Human Herpesvirus Type Research Articles

<i>In Silico</i> Assessment of Binding Affinities of Three Dementia-Protective Human Leukocyte Antigen (HLA) Alleles to Nine Human Herpes Virus Antigens

Background: Human herpes viruses (HHV) have been implicated in dementia. Class II Human Leukocyte Antigens (HLA) play a critical role in host protection from foreign antigens including herpes viruses through stimulating antibody production against them. In the present study we investigated the in silico binding affinity of 9 HHV to three Class II HLA alleles that have been found to protect against dementia: DRB1*01:01, DRB1*13:02, and DRB1*15:01. Methods: A sliding window approach was used to partition the amino acid sequences of surface glycoproteins from HHV 1-8 into subsequences. The binding affinity of the HHV subsequences to Class II HLA surface receptor proteins was predicted using the Sturniolo method in the Immune Epitope Database and reported as a percentile rank. Findings: Binding affinity varied widely for each HLA allele, HHV type, and HHV subsequence. For the three HLA alleles investigated here, HHV-6A and HHV-6B had the best overall binding affinity. Interpretation: The dementia protection conferred by the three HLA alleles investigated here is related to their ability to bind and successfully eliminate HHV epitopes – in particular, HHV6 - that could otherwise cause dementia if they persisted. Funding: The University of Minnesota and the United States Department of Veterans Affairs. Declaration of Interests: The authors declare no competing interests.

A case of abdominal-pelvic infiltrative lesion of chronic active Epstein–Barr virus infection

Epstein–Barr virus (EBV) belongs to a subfamily of herpesviruses, also known as human herpesvirus type 4. EBV is widely distributed in the population, with a high infection rate of 90%. EBV infects mainly B lymphocytes, stimulates cell proliferation and transformation and even causes cancer. In recent years, it has been found that it can also infect T lymphocytes, epithelial cells and natural killer (NK) cells and can cause related diseases. EBV infection can cause a variety of clinical symptoms and clinical manifestations, which brings some confusion to clinical diagnosis and easily leads to missed diagnosis and misdiagnosis. In this article, we report a case of EBV-induced severe abdominal and pelvic infection, which eventually led to death.

Infectious mononucleosis due to the virus epstein-Barr: Clinical and pathogenetic aspects

Epstein-Barr virus and infectious mononucleosis are synonymous for many physicians. Epstein-Barr virus causes approximately 90% of cases of infectious mononucleosis, while the rest of the cases are associated mainly with cytomegalovirus, human herpesvirus type 6, toxoplasmosis, HIV infection and adenovirus. Aim. Pathogenetic, clinical and epidemiological features of Epstein-Barr virus infectious mononucleosis have been analyzed as well as the problems of its diagnosis and treatment. Material and methods. The article presents an overview of Russian and foreign literature data on Epstein-Barr virus infectious mononucleosis. Results and discussion. In connection with significant increase in the incidence of infectious mononucleosis caused by Epstein-Barr virus in recent years, improvement of specific diagnostic methods and antiviral therapy will successfully solve the problem of arresting pathological process at the early stages of the disease. However, the problem of chronic forms of the disease requires in-depth study. Conclusion. The key to success in treatment of patients with infectious mononucleosis is timely diagnosis, correct individual approach to etiotropic and pathogenetic therapy, as well as timely hospitalization of patients with severe forms of infectious mononucleosis.

High Incidence of Herpes Simplex Virus-1 in Cord Blood and Placenta Infection of Women in Southern Brazil.

