Recurrent Herpes Simplex Virus Infection Research Articles

Parameters of cell-mediated immunity in recurrent herpes simplex.

Cell-mediated immunity was studied by a leukocyte migration inhibition assay, tuberculin, and a DNCB skin test in 32 patients with recurrent herpes simplex infection and in 34 healthy individuals who served as controls. Migration inhibition was found to be significantly reduced in patients who had suffered from recurrences for more than 1 year as compared to the controls. DNCB and tuberculin sensitivity were also found to be impaired in the group with infections of long duration. The data presented suggest a functional defect in cell-mediated immunity in individuals suffering from recurrent herpes simplex which could be responsible for the relapses.

Neutralising antibody in mice with primary and recurrent herpes simplex virus infection.

Neutralising antibody was studied in mice infected in the ear with herpes simplex virus type 1. Antibody was detected six days after infection and after one month it had reached titres which subsequently varied little. Geometric group mean titres were doubled by reinoculation of virus whereas recurrent disease induced by trauma did not change them (although titres did change in some individual animals). Mean titres in mice which had had unequivocal signs of primary disease were twice as high as in those which had not, and the frequency of recurrent disease in response to trauma in the former animals was greater than in the latter. A reduction in the frequency of induced recurrent disease was seen if the application of trauma was delayed for some time after the establishment of latency. Hyperimmunisation increased mean titres tenfold. If given soon after primary infection it reduced the frequency of induced recurrent disease but if its administration was delayed then the frequency was increased.

Recurrent herpes in pregnancy: Vontver L, Hickok D, Brown Z, et al.: Recurrent genital herpes simplex virus infection in pregnancy: Infant outcome and frequency of asymptomatic recurrences. Am J Obstet Gynecol 143:75, 1982

Recurrent herpes in pregnancy: Vontver L, Hickok D, Brown Z, et al.: Recurrent genital herpes simplex virus infection in pregnancy: Infant outcome and frequency of asymptomatic recurrences. Am J Obstet Gynecol 143:75, 1982

The pathogenesis of acute, latent and recurrent herpes simplex virus infections.

The pathogenesis of acute, latent and recurrent herpes simplex virus infections.

Herpes simplex virus-specific serum immunoglobulin a: detection in patients with primary or recurrent herpes infections and in healthy adults.

A sensitive radioimmunoassay was used to determine levels of herpes simplex virus (HSV)-specific immunoglobulin A (IgA) in serial serum samples drawn from patients with primary HSV infections and from persons with recurrent HSV infections, and in single samples from 90 healthy adults. Significantly rising HSV IgA titers were detected in patients with primary infections, whereas those with recurrent infections had nonfluctuating titers. Sera of IgG-seropositive healthy adults were all positive for HSV-specific IgA without special pretreatment.

Recurrent herpes simplex infection at a smallpox vaccination site

Recurrent herpes simplex infection at a smallpox vaccination site

Recurrent Herpes Simplex Infection at a Smallpox Vaccination Site

A patient who received smallpox vaccinations to treat a recurrent genital herpes simplex virus infection had development of recurrent herpes at the vaccination site while his genital lesions continued unabated. Until smallpox vaccine is removed from the general market or reclassified as a restricted biological, the inappropriate use of this agent will continue. (JAMA1982;247:2704-2705)

Herpes Simplex Antigen in Immune Complexes of Patients With Erythema Multiforme

Serum samples from patients with erythema multiforme (EM) were examined for the presence of herpes simplex virus (HSV) antigen in immune complexes using the Raji cell radioimmunoassay. Raji-cell-bound immune complexes from eight of 12 patients with EM after HSV infection and four of four patients with EM of uncertain cause had increased anti-HSV binding, while patients with EM after drug exposure and patients with recurrent HSV infections without EM had binding in the same range as controls. Viral cultures for HSV of immune complexes eluted from Raji cells were negative. Sucrose density gradient ultracentrifugation studies of serum samples of patients with EM after HSV infection showed HSV antigen in large molecular weight fractions. The HLA typing of lymphocytes from 16 patients with EM after HSV infection was not different from that of controls. Immune complexes composed of antibody and HSV antigen are present in serum samples of patients with EM after HSV infection and some cases of EM of uncertain cause and may mediate the pathogenesis of these disorders.

Herpes simplex antigen in immune complexes of patients with erythema multiforme: presence following recurrent herpes simplex infection

Herpes simplex antigen in immune complexes of patients with erythema multiforme: presence following recurrent herpes simplex infection

Recurrent genital herpes simplex virus infection in pregnancy: Infant outcome and frequency of asymptomatic recurrences

Eighty pregnant patients with a history of recurrent genital herpes simplex virus (HSV) infection were followed up with frequent genital examinations and cultures for HSV during their pregnancies. Recurrences of genital HSV during pregnancy were documented in 67 patients. Ninety-six percent of these had external genital lesions noted at some time during their pregnancy. One hundred eighty-six (93%) of the 199 recurrences of the disease were associated with external genital lesions. Of 13 episodes of asymptomatic viral shedding documented in this patient population, six were from the vulva alone, five were from the cervix alone, and two were from both the vulva and the cervix. Of 11 episodes of cervical HSV shedding, seven were asymptomatic and four were associated with external symptomatic lesions. Despite frequent recurrences of genital HSV infection during pregnancy, all study patients were delivered at term, and although they had a high rate of delivery by cesarean section (32.5%), the outcome of their infants was good.

