Herpes Simplex Virus IgM Research Articles

A Case Report on Anti-N-Methyl-D-Aspartate Encephalitis

Aim: The case study aims to describe and evaluate the initial neuropsychiatric symptoms, therapeutic methods, and diagnostic criteria, of a 3-year-old girl who had been diagnosed with anti-N-Methyl-D-Aspartate Receptor (NMDAR) encephalitis. This case study implies the importance of early detection and treatment in pediatric autoimmune encephalitis, highlighting its diagnostic challenges and the successive use of immunotherapy and outcomes. Presentation of Case: A 3-year-old developmentally normal girl child was brought to the hospital with C/O fever for 2 days. Following this she had seizures lasting for around 2 minutes and followed by shivering movements in the right leg for 15 minutes and then she regained consciousness after 25 minutes. CSF analysis showed pleocytosis. Serological tests (Typhoid IgM, Rapid Malaria, Scrub IgM, Dengue IgM, Japanese Encephalitis, and Herpes Simplex Virus IgM) were negative. MRI indicated diffuse encephalopathy, and EEG detected epileptic activity. Further antibody testing in serum and CSF revealed positive Anti-NMDAR antibodies. The patient was treated with amoxicillin-clavulanate(400mg), ceftriaxone(750mg), and acyclovir(130mg) intravenously initially. Once the definitive diagnosis was made, she was treated with IVIG(26g), methylprednisolone(390mg), and levetiracetam(280mg). Discussion: Anti-N-Methyl-D-Aspartate Receptor Encephalitis is an autoimmune encephalitis characterized by complicated neuropsychiatric symptoms and immunoglobulin G (IgG) antibodies against the NR1 subunit of the NMDA receptors in the central nervous system. Conclusion: The appropriate diagnosis and treatment of autoimmune encephalitis necessitate an organized approach. A wide range of autoantibody tests can be performed to identify or rule-out specific autoimmune causes. Patients may relapse and require appropriate follow-up care.

Longitudinal Effects of Herpesviruses on Multiple Cognitive Outcomes in Healthy Elderly Adults.

Herpesviruses have been proposed to be involved in Alzheimer's disease development as potentially modifiable pathology triggers. To investigate associations of serum antibodies for herpes simplex virus (HSV)-1 and cytomegalovirus (CMV) and anti-herpesvirus treatment with cognitive outcomes in relation to interactions with APOE ɛ4. The study included 849 participants in the population-based Prospective Investigation of the Vasculature in Uppsala Seniors study. Cognitive performance at the ages of 75 and 80 years was assessed using the Mini-Mental State Examination (MMSE), trail-making test (TMT) A and B, and 7-minute screening test (7MS). Anti- HSV-1 IgG positivity was associated cross-sectionally with worse performance on the MMSE, TMT-A, TMT-B, 7MS, enhanced free recall, and verbal fluency tests (p = 0.016, p = 0.016, p < 0.001, p = 0.001, p = 0.033, and p < 0.001, respectively), but not orientation or clock drawing. Cognitive scores did not decline over time and longitudinal changes did not differ according to HSV-1 positivity. Anti- CMV IgG positivity was not associated cross-sectionally with cognition, but TMT-B scores declined more in anti- CMV IgG carriers. Anti- HSV-1 IgG interacted with APOE ɛ4 in association with worse TMT-A and better enhanced cued recall. Anti- HSV IgM interacted with APOE ɛ4 and anti-herpesvirus treatment in association with worse TMT-A and clock drawing, respectively. These findings indicate that HSV-1 is linked to poorer cognition in cognitively healthy elderly adults, including impairments in executive function, memory, and expressive language. Cognitive performance did not decline over time, nor was longitudinal decline associated with HSV-1.

Is Vestibular Neuropathy Rather a Neuritis?