Estimate the prevalence of human herpesvirus type 1 HSV-1 DNA in placental samples, its incidence in umbilical cord blood of newborns and the associated risk factors. Placental biopsies and umbilical cord blood were analyzed, totaling 480 samples, from asymptomatic parturients and their newborns at a University Hospital. Nested polymerase chain reaction (PCR) and gene sequencing were used to identify the virus; odds ratio (OR) and relative risk (RR) were performed to compare risk factors associated with this condition. The prevalence of HSV-1 DNA in placental samples was 37.5%, and the incidence in cord blood was 27.5%. Hematogenous transplacental route was identified in 61.4% from HSV-1+ samples of umbilical cord blood paired with the placental tissue. No evidence of the virus was observed in the remaining 38.6% of placental tissues, suggesting an ascendant infection from the genital tract, without replication in the placental tissue, resulting in intra-amniotic infection and vertical transmission, seen by the virus in the cord blood. The lack of condom use increased the risk of finding HSV-1 in the placenta and umbilical cord blood. The occurrence of HSV-1 DNA in the placenta and in cord blood found suggests vertical transmission from asymptomatic pregnant women to the fetus.

Seroprevalence to herpesviruses in patients with primary brain gliomas

Purpose of the study . The purpose of the study was to assess the level of seroprevalence and the frequency of detection of serological markers of acute herpesvirus infection in patients with PGBT in comparison with those in patients with chronic non-tumor diseases. Materials and methods . Before conducting antitumor therapy, the blood serum of 42 patients with PGBT (the main group) was studied. The comparison group consisted of 137 patients with chronic non-tumor diseases. Antibodies of classes M and G to herpes simplex virus types 1, 2 (HSV-1,2), cytomegalovirus (CMV), Epstein-Barr virus (EBV), human herpes virus type 6 (HHV-6) were determined by ELISA using JSC Vector-Best reagent kits. Results . Among patients with PGBT, seropositive for HSV-1,2 were 95.2%, CMV — 92.9%, EBV — 100%, HHV-6-40.5% of patients. No statistically significant differences in seroprevalence and the presence of markers of acute infection (IgM) were found either in comparison with non-tumor diseases or depending on the malignancy grade. Antibodies to HSV-1,2, CMV and EBV in patients with gliomas were significantly more often found in the medium range, and in the comparison group — in the high values of coefficient of positivity (CP) for IgG. In all the studied groups, antibodies to HHV-6 were determined statistically significantly less frequently than to other herpes viruses. Conclusion . The absence of statistically significant differences in seropositivity between groups of patients and their presence between pathogens is most likely a reflection of general trends in the population, and the question of the involvement of various representatives of the Herpesviridae family in neuro-oncogenesis of primary glial brain tumors still remains open.

Guidelines for the Management of Patients with Herpetic Keratitis/Keratouveitis in the Long Term: from Problem to Solution

Purpose . To identify problems contributed to the development of a chronic course of herpetic keratitis/keratouveitis and to suggest ways to solve them (taking into account the results of virological examination by PCR). Patients and methods . A group of patients ( n = 90) with herpetic keratitis/keratouveitis of the prolonged course was under observation. Biological secretions (tears, saliva, blood serum and urine) of patients were investigated for the presence of herpes simplex virus (HSV), varicella-zoster virus (VVZ), cytomegalovirus (CMV), Epstein-Barr virus (EBV), human herpesvirus type 6 (HHV-6), human herpesvirus type 7 (HHV-7) by polymerase chain reaction (PCR). Antiherpetic therapy included systemic oral administration of selective analogues of nucleosides (AN) — valacyclovir and phamcyclovir in daily doses of 2–3 g and 1.5 g, respectively. Local therapy included installations of mydriatic (if necessary), non-steroidal anti-inflammatory agents, antibacterial drugs. Reparative therapy consisted in prescribing conservative installations of HILOPARIN-COMOD ® and PARIN-POS ® ointment. Results. The clinical picture of herpetic keratitis/keratouveitis was presented by surface forms — 22 cases, deep forms — 68 cases. Positive results of HSV determination were obtained in 34.6 % of the surveyed. VZV was detected in 21 cases (28 %), CMV — in 14.6 %. EBV was detected in 28 cases (37.3 %), HHV-6 — in 37 cases (49.3 %). Genetic material of HHV-7 was found in 32 % of the examined. The results of PCR studies determined the appointment of adequate doses of nucleoside analogues (NA), which led to relief of symptoms in 100 % of cases. Active reparative therapy contributed to complete persistent epithelialization sustained by systemic use of NA in all cases within 4 weeks from the presentation. Conclusion . The results of PCR examination for the production of herpetic viruses in the tear/saliva/blood/urine are crucial to confirm the etiology of keratitis/keratouveitis, as well as determine the appointment of adequate (increased) doses of nucleoside analogues according to the recommended regimens until remission is achieved. Local therapy drugs should be used on the principle of “necessary minimum”. Therapeutic scheme for herpetic keratitis/keratouveitis already in the active stage should include local drugs with reparative effect, contributing to the achievement of persistent epithelialization.

