Herpesvirus Hominis Infection Research Articles

Effect of adenine arabinoside on severe Herpesvirus hominis infections in man. 1973.

Ten immunosuppressed patients received intravenous adenine arabinoside (ara-A, 3.3–10 mg/kg per day for five to 13 days) for treatment of severe mucocutaneous infection due to Herpesvirus hominis (HVH). After ara-A, virus excretion by patients with orofacial lesions due to type 1 HVH infection was reduced 90% within 72 hr. By nine days, these lesions contained no virus and were healed, whereas three untreated patients had exreted virus and had clinical lesions for two to 16 weeks. In contrast, type 2 HVH genitoperineal infection responded less well clinically and virologically. Nine neonates, six with disseminated HVH infection and three with localized HVH infection, were also treated with ara-A (10–15 mg/kg per day for five to 15 days). In contrast with the usually fatal outcome of disseminated HVH infection, three of the six neonates survived. The three with localized infection recovered without further extension of the disease. Unlike 5-iodo-2′-deoxyuridine and cytosine arabinoside, ara-A, within its apparent antiviral dose range, produced no demonstrable hepatic, renal, or hematologic toxicity. These preliminary data suggest a future role for ara-A in the treatment of severe HVH infections in man.

Herpesvirus hominis (HVH) infection in women with preterm labor.

A possible etiologic relationship between maternal asymptomatic genital HVH infection and pre-term labor was discussed on the base of the results of the investigation performed in this study. Latent HVH infection was diagnosed by the test of microneutralization. Asymptomatic HVH vaginal and cervical shedding was investigated by indirect immunofluorescence and cytologically. The incidence of latent HVH type 2 infection was higher in women with previous pre-term labor than in the control group. The obtained difference appeared to be statistically significant. The comparison of HVH type 2 asymptomatic cervical infection of the examined and the control group shows that it lies on the boundary of statistical significance. It means that further research of the subject is needed including prospective virologic investigations with the aim of detecting active HVH infections at the time of pre-term labor. Concerning the increasing significance of genital HVH infections in our environment, it seems reasonable to aim diagnostic efforts at the determination of both latent and active HVH infections, in order to reduce the incidence of pre-term labor and the perinatal morbidity and mortality rates by use of the appropriate preventive and therapeutic measures.

Three years' experience of sexually transmitted diseases in Seville, Spain.

At present there are no reliable statistics on the relative prevalences of sexually transmitted diseases (STDs) in Spain. In a report of the first three years' experience in an STD diagnostic centre between 1977 and 1979 a total of 879 patients (534 men adn 345 women) were seen. They mainly consisted of university students and the mean age was 22 years in 1977 and 23 years in the following two years. All the patients were examined for syphilis and all women for gonorrhoea and trichomoniasis. Investigations for Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum, Candida albicans, and Herpesvirus hominis infections were carried out according to the presenting symptoms. Non-specific genital infections occurred most commonly (25.7%); chlamydia were isolated from 30% of the patients with non-gonococcal urethritis (NGU). The second commonest infection was candidosis (13.5%). Gonorrhoea, which was found in 10.6% of the patients, was diagnosed more frequently in men (13.5%) than in women (6%). No strains of beta-lactamase-producing Neisseria gonorrhoeae were detected and all were sensitive to penicillin. Syphilis was diagnosed in 4.4% of patients (2% women and 5% men). Condylomata acuminata were diagnosed in 2.8% of patients and more frequently in men (4%). Herpes genitalis and venereophobia were uncommon (1.9% and 1.2% respectively) and were diagnosed only in men.

Sensitivity and Specificity of Diagnostic Tests for Genital Infection with Herpesvirus hominis

Three smear techniques for diagnosis of Herpesvirus hominis infection were evaluated by study of 168 unselected patients with genital lesions attending a venereal disease clinic. A tissue culture and results of three smear techniques were obtained for each patient in random order. H. hominis was recovered from 101 patients (60%). All three smear tests (immunofluorescence, Papanicolaou, and crystal violet) were highly specific, but the sensitivity of each was smaller than or equal to 40% among patients who had ulcerative lesions. Because H. hominis is a common cause of genital lesions and the clinical manifestations of disease are highly variable, future research must identify accurate diagnostic aids that are suitable for clinic use.