The Course of Untreated Recurrent Genital Herpes Simplex Infection in 27 Women

GENITAL herpes simplex infection affects an unknown but ever increasing number of persons in the United States. Because of the lack of a national surveillance system, no reliable data are available...

A primate model for age and host response to genital herpetic infection: determinants of latency.

Thirty five female Cebus albifrons monkeys (16 adolescents and 19 adults) were infected vaginally with herpes simplex virus (HSV) type 2. Fifteen developed spontaneous recurrent genital HSV infections. All 35 were killed for study eight to 12 months after primary infection, and tissue from the vagina, cervix, uterus, ovary, paracervical autonomic plexus, and lumbosacral dorsal root ganglia of eight animals. Host age was the most important variable influencing viral latency; 69% of adolescents and 42% of adults had latent HSV type 2 infections. Animals that developed latent infections were significantly easier to infect, shed virus during the primary infection significantly longer, and had more severe primary disease than those who did not become latently infected.

The course of untreated recurrent genital herpes simplex infection in 27 women.

GENITAL herpes simplex infection affects an unknown but ever increasing number of persons in the United States. Because of the lack of a national surveillance system, no reliable data are available to determine either the magnitude or the growth rate of this problem. However, reports from three different parts of the country indicate that genital herpes is diagnosed more frequently than gonorrhea in women visiting private gynecologists.1 2 3 Women are particularly burdened with this infection: in addition to the morbidity associated with recurring episodes, they may incur an increased risk of cervical cancer, 4 and they may transmit a severe or fatal . . .

Preparation and retrograde axonal transport of an antiviral drug/horseradish peroxidase conjugate.

Recurrent Herpes simplex virus infections of the cornea are currently treated with antiviral drugs administered locally during periods of active infection. We have examined the feasibility of an alternate approach to treating recurrent infection, that of delivering an antiviral drug by axonal transport to cell somata in the trigeminal ganglion where the latent virus is thought to reside. We have coupled an antiviral drug to horseradish peroxidase (HRP), a protein which is readily transported retrogradely in corneal sensory axons to ganglion cell somata in the trigeminal ganglion. The antiviral drug 5-iodo-5'-amino-2',5'-dideoxyuridine (AIDU) was synthesized with 125I and coupled to horseradish peroxidase by Schiff base formation between the 5' amino group and aldehydes generated on the carbohydrate of the HRP following short periodate oxidation. The useful ratio of AIDU:HRP was 2-9; higher ratios resulted in an insoluble product. Sodium dodecylsulfate (SDS) acrylamide gel electrophoresis of the drug-protein conjugate revealed considerable aggregation and the isoelectric point of HRP was changed from 8.1 to 4.4-5.8 following the coupling procedure. Despite evidence that the protein conformation was considerably altered, the specific enzymatic activity of the final product was 58% of native HRP and the drug-protein conjugate was still strongly transported retrogradely. Retrograde transport of this conjugate was demonstrated by autoraiography of the trigeminal ganglion neurons 24 h after corneal injection of the [125I]AIDU/HRP.

In vitro studies on the human cellular immune response to commercially available herpes simplex antigens.

Patients with recurrent herpes labialis and genitalis as well as normal controls were tested for the in vitro responsiveness of their lymphocytes to mitogens, to several herpes antigens and to carrier medium alone (containing chorioallantois membrane antigens). No statistically significant differences were found in the results with the direct and indirect migration inhibitory test (MIF) and in studies of the blastogenic response of lymphocytes (LTT) among the three groups. These findings held up when correlations were drawn to severity or course of the disease and suggest that immunological modulation can play at most a minor role in inducing recurrent herpes simplex infections.

Perinatal Herpes Simplex Virus Infections

Because of the relative paucity of data on the epidemiology and management of perinatal herpes simplex virus (HSV) infections, the following recommendations represent the best current judgments of the Committees on Fetus and Newborn and Infectious Diseases of the American Academy of Pediatrics. HSV infection of the newborn is associated with a case fatality rate of 60% and at least half of the survivors have significant neurologic or ocular sequelae, or both. Approximately 75% of isolates from affected neonates are HSV-2 and 25% are HSV-1. Although preliminary data suggest that antiviral chemotherapy is effective in reducing mortality and morbidity resulting from neonatal HSV infections, measures designed to prevent infection of newborns are currently the most important means of controlling neonatal infections. A maternal source of infection can be found in about 90% of neonatal cases. Maternal HSV infection is usually caused by type 2 strains and involves the labia, cervix, and/or vagina. The majority of genital infections are asymptomatic and difficult to recognize on clinical examination, making identification of women whose infants are in jeopardy very difficult. EPIDEMIOLOGY Maternal Infection Primary HSV infection during pregnancy may be associated with spontaneous abortion, prematurity, and rarely with congenital anomalies. The risk of infection to the newborn appears to be the highest in primary genital infection of the pregnant woman, but is also high in recurrent infection. Women with a history of recurrent genital HSV infection, those with active disease during the current pregnancy, and those whose sexual partners have proven genital HSV infection should be monitored with virologic or cytologic studies, or both, at least twice during the last six weeks of pregnancy.