Background/objectives Vestibular neuritis (VN) is one of the most common causes of peripheral vestibular neuropathy. The goal of this study is to investigate the possible infectious causes of VN in a large cohort of patients. Material and methods In total, 98 consecutive VN patients were enrolled in this retrospective study over a four-year period (04/2015-04/2019). Diagnosis of VN was made by clinical examination and functional diagnostics. We focused on infectious causes such as neurotropic viruses and Lyme disease (LD) and evaluated infection parameters as well as the concomitant diseases. Results In this cohort, we found pathologically elevated leukocytes or C-reactive protein (CRP) levels, and/or acute herpes simplex virus (HSV) infection, cytomegalovirus (CMV) infection and LD in 42 patients (42.85%). Leukocytes were elevated in 39 of 98 patients (39.8%) and the mean count was 9717 ± 2991 /μl. The group comparison between patients with vestibular loss (n=42) and patients with vestibular hypofunction (n=45) revealed a significant difference in regard to elevated leukocytes (p=0.028). In total, 28 of 53 patients (52.8%) were positive for HSV immunoglobulin (Ig) G and four of 53 patients were positive for HSV IgM (7.5%). Six of 53 patients (11.3%) were positive for LD IgM. Conclusion In this cohort, there was a large number of VN patients with infectious signs; several patients tested positive for HSV and LD. Therefore we recommend testing VN patients not only for HSV but also for LD and other neurotropic viruses. This approach enables to complement the standard VN treatment with a specific treatment.

Prevalence of herpes simplex virus types 1 and 2 antibodies among individuals screened in a tertiary hospital in the Eastern province of Saudi Arabia.

The epidemiology of herpes simplex virus (HSV) infections varies among populations depending on their demographic characteristics and exposure. This study describes the prevalence of HSV 1/2 IgG and IgM antibodies among individuals over a period of 5 years. A retrospective study was conducted to collect data on cases tested for HSV-1 and HSV-2 IgG and IgM antibodies for different medical conditions over five years between January 2014 and December 2018. 620 samples were tested for HSV 1/2 IgG and IgM during the study period. The total HSV seropositivity in the study population was 68% (422/620). The total seropositivity excluding children below 6 months of age was 65.3% (313/479). HSV-IgG seropositivity was significantly higher in married individuals (p<0.001, 95% CI 1.61-3.69). The HSV IgG seropositivity was significantly higher in children under the age of 6 months (N=109, 77.30%) than in children between 7 and 24 months old (27.6%) (Chi-square for linear trend, p<0.001), and it then tends to increase with age more than 24 months (Chi-square for linear trend, p=0.011). Eleven children showed laboratory evidence of recent HSV infection (6.2%) as indicated by HSV IgM antibodies and had diverse clinical conditions. HSV infection is highly prevalent in the Eastern Province of Saudi Arabia. Infection is most probably acquired during early childhood, and the tendency increases with age. However, a significant number of mothers are at risk of infection and transferring the infection to their fetuses.

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.

Detection and analysis on serum antibodies for five common pathogenic microbes in patients with Posner-Schlossmarm syndrome