ORAL KAPOSI SARCOMA FIRST MISDIAGNOSED AS AN INFLAMMATORY DISEASE

Kaposi sarcoma is a malignant neoplasm associated with human herpesvirus type 8 (HHV-8) infection that usually affects HIV-positive patients. A 34-year-old man was referred because of a swelling in the palate lasting 4 months that was initially interpreted and treated as an inflammatory endoperiodontal disease affecting teeth 21 and 22. Medical history revealed HIV infection. Physical examination revealed multiple purplish patches in the skin of the arms. Oral examination showed an exophytic reddish growth in the gingiva and palatal area close to the described teeth and a purplish patch in the left posterior hard palate. Periapical radiograph showed a radiolucent image involving the apexes of the aforementioned teeth. Clinical diagnosis was Kaposi sarcoma, and a biopsy was performed. Histologic analysis showed a proliferation of neoplastic HHV-8–positive spindle cells confirming the diagnosis of Kaposi sarcoma. The patient was referred to the infectious disease specialist, is currently under highly active antiretroviral treatment, and has been followed-up for the oral lesions.

ESGCT 27th Annual Congress In collaboration with SETGyc Barcelona, Spain October 22–25, 2019 Abstracts

Xenotransplantation of transgenic porcine pancreatic islets offers a promising alternative source to circumvent current limitations posed by the scarcity of allogeneic donors. We have investigated the feasibility to generate tissue engineered SLA silenced islet cell clusters (ICC) to decrease xenogeneic immune responses Pancreatic islets single cell suspensions were generated by enzymatic digestion of porcine ICCs. Single cells were silenced for SLA expression by lentiviral vectors encoding for Nanoluciferase as reporter gene and for short hairpin RNAs targeting beta2-microglobulin or class II transactivator, respectively. SLA transcripts were evaluated by real-time PCR and protein levels by flow cytometry and fluorescence microscopy analyses. The effect of SLA silencing was evaluated in human T and NK cell cytotoxicity assays. SLA-silenced pancreatic beta-cells were then reassembled into ICCs in stirred bioreactors. SLA class I silencing reached a level of up to 84% and class II by up to 50% on pancreatic islet cell. Silencing SLA expression did not affect cell viability and the insulin-producing beta-cell phenotype. Xenogeneic T-cell immune responses (p < 0.05) as well as antibody-mediated cellular-dependent immune responses (p < 0.01) were significantly decreased. Silencing SLA class I expression did not increase susceptibility to NK-cell cytotoxicity. In stirred bioreactors, tissue engineered islets showing the typical 3D-structure and morphology of ICC were assembled from SLA-silenced pancreatic cell suspensions. These data shows the feasibility to generate low immunogenic porcine ICC from transgenic pigs after single cell engineering and post-transduction islet reassembling that might serve as a robust alternative to allogeneic pancreatic islet cell transplantation.

