normally, the patient's voiding is normal. Biopsy or acid fast bacilli in penile discharge or positive Elisa serology or PCR for tuberculosis are used to confirm the diagnosis. Needs 6 months, pulmonary tuberculosis therapy. Conclusions: Tb of the glans penis is an uncommon occurrence. After a biopsy, antitubercular medications are the standard treatment, thus doctors should evaluate the potential of Tb of the penis in instances of penile lesions. Keywords: Tb, penis, presentatation management and review litrarature

Phototherapy-Based Treatment for Sexually Transmitted Infections—Shining Light into Unexplored Territory

New therapeutic strategies are urgently needed to overcome drawbacks in the treatment of some infections, particularly sexually transmitted infections (STI). STIs are easily spread by the transmission of various bacteria, viruses, and parasites with some of the infections being incurable or even lethal, leading to a serious impact on reproductive health worldwide. Phototherapy (PT) is a major therapeutic approach based on the controlled administration of light in the visible, near infrared, or UV spectrum, with or without the application of an external photosensitizer. Despite the fact that PT has not been explored to its full potential in the control of STIs, it has already demonstrated good clinical response rates and lower recurrence rates in genital infections. For instance, increasing evidence has demonstrated that 5-aminolevulinic acid photodynamic therapy (5-ALA-PDT) is effective in the treatment of condyloma acuminatum (CA), by eliminating the causative latent human papillomavirus (HPV) infection, and also in the antiviral treatment of recurrent genital herpes simplex virus (HSV) infections. The clinical application of PDT is a new treatment for oral fungal infection caused by Candida albicans in adult acquired immune deficiency syndrome (AIDS) patients, with human immunodeficiency virus (HIV), and could also be used for genital fungal infections. Another antimicrobial PT strategy, water-filtered infrared A combined with visible light irradiation, has been shown to be effective against genital Chlamydia trachomatis bacterial infection, and an optical nano-genosensor has been designed for the diagnosis of trichomoniasis, a parasitic Trichomonas vaginalis infection. This review aims to summarize the published evidence for the effectiveness of PT in the treatment of STIs, and for the suppression of STI-related pathogens of various types.

Healthcare resource utilisation pattern and costs associated with herpes simplex virus diagnosis and management: a systematic review

ObjectivesLittle is known about the economic burden of herpes simplex virus (HSV) across countries. This article aims to summarise existing evidence on estimates of costs and healthcare resource utilisation associated...

Prevalence of sexually transmitted infections in a tertiary care centre of North India

Background: Sexually transmitted infections (STI’s) are most common notifiable infectious diseases in the world. Knowledge of prevalence of STI’s is important to implement appropriate control strategies. This study is undertaken to see any changing trends in prevalence of STI’s by comparing with previous studies.Methods: All the patients who attended STI clinic from July 2019 to June 2020 were included in the study. Diagnosis was made on basis of history, clinical examination and laboratory investigations.Results: The 2188 patients were seen from July 2019 to June 2020 in STI clinic. Mean age group of patients is 25-44 years. Scabies (31.6%) was the commonest STI seen in outpatient department followed by balanoposthitis (16.4), vaginal discharge (12.5%), human immunodeficiency virus (HIV) (11.4%), herpetic genital ulcer disease (7.9%), genital warts (5.8%), molluscum contagiosum (2.4%), syphilis (2.4%), urethral discharge (1.7%), non-herpetic genital ulcer disease (0.4%), non-gonococcal urethritis (0.4%).Conclusions: Scabies was the most common STI reported in our study followed by balanoposthitis and vaginal/cervical discharge. Among the viral STI’s, HIV is showing alarmingly rising trends and is most common viral STI seen in the study followed by herpes simplex virus (HSV). May be there is less reporting of genital herpes simplex infection due to its self-resolution. As compared to previous studies, rising trends of fungal infections are seen which can be due to syndromic management of bacterial STI’s, rising incidence of diabetes mellitus as well as illicit use of over-the-counter broad-spectrum antibiotics given by the local practitioners.

Characteristics of neonatal herpes simplex virus infections in Germany: results of a 2-year prospective nationwide surveillance study

ObjectiveTo assess incidence and burden of neonatal herpes simplex virus (HSV) infections and to explore possible transmission routes.MethodsA 2-year prospective nationwide surveillance study performed in 2017 and 2018. All German...

Managing herpes simplex virus genital infection in pregnancy

Managing herpes simplex virus genital infection in pregnancy

Acute Herpes Simplex Virus Hepatitis in Pregnancy

(Obstet Gynecol. 2020;135:396–400) Genital herpes simplex virus (HSV) infection is one of the most common sexually transmitted infections and poses risks to both pregnant women and their fetuses and newborns. In rare cases, HSV infection can cause severe maternal disease, including viral sepsis, encephalitis, and hepatitis. Although rare, HSV hepatitis can cause acute liver failure or death, and delaying or missing a diagnosis of HSV hepatitis can have serious consequences. This case study described an atypical case of HSV-1 hepatitis to demonstrate the diagnostic challenges associated with this disease as well as the necessity for early treatment.