Background Posner-Schlossman syndrome (PSS) is often recurrent and is a cause of blindness.The etiology of PSS remains to be elucidated.It is reported that there is a certain association between pathogenic microorganisms and PSS in rather small samples. Objective This study was to analyze the related serum antibody levels of cytomegalovirus (CMV), herpes simplex virus (HSV), rubella virus (RV), helicobacter pylori (HP) and anti-streptolysin O (ASO) and provide a clue for the study on pathogenesis and therapy of PSS. Methods A prospective cases-controlled study was carried out in Shenzhen Eye Hospital from December, 2014 to December, 2016 under the approval of Ethic Committee of this hospital and informed consent of each subject prior to initial of any medical examination.Peripheral blood samples were collected from 82 PSS patients as the PSS group and 100 age-and gender-matched healthy blood donors as the normal control group.The positive rates of serum CMV IgG, CMV IgM, HSV IgG, HSV IgM, RV IgG, RV IgM, HP IgG and HP IgM in the subjects were detected by indirect ELISA, and the positive rate of serum ASO antibody was determined by immuno-scatter turbidmetry. Results The positive rates of serum CMV-IgG, CMV-IgM, HP-IgG, HP-IgM and ASO antibody were 22.0%, 17.1%, 22.0%, 17.1% and 17.1% in the PSS group, which were significantly higher than 5.0%, 0.0%, 10.0%, 2.0% and 7.0% in the normal control group (χ2=11.726, 18.496, 4.943, 12.766, 4.479, all at P 0.05). Conclusions CMV, HP and hemolytic streptococcal infection may participate in the occurrence and development of PSS. Key words: Posner-Schlossman syndrome; Etiology; Cytomegalovirus; Herpes simplex virus; Rubella virus; Helicobacter pylori; Anti-streptolysin O; Antibody

Changes in Biochemical Properties of the Blood in Winter Swimmers

The aim of the study was to investigate the effects of winter swimming on biochemical indicators of the blood. The subjects - winter swimmers - belonged to the Krakow Walrus Club "Kaloryfer" - "The Heater". The study group consisted of 11 men, aged 30-50 years, 'walrusing' throughout the whole season from November to March. Statistically significant changes throughout the 'walrusing' season were observed for the following biochemical parameters: a decrease in sodium (mmol/1), chloride (mmol/1), alpha-2 globulin(g/1), gamma globulin (g/1), IgG (g/1), and an increase in albumin (g/1), indicator A/G, IgA (g/l ), Herpes simplex virus IgM. Seasonal effort of winter swimmers has a positive influence on biochemical blood parameters.

Asymptomatic Herpes Simplex Virus Infection in Iranian Mothers and Their Newborns

ABSTRACTThis study aims to determine the prevalence of herpes simplex virus (HSV) infection among pregnant women as well as congenital infection of their newborns in Tehran. One hundred samples of blood sera from pregnant women were analyzed for the presence of HSV specific antibodies. Umbilical cord blood samples from the newborns were analyzed for the presence of HSV DNA using real-time PCR. HSV IgG and IgM antibodies were found in 97% and 2% of pregnant women, respectively. Of all the 100 cord blood samples, 6 were positive for HSV DNA in which 2 cases were from mothers who had detectable IgM. It was notable that all corresponding mothers of six HSV positive infants had detectable IgG antibodies in their sera. It was demonstrated that the presence of HSV DNA in cord blood of newborns could be a risk marker for maternal-fetal transmission of the virus in asymptomatic pregnant women.

Prevalence of serum antibodies to TORCH infection in the first trimester of the pregnancy in Kashan, Iran

Introduction:TORCH infections causing via Toxoplasma gondii, other microorganisms (e.g., Treponema pallidum), Rubella virus, Cytomegalovirus (CMV) and the Herpes Simplex Virus (HSV) types 1 and 2 during the first trimester of pregnancy can lead to severe fetal anomalies or even fetal loss. The current study determined the serological data of TORCH infections in women who were in their first trimesters of pregnancy.This descriptive study was carried out on 80 pregnant women in their first trimester in Kashan, Iran.Methods: To detect specific IgM antibodies and specific IgG antibodies against the TORCH infections via ELISA, Sera were collected from the pregnant women.Results: The specific IgG antibodies were found to be positive in 30(37.5%) cases for toxoplasmosis, in 74 (92.5%) cases for the Rubella virus, in 79(98.8%) cases for CMV and in 73 samples (91.3%) for the HSV types 1 and 2 infection. 3.8% of cases were found to be seropositive for Toxoplasma IgM antibody (95% CI, 0.38-7.9), 5% were positive for CMV IgM antibody (95% CI, 0.23-9.77) and 7.5% were positive for the HSV IgM antibody (95% CI, 1.8-13.2). 63.8% of pregnant women were at risk for at least to one of the TORCH agents.Conclusion: This study showed a high prevalence of infections caused by TORCH agents among pregnant women. Therefore, national screening programmed is necessary to screen the TORCH infections routinely and to prevent and treat congenital TORCH infection