P5564The myocarditis as a regular phenomenon in primary noncompact myocardium: clinical and morphological diagnostics, significance and treatment

Abstract Purpose To estimate the frequency of myocarditis in adult patients with noncompact myocardium (NCM) of the left ventricle (LV), its influence on the disease, the outcome and results of treatment. Methods We included 103 adult patients with NCM (61 males, 45.6±14.9 years). The average EDD LV was 6.0±0.8 cm, LV EF 38.8±14.5%. To diagnose NCM were performed Echo-CG, CT (n=81) and MRI (n=39). We performed NGS sequencing, followed by Sanger sequencing of detected variants (revealed in 9% of patients in the genes MYH7, MyBPC3, LAMP2, DES, DSP, TTN). The examination also included anti-heart antibodies and viruses (PCR) study and morphological study in 19 patients (endomyocardial biopsy in 14, intraoperative biopsy in 1, explanted heart study in 1 and autopsy in 3). The mean follow-up was 12 [2; 32] months. Results The myocarditis was diagnosed in 55 (53.4%) patients with NCM: in 19 patients by morphological study (active in 10 and borderline in 9 patients) and in 36 patients on the basis of a complex examination (the relationship with a respiratory infection, a 3–4-fold increase in the anti-heart antibodies, the viral genome in the blood, pericardial effusion, subepicardial LGE). The myocarditis was virus-positive in 17 patients (36.1%). The parvovirus B19, human herpes virus type 6, cytomegalovirus, herpes simplex virus and Epstein-Barr virus were detected in the myocardium in 8 patients (42.1%), and in 14 patients (25.5%) in the blood. Pathogenic genetic variants were revealed in four patients with morphologically verified myocarditis. The rate of myocarditis depended on the clinical form of NCM: 44.4% in arrhythmic form, 12.5% in chronic ischemic form, 57.5% in dilated pattern and 50.0% in association of NCM with other cardiomyopathies. In 10% of all patients, acute myocarditis was the first manifestation of the disease. In 5% the myocardial necrosis was the main manifestation of the myocarditis. The association of NCM with myocarditis led to more severe myocardial dysfunction (NYHA class 2 [1; 3] v 1.75 [0; 2], p&lt;0.01, EF 33.8±13.5 v 44.7±13.6%, p&lt;0.001), higher rate of the nonsustained ventricular tachycardia (67.3% v 29.3%, p&lt;0.01), appropriate shocks of defibrillators (38.9% v 0, p&lt;0.05), death (16.4 and 4.2%, OR 5.75, 95% CI 1.21–27.43, p&lt;0.05), and heart transplantation (7.3% v 2.1%, p&gt;0.05). Only in patients with myocarditis, there was a significant increase in EF (in acute myocarditis from 25.4±7.9 to 38.6±9.5%, p&lt;0.01), decrease sizes of the LV and systolic pulmonary artery pressure as a result of basic therapy. Morphological verification of myocarditis Conclusion Myocarditis is a regular phenomenon that develops in half of patients with primary NCM. The nature of myocarditis in NCM may be different (primary infectious and immune, secondary in response to genetic/ischemic damage to cardiomyocytes). However, it leads to a significant deterioration of structural and functional parameters, an increase in life-threatening arrhythmias, unfavorable outcomes and requires basic therapy.

Vitamin D deficiency or supplementation and the risk of human herpesvirus infections or reactivation: a systematic review protocol

IntroductionHuman herpesviruses induce lifelong latent infections and may reactivate as the immune system deteriorates. Recent studies have suggested that vitamin D, an essential element of bone health, may have some...

Clinical and laboratory features of human herpes virus type 7 infection in children

Clinical and laboratory features of human herpes virus type 7 infection in children

Primary effusion lymphoma in a human immunodeficiency virus-negative patient with unexpected unusual complications: a case report