Cellular and humoral immunity in the pathogenesis of recurrent herpes viral infections in patients with lymphoma.

86 patients with lymphoma were evaluated prospectively for clinical and laboratory evidence of recurrent varicella-zoster, herpes simplex, and cytomegalovirus infections during the first 16 mo of treatment. Cellular immunity to the viral antigens was measured by in vitro lymphocyte transformation and interferon production. Antibody titers and nonspecific measures of cellular immunity, including T-cell quantitation and transformation to phytohemagglutinin, were also assessed. The patients treated with radiation and chemotherapy had the highest incidence of reactivation of each of the viruses (15-19%). Greater susceptibility to herpes viral reactivation in these patients correlated with suppression of cell-mediated immunity to the specific virus. In individual patients, suppression of cellular immunity to the specific herpes viral antigen preceded each episode of reactivation, but recurrent infection did not occur in all patients with diminished specific lymphocyte transformation. Absence of the response appears to be a necessary but not a sufficient condition for the recrudescence of latent infection. Better preservation of cellular immunity to herpes simplex antigen during treatment was associated with infrequent reactivation of herpes simplex. In 25 patients with acute herpes zoster, uncomplicated recovery from the infection was accompanied by the development of lymphocyte transformation and interferon production to varicella-zoster antigen. Quantitation of T-cell numbers and phytohemagglutinin transformation did not correlate with the presence of viral cellular immunity in treated patients. Responses returned while T-cell numbers were low, and the recovery of phytohemagglutinin transformation often preceded recovery of the responses to viral antigens. Although some patients had deficiencies in viral cellular immunity at diagnosis, the duration of the suppression of specific antiviral responses resulting from treatment appears to be the most important factor predisposing to the recurrence of herpes infections in lymphoma patients.

Herpes Simplex Polyganglionitis

In this issue of theArchives(see p 1423), Drs Magnussen and Patanella reemphasize that the ubiquitous herpes simplex virus (HSV) has been isolated from the trigeminal, vagal, and superior cervical ganglion 1 of unselected human cadavers; they used conventional laboratory methods to diagnose probable HSV recurrent laryngeal nerve palsy. Unfortunately, HSV is unconventional, defying the rules of virologic diagnosis—the authors have adequately described a catch-22 situation. Further frustration in HSV diagnosis arises because recurrent HSV infection frequently occurs as a secondary manifestation of a primary viral infection. For example, in one of our patients with proven infectious mononucleosis caused by the Epstein-Barr virus (EBV), multiple symptoms of cranial neuritis developed, including unilateral trigeminal, second cervical, and glossopharyngeal Nerve hypesthesia with superior laryngeal and facial nerve paralysis (Bell's palsy). Herpetic inclusion bodies were found in mucocutaneous vesicles. The HSV complement fixation antibody titer was 1:32 in both the acute and

Clinical course and diagnosis of genital herpes simplex virus infection and evaluation of topical surfactant therapy

A prospective study of 37 men and 32 women with culture-proved genital herpes simplex virus (HSV) infection was undertaken to characterize the clinical manifestations of the disease and effects of topical therapy with Nonoxynol 9,∗ a nonionic surfactant active in vitro against HSV. The duration of pain, lesions, and virus shedding was significantly longer in initial than in recurrent genital HSV infection. Cervical HSV shedding occurred in 11 of 13 initial infections versus two of 19 recurrences (p < 0.001). Type 1 HSV caused seven of 29 initial and none of 40 recurrent infections (p < 0.01). Clinical recurrences within six weeks were detected more often in men than in women and were unrelated to the menstrual cycle. The influence of coitus on recurrences is unclear. Papanicolaou smears were transiently abnormal (Class II) in four (12.5 per cent) of 32 female patients. Evidence of herpesvirus was detected in cytologic smears from only 28 (41 per cent) of 69 culture-proved external lesions and three (23 per cent) of 13 culture-positive cervices. Serology was also of limited diagnostic value except in testing paired sera from initial infections. The topical therapy had no beneficial effect.

Leukocyte migration inhibitory factor in primary and recurrent ocular infections by herpes simplex-virus

Using a direct assay of leukocyte migration inhibitory factor (LMIF), cell-mediated immunity to herpes simplex virus (HSV) antigen was measured in patients who had primary and recurrent ocular HSV infections. Those with primary and recurrent epithelial disease had a significantly lower production of LMIF than a control population than had had no herpetic infection for at least a year or longer (P less than 0.001). On the contrary, patients with deep stromal involvement and anterior uveitis showed significant migration inhibition with HSV antigen, similar to the one found in the healthy control group. The clinical and possible therapeutic implications of thes findings are discussed.