The role of Screening for Herpes Simplex Virus in Candidates of Renal Transplantation

Background: Herpes Simplex Virus (HSV) infection in immunocompromised hosts like kidney transplant patients causes more morbidity and mortality than the general population. Objectives: The aim of this study was to evaluate the role of screening for HSV in donors and recipients of kidney transplantation. Materials and Methods: From October 2012 to November 2013, this cross sectional study was conducted on donors and recipients who were referred to our kidney transplant center in Ahvaz city, Iran. A standardized questionnaire was used to collect social and demographic data. The patients and donors were screened for HSV IgG and IgM antibodies by direct fluorescent antibody (DFA).Other routine pretransplant laboratory studies were also performed. Results: Overall 37 people (22 donors, 20 males and 2 females with mean age of 30 ± 5 years; 15 recipients, eight males and seven females with mean age of 45 ± 6 years) were enrolled in this study. All of the recipients were on hemodialysis. The markers of HBV and HCV infection were negative in 100% of recipients and donors. Herpes Simplex Virus (HSV) IgG antibody was positive in 93.33% of recipients (n = 14) and 77.27% of donors (n = 17). Herpes Simplex Virus (HAV) IgM antibody was positive in 33.33% of recipients (n = 5) and 13.63% of donors (n = 3). Conclusions: Herpes Simplex Virus is a common infection in donor and recipient candidates for kidney transplantation in Khuzestan province of Iran, and it seems that we need to perform screening for this infection to avoid kidney donation from seropositive donors to seronegative recipients.

Prevalence of Herpes Simplex Virus in Pregnant Women from Gangetic Plain Region of Allahabad, India

Herpes Simplex Virus (HSV) is a common pathogen that leads to lifelong latent infection and may be associated with transmission from mother to their fetus. A total of 191 blood samples of preg- nant women were collected to check the prevalence of Herpes Simplex Virus (HSV). It was ob- served that 124 (64.9%) and 04 (2.1%) samples were positive for HSV IgG and HSV IgM, respec- tively. Seropositivity of HSV IgG was the highest for third trimester and it was followed by second and first trimester; while it was the highest for first trimester for HSV IgM and it was followed by third and second trimester. Seroprevalence of HSV IgG and IgM was statistically insignificant (P > 0.05) according to gestation age. A significant correlation was observed between HSV IgG and age groups of pregnant women; while it was insignificant for HSV IgM. Seroprevalence of HSV IgG+ IgM- was 32 (53.3%), 61 (66.3%), and 27 (69.2%) for first, second and third trimester, respectively. Seroprevalence of HSV IgG+ IgM+ group was 02 (3.3%), 01 (1.1%) and 01 (2.6%) for first, second and third trimester, respectively. Seroprevalence of HSV IgG- IgM- group was 26 (43.3%), 30 (32.6%), and 11 (28.2%) for first, second and third trimester, respectively.

Herpes Simplex &amp; Cytomegalo Viruses inflicted semen substantiates infertility among men.