BackgroundPrimary effusion lymphoma is a rare, high-grade non-Hodgkin’s lymphoma that usually occurs in immunosuppressed or human immunodeficiency virus-positive individuals in advanced stages of the disease. However, primary effusion lymphoma occasionally affects immunocompetent patients who are infected with human herpes virus type 8 or Epstein-Barr virus. This disease manifests with liquid collections in cavities, producing constitutional symptoms; fever; weight loss; and symptoms related to extrinsic compression, such as dyspnea or abdominal discomfort. Diagnosis is confirmed with cytological or tissue evaluation showing large, multinucleated lymphoid cells with positive specific markers for the disease, such as CD45 and markers related to viral infections, when present. There is no standard treatment for primary effusion lymphoma, but several chemotherapy protocols are recommended, usually with poor results.Case presentationWe present a case of an adult human immunodeficiency virus-negative Hispanic origin woman with primary effusion lymphoma with pleuritic, pericardial, and peritoneal compromise who also had unusual complications during a diagnostic procedure: the accidental rupture of the left ventricle and the development of a secondary left ventricular pseudoaneurysm. We describe the clinical, radiological, and laboratory characteristics as well as the outcome of this case.ConclusionsPrimary effusion lymphoma is a very rare entity that represents 4% of non-Hodgkin’s lymphoma cases associated with human immunodeficiency virus and 0.1% to 1% of all lymphomas in patients with another type of immunodeficiency in regions where human herpes virus type 8 is not endemic. This reported case is an unusual presentation of primary effusion lymphoma because it occurred in an immunocompetent human immunodeficiency virus-negative adult woman without the presence of Kaposi’s sarcoma or Castleman’s disease and for whom the clinical course after chemotherapy was successful. However, the rupture of the free wall of the left ventricle is a very rare catastrophic event that usually occurs after myocardial infarction. Left ventricle free wall rupture rarely goes unnoticed, but when it occurs, it leads to the development of a ventricular pseudoaneurysm in which the rupture is contained by the pericardium with an organized thrombus and an adjacent hematoma.

The Prevalence of Human Herpes Virus Type 8 in Semen Specimens of HIV-Negative Iranian Population Detected by Nested Polymerase Chain Reaction

Background: Human herpesvirus type 8 (HHV-8) is a member of the herpes family that, like other herpesviruses, causes a lifelong infection following entrance into the human body. The etiological agent of Kaposi’s sarcoma, this virus, was first identified in a biopsy of a Kaposi’s sarcoma tumor in an HIV-infected patient. Objectives: The aim of this research was to evaluate the prevalence of HHV-8 in semen specimens from HIV-negative individuals. Methods: Semen specimens obtained from HIV-negative individuals referred to an infertility center were transferred to the central laboratory for HHV-8 DNA amplification via the nested polymerase chain reaction (PCR) technique. Results: The prevalence of HHV-8 in the referral population was 26%. Conclusions: The prevalence of HHV-8 in the semen samples of our study population may be representative of its prevalence in the normal population. Further studies are, therefore, recommended to determine the prevalence of the virus in the normal Iranian population.

Male infertility and viral infection: Interference role of the human herpesvirus types (3 – 6) with disturbances effects of some cytokines hypersecretion and seminal oxidative defense system in the infertility etiopathogenesis of some idiopathic infertile Iraqi patients

To study the role of potential relationship of chronic human herpes virus types (3 – 6) infection and their correlation with the up-regulation of some cytokines (IL-2, IL-10 and IFN gamma) and effect of (8-OHdG) and (TAOC) levels onto male infertility. A Case – control study with semen samples which were collected by masturbation during the routine semen analysis of a total ninety age-matched participants as; fertile males 35 (38.9%) with proven fertility as a normal semen quality and infertile males 55 (61.1%) with at least one year of infertility and poor semen quality. All semen biomarkers of Human herpes viruses (HHVs): Varicella zoster virus (VZV-IgG), Epstein-Barr virus (EBV-IgG), Cytomegalovirus (CMV-IgG), Human herpes virus type 6 (HHV6-IgG), Interlukin-2 (IL-2), Interlukin-10 (IL-10), Interferon-gamma (IFN-γ), 8-hydroxy-2'-deoxy guanosine (8-OHdG) and Total Antioxidant Capacity (TAOC) which were included in the study had been estimated by quantitative ELISA based method and the correlations with sperms parameters were evaluated. The main significant outcomes in this study of the infertile males group 55 (61.1%) were: high percentages of seminal IgG; N (%; Mean±SD) were detected of HHV6, 48 (53.3%;1.26± 0.51) then CMV, 39 (43.3%;1.51± 0.95) followed by EBV, 34 (37.8%; 2.20±1.47), and the highest abnormal cytokines levels were estimated in; 44 (48.9%; 112.62±38.64) and 40 (44.4%; 22.75±10.65) for IFN-γ and IL-10 respectively. Furthermore, High 8-OHdG level was detected in 47 (52.2%;7.29±2.15) and very low level of TAOC was detected in 16 (17.8%;19.34±12.17). Significant negative correlation between semen biomarkers and standard sperms parameters was found which were represented by: 45 (50.0%) of total sperms count less than (33 million ml), 52 (57.8%) of progressive motile sperms less than (31%). Finally, about 33 (24.4%) of abnormal sperm morphology was detected. Our results hypothesized that chronic asymptomatic viral infection with increasing of cytokines concentrations consequently disturbance the semen oxidative status, antioxidant defense systems that induce sperms DNA damage then might be collectively act as a co-factors on the etiology of the male infertility.