Genotype-Informed Versus Empiric Management Of VirEmia (GIVE MOVE): study protocol of an open-label randomised clinical trial in children and adolescents living with HIV in Lesotho and Tanzania

BackgroundGlobally, the majority of people living with HIV have no or only limited access to HIV drug resistance testing to guide the selection of antiretroviral drugs. This is of particular concern for children and adolescents, who experience high rates of treatment failure. The GIVE MOVE trial assesses the clinical impact and cost-effectiveness of routinely providing genotypic resistance testing (GRT) to children and adolescents living with HIV who have an unsuppressed viral load (VL) while taking antiretroviral therapy (ART).MethodsGIVE MOVE is an open-label randomised clinical trial enrolling children and adolescents (≥6 months to <19 years) living with HIV with a VL ≥400 copies/mL (c/mL) while taking first-line ART. Recruitment takes place at sites in Lesotho and Tanzania. Participants are randomised in a 1:1 allocation to a control arm receiving the standard of care (3 sessions of enhanced adherence counselling, a follow-up VL test, continuation of the same regimen upon viral resuppression or empiric selection of a new regimen upon sustained elevated viremia) and an intervention arm (GRT to inform onward treatment). The composite primary endpoint is the occurrence of any one or more of the following events during the 36 weeks of follow-up period: i) death due to any cause; ii) HIV- or ART-related hospital admission of ≥24 h duration; iii) new clinical World Health Organisation stage 4 event (excluding lymph node tuberculosis, stunting, oral or genital herpes simplex infection and oesophageal candidiasis); and iv) no documented VL <50 c/mL at 36 weeks follow-up. Secondary and exploratory endpoints assess additional health-related outcomes, and a nested study will assess the cost-effectiveness of the intervention. Enrolment of a total of 276 participants is planned, with an interim analysis scheduled after the first 138 participants have completed follow-up.DiscussionThis randomised clinical trial will assess if the availability of resistance testing improves clinical outcomes in children and adolescents with elevated viremia while taking ART.Trial registrationThis trial is registered with ClinicalTrials.gov (NCT04233242; registered 18.01.2020). More information: www.givemove.org.

Management of Genital Herpes in Pregnancy: ACOG Practice Bulletin Summary, Number 220.

Genital herpes simplex virus (HSV) infection during pregnancy poses a risk to the developing fetus and newborn. Genital herpes is common in the United States. Among 14- to 49-year-old females, the prevalence of HSV-2 infection is 15.9%. However, the prevalence of genital herpes infection is higher than that because genital herpes is also caused by HSV-1 (1). Because many women of childbearing age are infected or will be infected with HSV, the risk of maternal transmission of this virus to the fetus or newborn is a major health concern. This document has been revised to include that for women with a primary or nonprimary first-episode genital HSV infection during the third trimester of pregnancy, cesarean delivery may be offered due to the possibility of prolonged viral shedding.

Management of Genital Herpes in Pregnancy: ACOG Practice Bulletinacog Practice Bulletin, Number 220.

Genital herpes simplex virus (HSV) infection during pregnancy poses a risk to the developing fetus and newborn. Genital herpes is common in the United States. Among 14- to 49-year-old females, the prevalence of HSV-2 infection is 15.9%. However, the prevalence of genital herpes infection is higher than that because genital herpes is also caused by HSV-1 (). Because many women of childbearing age are infected or will be infected with HSV, the risk of maternal transmission of this virus to the fetus or newborn is a major health concern. This document has been revised to include that for women with a primary or nonprimary first-episode genital HSV infection during the third trimester of pregnancy, cesarean delivery may be offered due to the possibility of prolonged viral shedding.

Frequent Recurrences of Genital Herpes Are Associated with Enhanced Systemic HSV-Specific T Cell Response.

Objectives Genital herpes simplex virus (HSV) infection is controlled by HSV-specific T cells in the genital tract, and the role of systemic T cell responses is not fully understood. Thus, we analysed T cell responses in patients with recurrent genital herpes (GH). Methods T cell responses to HSV-1 and HSV-2 native antigens and the expression of HLA-DR and CD38 molecules on circulating CD8+ T cells were analysed in adults with high frequency of GH recurrences (19 patients) and low frequency of GH recurrences (7 patients) and 12 HSV-2 seronegative healthy controls. The study utilized the interferon-γ Elispot assay for measurement of spot-forming cells (SFC) after ex vivo stimulation with HSV antigens and flow cytometry for analysis of the expression of activation markers in unstimulated T cells. Results The patients with high frequency of GH recurrences (mean number of recurrences of 13.3 per year) had significantly enhanced HSV-specific T cell responses than the HSV-2 seronegative healthy controls. Moreover, a trend of higher numbers of SFC was observed in these patients when compared with those with low frequency of GH recurrences (mean number of recurrences of 3.3 per year). Additionally, no differences in CD38 and HLA-DR expression on circulating CD8+ T cells were found among the study groups. Conclusions Frequency of GH recurrences positively correlates with high numbers of systemic HSV-specific T cells.