Herpesvirus-hominis-Erkrankungen

In a 14-year-old girl treated with cytostatics because of leukaemia a severe and chronic atypical herpes virus hominis infection occurred. The same disease also occurred in a 30-year-old man under immunosuppression after a renal transplant. The skin reactions posed diagnostic and therapeutic problems. In both cases withdrawal of the cytostatic agent or drastic reduction of the immunosuppressive drug were successful therapeutically.

Herpesvirus in Sensory and Autonomic Ganglia After Eye Infection

In herpesvirus hominis (HVH) infections, virus harbored in the sensory ganglia is now thought to be the main source of recurrent infection at peripheral sites. Experimental HVH infection of the external eye in rabbits produces an acute infection and then latent infection of the trigeminal ganglion. In this study, acute infection of the automatic ganglia serving the eye (superior cervical and ciliary) as well as trigeminal ganglia occurred after HVH inoculation of rabbits' corneas with a herpes type 1 strain (RE). Latent virus infection was detected in the trigeminal ganglion of one of five animals tested six months after initial infection. Since the superior cervical and other autonomic ganglia serving the eye become infected during acute herpes simplex virus infection of the external eye in rabbits, it is possible that these ganglia are also sources of reinfection in recurrent herpetic disease of the eye. Following the initial eye disease with this virus strain, HVH shedding could not be demonstrated even after induction attempts by topically applied epinephrine or systemic use of cyclophosphamide. Thus, establishment of latent HVH infection in the ganglia and chronic shedding of virus into the external eye is not a constant feature of this animal model, but may depend on the specific strain of herpesvirus used.

Atypical herpesvirus hominis type 2 infection in uremic patients receiving immunosuppressive therapy

In four uremic patients (three renal transplant recipients and one with idiopathic thrombocytopenia), painful, initially vesicular lesions developed in the anogenital region while they were receiving immunosuppressive drug therapy. These lesions enlarged, coalesced and ulcerated, presenting a puzzling diagnostic problem. Initial misdiagnoses often resulted in inappropriate antimicrobial therapy. Routine cultures, histologic sections and Tzanck preparations were seldom helpful. The correct diagnosis of herpesvirus hominis (HVH) infection was established within 18 to 48 hours by viral culture of swab or biopsy material. Subsequent identification of isolates as HVH type 2 was confirmed by neutralization kinetics, infectivity titers and ability to plaque in chick embryo cells. Various therapeutic regimens were ineffective. Clinical improvement best correlated with decrease in dosage of immunosuppressive agents.

Techniques for Typing Herpesvirus Hominis Antibody: A Comparison of Inhibition of Peroxidase-Labelled Antibody Staining with Inhibition of Indirect Haemagglutination and with Microneutralisation

A new technique based upon the inhibition of the peroxidase-labelled antibody staining (PLAS) has been used to type Herpesvirus hominis (HVH) antibodies in four groups of human sera taken from patients with one or both types of HVH infection and in mixtures of different proportions of type 1 and type 2 antisera. The results were compared with those of the microneutralisation (MN) test and the indirect haemagglutination (IHA) inhibition test. The sensitivity and specificity of the three methods were identical for sera containing only one type of HVH antibody. The MN test was slightly more sensitive than the other tests for detecting small amounts of HVH-1 antibody mixed with large amounts of HVH-2 antibody. Nevertheless, the PLAS inhibition technique was far more rapid and it would seem a satisfactory alternative to the IHA inhibition test for HVH antibody typing.

