herpes
Comparison of clinically directed, disease specific, and syndromic protocols for the management of genital ulcer disease in Lesotho.

Htun Y, Morse SA, Dangor Y, Fehler G, Radebe F, Trees DL, Beck-Sague CM, Ballard RC.

National Reference Centre for Sexually Transmitted Diseases, School of Pathology, South African Institute for Medical Research, Johannesburg, South Africa.

OBJECTIVE: To evaluate two protocols for the syndromic management of genital ulcer disease (GUD) in Lesotho, southern Africa and to compare the performance of these protocols with that of a conventional disease specific approach. METHODS: A cross sectional study was conducted among consecutive patients with GUD attending an STD clinic in Maseru, Lesotho. The clinical diagnoses were made by using predefined criteria at the initial visit before the performance of laboratory tests. Attempts were made to detect the specific aetiology of the genital ulcers using PCR assays and syphilis serology. The results of PCR assays and syphilis serology were used as the gold standard against which the performance of the management approaches were applied. RESULTS: Of 100 patients initially recruited into the study, Haemophilus ducreyi infection was detected in 56%, herpes simplex virus in 26%, Treponema pallidum in 23%, and lymphogranuloma venereum in 7%. No pathogens were detected in 6% of patients. 17% of patients had mixed infections. Sensitivity, specificity, positive and negative predictive values of the three management protocols for GUD were compared after applying each to the study population. Theoretically, the lowest correct treatment rate would have been obtained by using the disease specific protocol (62%) compared with more than 90% in both syndromic management protocols. Considerable overtreatment for primary syphilis would occur following application of both syndromic protocols. This would be the result of the overdiagnosis of chancroid, in particular the misdiagnosis of genital herpes as chancroid, which would receive treatment for syphilis unnecessarily. The HIV seroprevalence among these patients was 36%. A significantly higher rate of HIV seropositivity was detected among the patients with herpes simplex virus infection when compared with those patients having other causes of genital ulcer disease (58% v 27%; odds ratio 3.73; 95% CI 1.26-11.26; p = 0.01). CONCLUSIONS: Poor sensitivity, specificity, and predictive values were recorded when the disease specific protocol was applied to the study population. In contrast, the syndromic management protocols provided adequate treatment for more than 90% of patients with GUD. Protocol C, which identified a minority of cases of genital herpes, was found to have an advantage when compared with protocol B (all patients with genital ulcer disease treated for both syphilis and chancroid) in that 29% of genital herpes cases would receive appropriate counselling.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10023349&dopt=Abstract herpes medicine



herpes
Development of a competitive ELISA for detection of primates infected with monkey B virus (Herpesvirus simiae).

Blewett EL, Saliki JT, Eberle R.

Department of Biochemistry and Microbiology, College of Osteopathic Medicine, Oklahoma State University, Tulsa 74107-1898, USA. blewett osuunx.ucc.okstate.edu

Two competitive ELISAs (C-ELISAs) are described that allow detection of antibodies against monkey B virus (BV, Cercopithecine herpes virus 1). The assays utilize monoclonal antibodies (MABs) directed against the BV glycoprotein B (gB). Two of these MABs specifically recognize BV gB while a third MAB also reacts with the gB homologues of other primate alpha-herpes viruses (herpes simplexvirus-1, HSV-1: HSV-2; simian agent-8, SA8; and Herpesvirus papio-2, HVP2). A C-ELISA using the single cross-reactive MAB 3E8 allowed detection of host antibodies against HSV-1, HSV-2, SA8, HVP2 or BV, thus proving to be a sensitive assay for the detection of infection by any of these primate alpha-herpes viruses. The C-ELISA using BV-specific MABs was less sensitive but did allow some discrimination between infection by BV versus other alpha-herpes viruses. It was also shown that a C-ELISA using HVP2 as antigen and the cross-reactive MAB 3E8 was as sensitive for detection of BV antibody in macaque sera as an assay employing BV antigen. This test format allows detection of BV-infected primates without the biohazards associated with preparation and use of BV antigen.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10029325&dopt=Abstract herpes medicine



herpes
Prevalence of herpes simplex virus types 1 and 2, cytomegalovirus, and varicella-zoster virus infections in Eritrea.

Ghebrekidan H, Ruden U, Cox S, Wahren B, Grandien M.

Swedish Institute for Infectious Disease Control, Microbiology and Tumour Biology Centre, Karolinska Institute, Stockholm.