Anale Herpes-simplex-Virus-Infektionen

Herpes simplex virus (HSV) type1 and type2 may infect the anal region and induce aphthous ulcers. HSV-induced proctitis may be severe with fever, anal pain, anal bleeding, and diarrhea. The pathogenic agents and treatment are reviewed. A review of the current literature was performed. The shift to later primary infections with HSV1 and changes towards more frequent oro-genital and oro-anal sex has increased the incidence of HSV1-induced primary anal infections. Due to frequent recurrences, HSV2 remains the most common cause of anal HSV infection. Anal and genital HSV infections are arisk factor for subsequent HIV infection. In case of suspicion, pathogen detection by polymerase chain reaction (PCR) should be performed and other sexually transmitted diseases should be excluded. HSV proctitis may mimic inflammatory bowel disease. Treatment should include antiviral medication as in genital herpes simplex. HSV may induce perianal infections, anal infections and HSV proctitis. Diagnosis of HSV1 and HSV2 using PCR is recommended. Anal and genital HSV infections are arisk factor for subsequent HIV infection. The risk is higher for HSV2 infection due to more frequent recurrences.

Superadded bacterial and fungal infections in oral and genital herpes simplex lesions

Background: Two types of herpes simplex virus (HSV) HSV type 1 (HSV-1) and HSV type 2 (HSV-2) can cause oral and genital infections, respectively. Superadded bacterial and fungal infections of HSV lesions are one of the complications seen in herpes simplex infections. Objective: The study aims to identify the super added bacterial and fungal infections in oral and genital herpes simplex infections. Materials and Methods: This is an observational study carried out at SRM Medical College Hospital and Research Centre, Tamil Nadu, India, from February 2019 to February 2020 after the Institutional Ethical committee approval. Patients with clinically suspected oral and genital herpes infections in all age groups are included in the study excluding neonates and infants. Under aseptic precautions vesicular fluid, blood and wound swabs were collected. Vesicular fluid examined by Tzanck smear for multinucleated giant cells, and Immunoglobulin M enzyme-linked immunosorbent assay performed in positive cases. Superadded bacterial and fungal infections identified using conventional culture and identification methods. Results: In this observational study, a total of 75 patients were screened for oral and genital herpes infection. Thirty-five (46.6%) were clinically positive. Out of the positive cases, Tzanck smear was positive in 17 (48.6%), superadded bacterial and fungal infections are seen in 18 (51.4%). The most common super added infections are Candida albicans 9 (50%), Candida non-albicans 4 (22.2%), Escherichia coli 2 (11%), Staphylococcus 1 (5.6%), Enterococcus 1 (5.6%), and Proteus mirabilis 1 (5.6%). Conclusion: Most common superadded infections associated with oral and genital herpes simplex infections are with Candida species, E. coli, and Staphylococcus.

Time Trends in First-Episode Genital Herpes Simplex Virus Infections in an Urban Sexually Transmitted Disease Clinic.

Genital herpes simplex virus type 1 (HSV-1) has emerged as the leading cause of first-episode genital herpes among specific populations in the United States, such as adolescents, young adult women, and men who have sex with men (MSM). We examined trends in the etiology of first-episode genital herpes diagnoses over time in a sexually transmitted disease (STD) clinic population. Using an electronic database, we identified persons diagnosed as having first-episode genital herpes at Public Health - Seattle & King County STD Clinic from 1993 to 2014 and compared risk factors for genital HSV-1 versus herpes simplex virus type 2 (HSV-2) infection. Of 52,030 patients with genital ulcers, 3065 (6.15%) had first-episode genital herpes infection: 1022 (33.3%) with HSV-1 and 2043 (67.7%) with HSV-2. Overall, 1154 (37.7%) were women, the median age was 28 years (interquartile range, 24-36 years), 1875 (61.2%) patients were white, and 353 (11.5%) were MSM. The number of patients diagnosed as having first-episode genital HSV-2 declined on average by 5.5 persons per year, from 208 in 1993 to 35 in 2014 (change of -5.6 per year; 95% confidence interval [CI], -6.9 to -4.1), whereas HSV-1 diagnoses remained stable at approximately 50 per year (change of 0.2; 95% CI, -0.4 to 0.9). In a multivariate model, persons diagnosed as having first-episode genital HSV-1 rather than genital HSV-2 infection were more likely to be younger (age <30 years [relative risk {RR}, 1.38; 95% CI, 1.22-1.55]), white (RR, 3.16; 95% CI, 2.57-3.88), and MSM (RR, 1.50; 95% CI, 1.31-1.71). We observed a significant decrease in the frequency of first-episode genital HSV-2 and a stable number of first-episode genital HSV-1 infections in a STD clinic over the last 2 decades.