Disseminated Herpesvirus hominis infection in a child with acute leukemia

Disseminated Herpesvirus hominis infection in a child with acute leukemia

Genital Herpesvirus hominis Infection in Mice. II. Treatment with Phosphonoacetic Acid, Adenine Arabinoside, and Adenine Arabinoside 5'-Monophosphate

Genital infection of mice with Herpesvirus hominis type 2 provides an experimental model for screening potential antiviral chemotherapeutic agents before clinical trials in humans. Intravaginal treatment with phosphonoacetic acid (at a dose of 500 mg/kg in saline or as a 5% cream) initiated 3 hr after inoculation with H. hominis type 2 completely inhibited viral replication in the genital tract and prevented subsequent mortality. Although therapy initiated 24-72 hr after infection significantly reduced titers of virus in vaginal secretions from three- to 100-fold, most mice eventually died of encephalitis. Topical treatment with either adenine arabinoside or adenine arabinoside 5'-monophosphate at a dose of 500 mg/kg in saline or as a 10% cream failed to alter viral replication in the genital tract or to protect the mice from death due to encephalitis. Treatment by the intraperitoneal route with any of these three agents had no effect on local viral replication or final mortality.

Neuroretinitis Associated with Herpes Simplex Encephalitis in an Adult

A 48-year-old man who died of herpes simplex encephalitis had a bilateral papillitis at autopsy. Intranuclear inclusion bodies were especially numerous within the ganglion cells and inner nuclear layer of the macula and consisted of typical virions by electron microscopy. Contiguous spread from the brain to the eyes may have occurred via the optic nerves. Clinically, the disk and retinal changes were misinterpreted as being caused by papilledema. Papillitis should be included in the differential diagnosis of disk swelling in adults with suspected Herpesvirus hominis infection of the central nervous system.

Interaction of Adenine Arabinoside and Host Defense Factors in Experimental Infections Due to Herpesvirus hominis

The role of host immune functions in relation to the antiviral effects of adenine arabinoside (ara-A) and/or humoral antibodies in Herpesvirus hominis infection was studied in four different mouse models (newborn Swiss mice, three-week-old Swiss mice, athymic nude [nu/nu] mice, and phenotypically normal [nu/+] littermates of nude mice). Although the overall beneficial effects afforded by the administration of ara-A and/or humoral antibodies were similar, the degree of protection varied among the four host systems. The data indicate that host defense factors play an important role in modulating the effect of humoral antibodies and/or an antiviral agent. Combined use of ara-A and humoral antibodies resulted in enhanced protection against H. hominis infection. Our data suggest that control of viral infection, particularly in compromised hosts, may require chemoimmunotherapy.

Lack of association between defective delinquents and antibody of herpesvirus hom in is

Several groups have reported a relation between herpesvirus hominis infection and certain psychiatric disorders. We have investigated herpes antibody levels in chronic criminal offenders who were diagnosed as defective delinquents and in criminals who were not defective delinquents. We found no difference in the frequency of titers of herpesvirus type I or type 2 antibody in these groups.

Herpesvirus hominis Hepatitis and Disseminated Intravascular Coagulation

Herpesvirus hominis (HVH) hepatitis, a rarely recognized manifestation of HVH infection in adults, occurred in a 36-year-old woman who had received prednisone therapy for pemphigus vulgaris continuously for seven years. After an acute terminal illness that was characterized by fulminant hepatic failure and disseminated intravascular coagulation (DIC), postmortem examination disclosed massive hepatic necrosis. Herpesvirus hominis (type 1) was isolated from the liver. The association of disseminated HVH infection with impaired immunologic defenses, as well as the occurrence of DIC in association with acute hepatic failure, are discussed. Greater awareness of the clinical manifestations of HVH hepatitis should lead to early diagnosis, although sucessful modes of therapy await development.

Passive immunization in experimental Herpesvirus hominis infection of newborn mice

Infection of newborn mice with Herpesvirus hominis type 2(HVH-2) was used as an experimental model of disseminated HVH infection in newborn humans. Mice were challenged with 103 plaque-forming units of HVH-2 intranasally and were given 0.2 ml of rabbit serum intraperitoneally. Passive immunizations with rabbit anti-HVH-2 serum resulted in a significant decrease in mortality and prolongation of survival time. This effect correlated with the neutralizing antibody titer of the serum against HVH-2 and was more pronounced when immune serum was administered 1 h after infection as compared with 24 h. These results suggest that administration of high-titer anti-HVH-2 immunoglobulins shortly after delivery could afford significant protection to the newborn of a mother with genital HVH-2 infection.