BACKGROUND: Herpesviruses establish latent infections in their hosts for life. The scarcity of data that exists in regard to herpes virus infections in many African regions, could partly be due to the mild nature of their primary infections and the lack of means for their proper diagnosis. However, in recent decades the alarming spread of HIV infection in Africa and associated frequent reactivation of herpes virus infections is leaving less room for neglect. This seroprevalence study is intended to help in the evaluation of the prevalence of herpes virus infections in Eritrea. OBJECTIVE: To evaluate the spread of herpes simplex virus types 1 and 2 (HSV-1 and HSV-2), cytomegalovirus (CMV), and varicella-zoster virus (VZV) infections. STUDY DESIGN: The study population groups comprise female sex workers (FSW), former guerrilla fighters, truck drivers, port workers, a tribe called Rashaida, pregnant women, children under 5 years of age, and children over 5 years of age. The groups of pregnant women and children under and over 5 years of age were included to form a background for the evaluation of groups considered at risk for sexually transmitted or blood borne infections. RESULTS: All study groups had a high seroprevalence of HSV-1 infections ( > 80%), except for the children under 5 years of age. The FSW had the highest prevalence of HSV-2 infections, 80%, followed by guerrilla fighters, truck drivers, port workers, pregnant women, children, and the Rashaidas. Positivity for antibodies against CMV was > 90% in all studied populations. The prevalence of VZV infections was surprisingly low in the tribe of Rashaida, 44% compared to more than 90% in the other adult groups tested for VZV (P = 0.0001). CONCLUSION: The study shows that the prevalence of HSV-2 in the risk group of FSW was high, which could partly be explained by their sexual behaviours. HSV-2 was particularly low in the Rashaida group and, as expected, in the children. The low prevalence of VZV observed in the Rashaida is of importance since it makes them vulnerable to infection with varicella during their inevitable integration with the other tribes in their society.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10073414&dopt=Abstract herpes medicine



herpes
Amplification of the six major human herpes viruses from cerebrospinal fluid by a single PCR.

Minjolle S, Michelet C, Jusselin I, Joannes M, Cartier F, Colimon R.

Laboratoire de Bacteriologie-Virologie, CHU Pontchaillou, Rennes, France.

We used a novel type of primer system, a system that uses stair primers, in which the primer sequences are based on consensus sequences in the DNA polymerase gene of herpes virus to detect herpes viruses by PCR. A single PCR in a single tube detected the six major herpes viruses that infect the central nervous system: herpes simplex virus type 1 (HSV-1), and type 2 (HSV-2), cytomegalovirus (CMV), Epstein-Barr virus (EBV), varicella-zoster virus (VZV), and human herpes virus 6 (HHV-6). We used the technique to analyze 142 cerebrospinal fluid (CSF) samples that had been stored at -80 degrees C and compared the results with those obtained previously for the same samples by standard, targeted PCR. Four hundred one targeted PCR tests had been run with the 142 samples to detect HSV-1, HSV-2, CMV, and VZV; screening for EBV and HHV-6 was not prescribed when the samples were initially taken. Eighteen CSF samples tested positive by classic targeted PCR. The herpes virus consensus PCR detected herpes viruses in 37 samples, including 3 samples with coinfections and 17 viral isolates which were not targeted. Two samples identified as infected by the targeted PCR tested negative by the consensus PCR, and eight samples that tested positive by the consensus PCR were negative by the targeted PCR. One hundred three samples scored negative by both the targeted and the consensus PCRs. This preliminary study demonstrates the value of testing for six different herpes viruses simultaneously by a sensitive and straightforward technique rather than screening only for those viruses that are causing infections as suggested by clinical signs.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10074507&dopt=Abstract herpes medicine



herpes
The ultrastructure of corneal epithelium after co-cultivation with herpes simplex virus.

Lee DY, Ko MK, Choe JK.

Department of Ophthalmology, School of Medicine, Hanyang University, Seoul, Korea.

To elucidate the ultrastructural change of corneal epithelium co-cultured with herpes simplex virus (HSV), the corneal epithelium of 3 rabbits was excised and cultivated in culture media. After 7 days, the Kos strain of herpes simplex virus was inoculated in the cultured cornea epithelium until cytopathic effect was occurred. It was fixed in the solution of 3% glutaraldehyde and examined with electronmicroscope. In co-cultured cells, the intercellular spaces had increased and microvilli were seen prominently. The virus particles that initiated the infection by fusing the viral envelope with the plasma membrane were also seen. The nuclear degeneration in an infected cell was prominent. The nuclear membrane was folded markedly, and the chromatin was degraded, condensed and displaced toward the nuclear membrane. Numerous viral particles and inclusion bodies were present in the nuclei. These findings suggest that the infectious process of herpes simplex virus in the human corneal epithelium may occur in a similar way. This result would be helpful in understanding the pathogenesis of herpes simplex epithelial keratitis.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10188370&dopt=Abstract herpes medicine



herpes
Cellular elongation factor 1delta is modified in cells infected with representative alpha-, beta-, or gammaherpes viruses.