First results of application of an enzyme immunoassay in the serological diagnostics of infection caused by herpesvirus type 7.

HHV-7 (Human Herpes virus type 7) is a relatively recently discovered, ubiquitous beta herpes virus. In Russia, the diagnosis of HHV-7 infection is carried out by PCR, which determines the DNA in serum or plasma, if there are clinical indications. Laboratory serological tests for HHV-7 are not performed. Currently, in the scientific literature, information on clinical studies of HHV-7 infection, its epidemiology, and its role in the etiopathogenesis of various diseases is insufficient. This article presents the results of the development of a test kit "ELISA-HHV-7-IgG", designed to detect specific IgG to HHV-7 by enzyme-linked immunosorbent assay (ELISA). Studies of the sensitivity and specificity of the developed test kit, including potential cross-reactive samples positive for other herpesvirus infections, were carried out. In the context of serological diagnostics, we studied samples of the sera of children (n = 167) and old people (n = 238) for the presence of IgG to HHV-7 with confirmation of the results in the indirect immunofluorescence reaction and the immune blotting reaction. The research results are evidence of the possibility of using the developed test kit for serological diagnosis of HHV-7 infection.

Impact assessment and investigation of factors associated with herpesviruses viremia in the first year of renal transplantation.

The increased risk for opportunistic infections after a renal transplant requires monitoring of viral infections to avoid future complications. Our goal was to investigate the impact and factors associated with Epstein-Barr virus (EBV), human cytomegalovirus (HCMV) and human herpesvirus type 6 (HHV-6) viremia in renal transplant recipients. Whole blood samples were collected monthly from 82 patients during the first semester and then quarterly up to 1 year after transplantation. EBV, HCMV, and HHV-6 were detected and quantified by TaqMan real-time polymerase chain reaction. The results showed that EBV and HCMV viremia were detected in 32 patients (39% each), while HHV-6 viremia in only 3 patients (3.7%). EBV was significantly associated with age (P = .050), thymoglobuline induction (P = .019), mTOR inhibitor-based therapy (P = .003), and female gender (P = .044). HCMV was significantly associated with basiliximab induction (P = .015), mycophenolate mofetil (MMF)-based therapy (P = .003) and allograft acute rejection (P = .033). Moreover, HCMV-disease was correlated with MMF-based therapy (P = .021) and female gender (P = .003). In conclusion, EBV and HCMV viremia were associated with different immunosuppressive induction and maintenance strategies. Additionally, higher HCMV viremia (> 10 4 copies/mL) was related to acute allograft rejection.