Infertility is a growing challenge worldwide that cause many affiliated socio-psychological problems in many cultures that carry a negative impact on many families. As a last resort, many physicians engage certain drugs to over stimulate the gonadotropins to hope for the production of healthy Sperms and Ovum to materialize the fertility. Also, Fertilization in Vitro is a growing solution for the rich but many patients are not able to afford. Over stimulation of the sperms or ovum does not constitute the chromosomal DNA/RNA to amicably contribute to the successful fertility, Normal fetal development, uneventful pregnancy and/ or normal delivery. Many countries have established the prominent link to the Cytomegaloviral and Herpes Simplex Virus to the infertility. We studied the prevalence and the role of herpes simplex virus (HSV), cytomegalovirus (CMV) in the semen of infertile men. Data was collected from sixty nine infertile men. Serum AntiHSV IgG & IgM, CMV IgG & IgM from the blood and the Real Time Polymerase chain reaction RT/ PCR test were performed on the semen to detect the presence of the HSV & CMV RNA’s in these infertile subjects. AntiCMV IgG was found in 44 (62.9%), CMV IgM in 4 (5.9%), HSV IgG in 22 (31.4%), HSV IgM in (0%) and PCR of CMV in 26 (37.1%), HSV PCR in 13 (18.8%). Overall, results revealed that the RT/ PCR of CMV were relatively more prevalent in the semen of infertile men as compared to the HSV IgG & IgM, CMV IgG & CMV IgM in the blood of infertile men.

Time to Consider Empiric Acyclovir

Purpose: A 63-year-old female presented to the emergency department with a two-day history of fever of 101.9°F and worsening fatigue. She denied a history of liver disease and was otherwise in good health, aside from a history of arthritis. She denied any recent changes in medications, use of antibiotics or travel history. Urine toxicology screen, acetaminophen level and hepatitis A-C serology were negative. Her laboratory assessment was notable for AST 4755 IU/L, ALT 3569 IU/L and an INR of 1.4. She was admitted into her local hospital and started on intravenous N-acetylcysteine. Overnight, she developed subtle changes in behavior without any change in level of consciousness. She was subsequently transferred to a liver transplant center. Upon arrival, the patient was oriented, but very somnolent, and remained febrile at 103.1°F. Physical exam was negative for stigmata of chronic liver disease, rash or asterixis. Laboratory assessment revealed total bilirubin 0.6 mg/dl, AST 7392 IU/L, ALT 5942 IU/L, INR of 2.2, WBC 2900 cells/ mm3, hemoglobin 16 g/dL and platelets of 29,000/mm3. Abdominal ultrasound showed a normalappearing liver with normal hepatic and portal flow. Further history from family revealed the patient was taking oral prednisone the past few weeks for chronic joint pain. Given this history, combined with fever, leukopenia and anicteric hepatitis, she was started on empiric IV acyclovir for possible herpes simplex virus (HSV)-induced liver failure. She underwent expedited liver transplant evaluation. A trans-jugular liver biopsy revealed minimal inflammation with scattered hepatocyptes with glassy nuclear inclusions, azonal areas of necrosis and positive HSV stain. Her serum HSV DNA testing by PCR was 1.2 x 10ˆ6 copies/ml, although her initial HSV IgM was within reference range. Her laboratory values normalized completely within 15 days, and she was discharged to a local rehab center. HSV-induced liver failure accounts for only 1% of all ALF, but confers a mortality rate of 75%. Although immunocompetent patients can be affected, 75% of affected patients are immunosuppressed or pregnant in the third trimester. Patients who present with fever, vesicular skin lesions, leukopenia and anicteric hepatitis need to be considered for empiric acyclovir therapy and transferred to a liver transplant center. Serological testing with antibodies against HSV in the serum is nonspecific and has low utility in early treatment decisions. Confirmation of diagnosis is best performed with liver biopsy and serum HSV PCR. Empiric therapy with acyclovir for patients at risk may obviate the need for liver transplantation.