Kawaguchi Y, Matsumura T, Roizman B, Hirai K.

Department of Tumor Virology, Division of Virology and Immunology, Medical Research Institute, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.

Earlier reports (Y. Kawaguchi, R. Bruni, and B. Roizman, J. Virol. 71:1019-1024, 1997; Y. Kawaguchi, C. Van Sant, and B. Roizman, J. Virol. 72:1731-1736, 1998) showed that herpes simplex virus 1 (HSV-1) infection causes the hyperphosphorylation of translation elongation factor 1delta (EF-1delta) and that the modification of EF-1delta is the consequence of direct phosphorylation by a viral protein kinase encoded by the UL13 gene of HSV-1. The UL13 gene is conserved in members of all herpes virus subfamilies. Here we report the following. (i) In various mammalian cells, accumulation of the hyperphosphorylated form of EF-1delta is observed after infection with alpha-, beta-, and gammaherpes viruses, including HSV-2, feline herpes virus 1, pseudorabiesvirus, bovine herpes virus 1, human cytomegalovirus (HCMV), and equine herpes virus 2. (ii) In human lung fibroblast cells infected with recombinant HSV-1 lacking the UL13 gene, the hypophosphorylated form of EF-1delta is a minor species, whereas the amount of the hyperphosphorylated form of EF-1delta significantly increases in cells infected with the recombinant HSV-1 in which UL13 had been replaced by HCMV UL97, a homologue of UL13. These results indicate that the posttranslational modification of EF-1delta is conserved herpes virus function and the UL13 homologues may be responsible for the universal modification of the translation factor.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10196346&dopt=Abstract herpes medicine



herpes
The murine homolog (Mph) of human herpes virus entry protein B (HveB) mediates entry of pseudorabies virus but not herpes simplex virus types 1 and 2.

Shukla D, Rowe CL, Dong Y, Racaniello VR, Spear PG.

Department of Microbiology-Immunology, Northwestern University Medical School, Chicago, Illinois 60611, USA.

A mouse member of the immunoglobulin superfamily, originally designated the murine poliovirus receptor homolog (Mph), was found to be a receptor for the porcine alphaherpes virus pseudorabies virus (PRV). This mouse protein, designated here murine herpes virus entry protein B (mHveB), is most similar to one of three related human alphaherpes virus receptors, the one designated HveB and also known as poliovirus receptor-related protein 2. Hamster cells resistant to PRV entry became susceptible upon expression of a cDNA encoding mHveB. Anti-mHveB antibody and a soluble protein composed of the mHveB ectodomain inhibited mHveB-dependent PRV entry. Expression of mHveB mRNA was detected in a variety of mouse cell lines, but anti-mHveB antibody inhibited PRV infection in only a subset of these cell lines, indicating that mHveB is the principal mediator of PRV entry into some mouse cell types but not others. Coexpression of mHveB with PRV gD, but not herpes simplex virus type 1 (HSV-1) gD, inhibited entry activity, suggesting that PRV gD may interact directly with mHveB as a ligand that can cause interference. By analogy with HSV-1, envelope-associated PRV gD probably also interacts directly with mHveB during viral entry.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10196354&dopt=Abstract herpes medicine



herpes
Antigenic and nucleotide characterization of a herpes virus isolated from Pacific harbor seals (Phoca vitulina richardsii).

King DP, Parselles R, Gulland FM, Lapointe JM, Lowenstine LJ, Ferrick DA, Stott JL.

Marine Mammal Center, Sausalito, California, USA.

This report describes the antigenic and nucleotide characterization of a herpes-like virus that has been isolated from the adrenal tissues of neonatal Pacific harbor seals. Infection with this virus has been previously implicated as a major cause of death of animals undergoing rehabilitation. Comparison and phylogenetic analysis of sequenced fragments of the DNA polymerase, glycoprotein B and glycoprotein D genes, and immunofluorescence assay using herpes virus-specific monoclonal antibodies, demonstrated close similarity of the Pacific harbor seal herpes virus to European isolates of phocid herpes virus-1 (PHV-1) and other alpha-herpes viruses affecting terrestrial carnivores.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9856089&dopt=Abstract herpes medicine