Syndrome of Primary Myocardial Hypertrophy: Clinical and Morphological, Genetic Diagnostics and Comparison of Sarcomerial Variants of Cardiomyopathy and its Phenocopy

Aim. To study the nosological spectrum in the syndrome of primary left ventricle hypertrophy (PLVH) using morphological and genetic diagnostics and to compare the clinical course of true hypertrophic cardiomyopathy (HCM) and its phenocopy.Material and methods. Fifty five adult patients (29 men, 48.2±17.0 years) with PLVH (12 mm and more) were included. The exclusion criteria were athletic heart, hypertensive heart disease, severe valvular disease and other causes of secondary left ventricle (LV) hypertrophy. We performed 11 endomyocardial biopsy, 8 intraoperative biopsy, 1 study of explanted heart, 1 autopsy with virus investigation (real-time polymerase chain reaction) of the blood and myocardium. Mutational screening had included simultaneous sequencing of the MYBPC3, TAZ, TPM1, LDB3, MYL2, ACTC1, MYL3, MYH7, TNNI3 and TNNT2 genes based on NGS technology (Ion Torrent PGMTM) with following Sanger resequencing of potentially significant genetic variants. For patients with a phenotype of particular genetic syndrome the Sanger sequencing of target gene(s) for performed first. Clinical examination had included electrocardiography, Holter monitoring, echocardiography, coronary angiography, computer tomography/magnetic resonance imaging (by indication). The mean follow-up was 8 [3;32] month.Results. Isolated HCM was found in 28 patients, and 10 have a combination of HCM and noncompaction myocardium (NCM). Mutations in the MYH7 and MYBPC3 genes were detected in six cases. In 17 cases (30.9%) the non-sarcomeric causes of LVHS were detected. Three patients had Fabry disease, 2 ‒ had Danon disease, in 10patients we found amyloidoses, in 1 – Friedreich ataxia, and 1 patient was diagnosed with LEOPARD syndrome (all cases were confirmed by DNA diagnostics). Genotype-positive diagnosis was established in 23.6% of patients. In patients with HCM were significantly more frequent asymmetric septal hypertrophy with obstruction and muscle bridges, in other forms of primary hypertrophy – right ventricular hypertrophy, low QRS voltage, QS complexes and increasing of ejection fraction (EF) (55.7±12.5% vs 62.5±10.1% in HCM, p=0.08). The morphologic signs of myocarditis were in 46.7% of patients with HCM detected: in 3 patients with NCM and in 4 patients with isolated HCM. The viral genome in the myocardium was in 11 patients with HCM (73.3%) detected, previously human herpes virus type 6 (it was correlation with myocarditis) and parvovirus B19. Eleven patients died due to a stroke/heart failure without no significant differences between patients with HCM and phenocopy.Conclusion. The spectrum of causes of the primary left ventricular hypertrophy is very wide. The frequency of myocarditis associated with sarcomeric HCM was 46.7%. When lower EF and heart failure in patients with HCM can be result of myocarditis, in patients with storage disease they are the result of disease itself.

Aetiology of encephalitis and meningitis in children aged 1-59 months admitted to the Children's Hospital, Lusaka, Zambia

Background: Meningitis and encephalitis are important causes of admissions and mortality in Zambia. Apart from bacterial causes, no data is available on viral agents that cause disease at the Children's Hospital, Lusaka, Zambia. We conducted a prospective descriptive study to determine the viral and bacterial causes of encephalitis and meningitis in children aged 1-59 months.&#x0D; Methods: From November 2016 to February 2018, we collected cerebrospinal fluid (CSF) samples and clinical details from children admitted to the inpatient wards with encephalitis and meningitis. Macroscopic examination, microscopy, bacterialculture and real-time (Multiplex) PCR were performed on the CSF samples.&#x0D; Results: A total of 106 patients were enrolled. The median age was 10 months and 81 (76.4%) had meningitis while 25 (23.6%) had encephalitis. One (0.9%) participant had Haemophilus influenzae detected by both culture and PCR. Two (1.9%) had Neisseria meningitidis while 5 (4.7%) had Streptococcus pneumoniae detected only by PCR. Viruses were detected in 26.4% (28/106) and 64% had meningitis. The viral agents detected were: EBV (10%); Parvovirus B19, Human herpes virus type 6, Human herpes virus type 7 and CMV at 2.8% each. A raised CSF WBC was associated with the case definition (P=0.01) of meningitis. Patients with meningitis were more likely to be alive at discharge than those with encephalitis (OR = 3.6, CI = 1.96 – 6.68, P-value &lt;0.001).&#x0D; Conclusions: Viral infections of the central nervous system (CNS) are the commonest causes of both encephalitis and meningitis at the Children's Hospital, Lusaka, Zambia.