Neonatal Risk Following Late Gestational Genital Herpesvirus Hominis Infection

Sir .—The report by St. Geme et al, which appeared in the March issue of theJournal(129:342, 1975), is interesting anecdotal information. However, their comment that no opportunity was available to modify the delivery of one of the infants is not accurate. The authors noted the fact that genital labial lesions were present four days prior to delivery. The physicians then waited for virologic confirmation that did not become available until the time of delivery. Unfortunately, the authors did not comment on the ability of cytologic smears of lesions, fixed and stained by the Papanicolaou technique, to diagnose herpesvirus infections. Smears of clinically apparent genital lesions that demonstrate the characteristic nuclear changes of herpesvirus are diagnostic for genital herpesvirus infection. This technique is capable of providing answers in terms of hours instead of days, and it is the patient very close to term, or the patient in labor with

Nosocomial and Maternally Acquired Herpesvirus Hominis Infections

Four fatal cases of neonatal herpes simplex infection occurred during a two-month period in the perinatal intensive care unit of a hospital. Virus isolation or serologic studies, or both, implicated herpesvirus hominis type 2 in all four cases. Three of the infants developed symptoms in the first week of life and were probably infected in utero or at delivery. The fourth infant did not develop signs of illness until age 6 weeks, an interval much longer than that expected with disease acquired at birth. An epidemiologic investigation indicated that the most likely source of this fourth infant's herpes infection was by indirect contact with one of the other three infected neonates. Nosocomial spread of herpes simplex virus within a hospital nursery, although uncommon, may pose an added risk to the newborn infant if nursery techniques among infants are compromised.

Neonatal risk following late gestational genital herpesvirus hominis infection.

Five women developed genital herpesvirus hominis (herpes simplex virus) infection beyond 32 week's gestation. Two of the women had fresh vesicular lesions at parturition. The five infants were delivered per vaginum at term and escaped subsequent overt herpesvirus hominis infection, although a scalp lesion in one infant was dismissed as inconsequential and disappeared without virologic study. Examination of the infants two months to four years after birth failed to detect sequelae of possible subclinical infection.

Diagnosis of Herpesvirus hominis infections in a general hospital laboratory

There is a greatly increased interest in Herpesvirus hominis infections especially those of type 2 associated with genital lesions or neonatal disease. Physicians are eager to confirm the clinical impression with a specific virologic diagnosis such as isolation of the agent and its typing, and type-specific antibody responses. Procedures are reviewed here which permit such studies in general microbiology laboratories equipped for simple cell culture and immunofluorescence. This paper recounts experience with several laboratory methods and evaluates their efficiency and practicability in a general laboratory. Virus isolation was optimal if specimens were obtained from visible lesions early in their evolution and it often provided a specific diagnosis, including typing of the isolate by immunofluorescence, within 24 to 48 h. Estimation of serum antibodies to herpes simplex virus type 1 and 2 by indirect immunofluorescence was more sensitive and perhaps also more specific than by microneutralization test. A pilot study of herpes simplex virus antibody titers in mothers and in the cord blood of the offspring suggested the need to evaluate a possible protective role of high titer antibody in the fetus.

Herpesvirus Hominis Infections in Renal Transplant Recipients

A longitudinal, prospective study of herpesvirus hominis (HVH, herpes simplex virus) was carried out in immunosuppressed renal allograft recipients using serologic, virologic and clinical techniques. The final study group consisted of 37 patients of which 31 were followed for at least 2 months and 26 for more than 1 year. A 4-fold rise or more in HVH complement-fixing antibody in relation to titers measured at the time of transplantation was found in 11 patients. Eight of these 11 patients had clinically recognizable herpetic lesions. An additional 9 patients had lesions without titer rise being demonstrable. The 20 of the 37 patients studied (54%) had evidence of active infection with HVH. Because of pain and discomfort herpetic sores were of clinical importance in 11 patients and lasted for 1 month or more in 9. Herpetic keratitis was seen in 3 and left permanent damage to sight in 2. Multiple, extensive, prolonged and sometimes destructive herpetic lesions affected 5 (16%) of all patients studied.