Sero-Prevalence of Herpes Virus Infection in Sudanese Pregnant Women

Objectives: The aim of the study was to know the sero-plevalence of Herpes Simplex Virus (HSV) infection in pregnant women attending a university hospital in Sudan. Methods: All pregnant women who came for delivery by lower segment caesarean section (LSCS) in National ribat teaching hospital between May and November 2011 were enrolled in this study. Their blood was tested for HSV IgG & IgM immunoglobulin. Their vulvas were examined for eruptions and ulcers and when those were found surface swabs were taken for isolation of organisms including syphilis. Their blood was also tested for HIV and syphilis. Results: One hundred thirty pregnant women were included in the study and forty five women (34.6%) tested positive for the IgG of Herpes virus but none of them was positive for the IgM test. Fourteen women had genital rashes/ulcers and nine of them tested positive for IgG but not IgM. Eleven women had lip ulcers or blisters and five of them tested positive for herpes. Conclusion: Acute infection during pregnancy was not documented in this study population and probably women develop immunity to herpes virus early in their reproductive life. Genital rashes and ulcers were not associated with active herpes infection.

Is HSV serology useful for the management of first episode genital herpes?

Background: First episode genital herpes simplex virus (HSV) infections can be classified into three groups, primary genital herpes (no previous exposure to HSV), non-primary first episode (IgG antibody to HSV...

Sequential antibody changes following ulcerative herpetic keratitis.

Blood and tear levels of immunoglobulins against herpes simplex virus (HSV) were examined in 28 patients with dendritic keratitis over a period of 28 days. By means of an indirect micro-immunofluorescent technique blood and tear HSV IgG were detected, but neither circulating HSV IgM nor local HSV IgA were found. Over a four-week interval non-diagnostic fluctuations of HSV IgG occurred in most patients, though seven (25%) developed a rising blood IgG titre. Tear IgG appeared to be an exudate from blood. HSV was isolated from 68% of corneal swabbings and 11% of conjunctival swabbings. This study provides guidelines for laboratory testing in recurrent herpetic keratitis.

Specific IgG and IgA antibodies to herpes simplex virus (HSV)-induced surface antigen in patients with HSV infections and in healthy adults.

Herpes simplex virus (HSV)-specific IgG and IgA antibody response in patients with HSV infection and in healthy adults was studied by the immunoperoxidase antibody-membrane antigen (IPAMA) technique. In all HSV infections in which specific IgM antibodies were detected by enzyme-linked immunosorbent assay (ELISA), a significant rise in the titer of HSV IgG and IgA antibodies was found. In contrast, in patients with recurrent herpes labialis in which no specific HSV IgM antibodies were detected by ELISA, HSV IgG and IgA antibodies were not found to fluctuate significantly during the course of infection. A higher geometric mean titer (GMT) for HSV IgG and for IgA antibodies was found in seropositive individuals with a previous history of recurrent HSV than in seropositive individuals without a previous history of recurrent HSV infection. Nineteen of 26 HSV IgG seropositive healthy medical students without a previous history of recurrent HSV infection had HSV IgA antibodies to membrane antigen. The significance of this finding in understanding the mechanism of latency in healthy seropositive individuals without previous history of HSV recurrent infections is discussed.

INDIRECT IMMUNOFLUORESCENCE DETECTION OF HUMAN IgM AND IgG ANTIBODIES AGAINST HERPES SIMPLEX VIRUS TYPE 1 INDUCED CELL SURFACE ANTIGENS

An indirect immunofluorescence method, based on the use of infected Hela cell coverslip cultures was developed to demonstrate human IgM and IgG class antibodies against herpes simplex virus (HSV) type 1 induced cell surface antigens. A total of 35 specimens from 20 patients have been tested; including patients with a clinical diagnosis of HSV type 1 or type 2 primary infection, patients with recurrent HSV infections, patients without any HSV infections, and patients with varicella-zoster virus (VZV) infections. In each patient with a primary HSV infection both IgM and IgG antibody response was observed, while the patients with recurrent HSV infections showed only IgG antibodies. The direct serological typing of HSV infections was not possible because of cross-reacting antibodies both in the IgG and IgM test. No cross-reactivity was found in this test with HSV and VZV antibodies. The HSV fluorescent IgG and IgM antibody titers were found to parallel the highly sensitive HSV radioimmunoassay antibody titers very closely though at a markedly lower level.