Aetiology of Encephalitis and Meningitis in Children Aged 1-59 Months Admitted to the Children's Hospital, Lusaka, Zambia

Background: Meningitis and encephalitis are important causes of admissions and mortality in Zambia. Apart from bacterial causes, no data is available on viral agents that cause disease at the Children's Hospital, Lusaka, Zambia. We conducted a prospective descriptive study to determine the viral and bacterial causes of encephalitis andmeningitis in children aged 1-59 months.&#x0D; Methods: From November 2016 to February 2018, we collected cerebrospinal fluid (CSF) samples and clinical details from children admitted to the inpatient wards with encephalitis and meningitis. Macroscopic examination, microscopy, bacterial culture and real-time (Multiplex) PCR were performed on the CSF samples.&#x0D; Results: A total of 106 patients were enrolled. The median age was 10 months and 81 (76.4%) had meningitis while 25 (23.6%) had encephalitis. One (0.9%) participant had Haemophilus influenzae detected by both culture and PCR. Two (1.9%) had Neisseria meningitidis while 5 (4.7%) had Streptococcus pneumoniae detected only by PCR. Viruses were detected in 26.4% (28/106) and 64% had meningitis. The viral agents detected were: EBV (10%); Parvovirus B19, Human herpes virus type 6, Human herpes virus type 7 and CMV at 2.8% each. A raised CSF WBC was associated with the case definition (P=0.01) of meningitis. Patients with meningitis were more likely to be alive at discharge than those with encephalitis (OR = 3.6, CI = 1.96 – 6.68, P-value &lt;0.001).&#x0D; Conclusions: Viral infections of the central nervous system (CNS) are the commonest causes of both encephalitis and meningitis at the Children's Hospital, Lusaka, Zambia.&#x0D; Disclosure: The authors declare no conflict of interest.

Features of Diagnostics and Complex Approach to Therapy of Herpetic Keratitis

Objective. To determine the characteristics of drug therapy in patients with herpetic keratitis (HK), based on laboratory diagnosis.Material and methods. 49 patients with clinical symptoms of HK were included in the study. The conjunctival cells were used as a material for laboratory diagnosis of adenovirus and enterovirus infection by polymerase chain reaction (PCR) and for microbiological examination. Herpesvirus DNA in tears, saliva, urine and blood was determined using PCR (for varicella-zoster virus (VZV) and human herpesvirus type 7 (HHV-7)) and real-time PCR (for herpes simplex virus types 1 and 2 (HSV-1,2), Epstein-Barr virus (VEB), cytomegalovirus (CMV) and human herpesvirus type 6 (HHV-6). Tear and urine were examined for the presence of DNA of obligate intracellular parasites (chlamydia, ureaplasma, and mycoplasma) by PCR.Results. Сlinical picture of HK was presented by superficial (57.1 %, n = 28) and deep forms of corneal inflammation (42.9 %, n = 21). The results of laboratory diagnostics of herpetic infection had showed replication of herpesviruses in all examined patients. Genetic material of herpesviruses in lacrimal fluid was found in half of the examined patients (51 %), in saliva — in 67,3 % of cases. Viruria was observed in 21 patients (42.9 %), viraemia in 6 (12.2 %). DNA of intracellular parasites in lacrimal fluid was detected in 18.4 % of patients and in urine — in 12.2 % of patients. Bacteriological sowing of the conjunctiva scrape was positive in 75.5 % of cases.Conclusion. Instrumental diagnostics (visometry, biomicroscopy) of HK should be supplemented with laboratory research of activity of not only herpesvirus infection, but also bacterial pathogens. Positive results of microbiological sowing of conjunctival scrapers allow to approach reasonably the prescription of antimicrobial drugs in patients with HK.