Herpes Simplex Infection During Pregnancy, Results of a Tertiary Referral Center in Turkey.

The present study aimed to determine herpes simplex virus (HSV) infection during pregnancy, serologic status of symptomatic patients, and the frequency of PCR and culture positivity and neonatal disease in an obstetric population. Sera of 1,690 women with genital lesions were tested for HSV IgM and/or HSV IgG between 2008 and 2017. All the patients were evaluated by PCR and viral culture to demonstrate genital herpes infection. The frequency of HSV IgG and IgM seropositivity was 73.8% (1245/1685) and 28.6% (484/1690). The number with a positive viral culture was 288, whereas positive PCR was 305. Five infants had localized skin lesions of HSV infection at the time of birth. This study shows the serologic status, viral culture and PCR testing results of pregnant women who had a symptomatic genital HSV infection and efficacy of management strategies to prevent neonatal herpes infection.

Increased Frequency of Virus Shedding by Herpes Simplex Virus 2-Infected Guinea Pigs in the Absence of CD4+ T Lymphocytes.

Reactivation of herpes simplex virus 2 (HSV-2) results in infection of epithelial cells at the neuro-epithelial junction and shedding of virus at the epithelial surface. Virus shedding can occur in either the presence or absence of clinical disease and is usually of short duration, although the shedding frequency varies among individuals. The basis for host control of virus shedding is not well understood, although adaptive immune mechanisms are thought to play a central role. To determine the importance of CD4+ T cells in control of HSV-2 shedding, this subset of immune cells was depleted from HSV-2-infected guinea pigs by injection of an anti-CD4 monoclonal antibody (MAb). Guinea pigs were treated with the depleting MAb after establishment of a latent infection, and vaginal swabs were taken daily to monitor shedding by quantitative PCR. The cumulative number of HSV-2 shedding days and the mean number of days virus was shed were significantly increased in CD4-depleted compared to control-treated animals. However, there was no difference in the incidence of recurrent disease between the two treatment groups. Serum antibody levels and the number of HSV-specific antibody-secreting cells in secondary lymphoid tissues were unaffected by depletion of CD4+ T cells; however, the frequency of functional HSV-specific, CD8+ gamma interferon-secreting cells was significantly decreased. Together, these results demonstrate an important role for CD4+ T lymphocytes in control of virus shedding that may be mediated in part by maintenance of HSV-specific CD8+ T cell populations. These results have important implications for development of therapeutic vaccines designed to control HSV-2 shedding.IMPORTANCE Sexual transmission of HSV-2 results from viral shedding following reactivation from latency. The immune cell populations and mechanisms that control HSV-2 shedding are not well understood. This study examined the role of CD4+ T cells in control of virus shedding using a guinea pig model of genital HSV-2 infection that recapitulates the shedding of virus experienced by humans. We found that the frequency of virus-shedding episodes, but not the incidence of clinical disease, was increased by depletion of CD4+ T cells. The HSV-specific antibody response was not diminished, but frequency of functional HSV-reactive CD8+ T cells was significantly diminished by CD4 depletion. These results confirm the role of cell-mediated immunity and highlight the importance of CD4+ T cells in controlling HSV shedding, suggesting that therapeutic vaccines designed to reduce transmission by controlling HSV shedding should include specific enhancement of HSV-specific CD4+ T cell responses.

Abstract # 2069 Regional but not systemic immune parameters relate to neuropsychiatric morbidity in patients with genital herpes simplex virus (HSV) infection

Neuropsychiatric disturbances, including during the prodromal stage of infection, are common among patients with genital herpes simplex virus (HSV) infection. These disturbances are typically interpreted as signs of stress – in a stress-diathesis disease model. The role of immunological triggers in these manifestations is less explored. We examined a role for regional and systemic markers of immune activation in neuropsychiatric manifestations among patients with documented genital HSV infection. Twenty-two patients of an inner-city tertiary sexual health clinic were assessed when herpetic lesions were present, and again when lesions were absent. Measures were also obtained from healthy control subjects. Each assessment included a clinical examination, self-report measures, as well as a blood and urine collection. Markers of immune activation [neopterin and interleukin (IL)-6] in serum and urine were quantified by enzyme-linked immunoassay. Urinary, but not serum, levels of neopterin and/or IL-6 correlated significantly with a spectrum of neuropsychiatric and urogenital symptoms. Symptoms were significantly more severe during active clinical lesions (p