The incidence of Herpesvirus hominis antibody in the population

Herpesvirus hominis type 2 infection in Ibadan. Problem of non-venereal transmission

Examination of sera from blood donors, from patients attending a special treatment clinic, a family planning clinic, and an antenatal clinic showed that the prevalence of herpes virus hominis type 2 antibodies among the adult population in Ibadan is similar to that in other parts of the world. The possibility of non-venereal transmission of herpes virus infection was confirmed by the finding that herpesvirus hominis type 2 could survive on cloth samples under humid tropical conditions for long enough to allow transmission of infection via fomites.

Eczema herpeticum: atopic dermatitis complicated by primary herpetic gingivostomatitis

Various aspects of eczema herpeticum are discussed, and a case of eczema herpeticum secondary to atopic dermatitis complicated by primary herpetic gingivostomatitis in a young adult is presented. The lesions cleared, and the patient was discharged after treatment via a multiphasic approach directed at the management of pyrexia, prevention of secondary bacterial infections, symptomatic and supportive care for the effects of the viral infection, and close monitoring for evidence of visceral viremia.

Herpesvirus hominis type 1: a summary of structure, composition, growth cycle, and cytopathogenic effects

The widespread occurrence of localized herpetic infections constitutes a significant problem for the dental profession. A summary of the structure and composition, growth cycle, and cytopathogenic effects of Herpesvirus hominis Type 1 is offered with the hope that a greater understanding of herpetic infections will ensue.

Herpesviruses

Images

Necrotising balanitis due to a generalised primary infection with herpes simplex virus type 2

Virological studies have proved herpes simplex virus type 2 to be the cause of the severe primary infection in a 37-year-old man with necrotising balanitis. Symptoms of urethritis preceded the appearance of a severe local lesion; dissemination of infection occurred and lesions developed on the skin of the scalp, neck, trunk, buttocks, arms, legs, and feet. No evidence of involvement of the central nervous system was found, and the penile and skin lesions improved rapidly after the application of 5% idoxuridine in dimethylsulphoxide. Recurrences occurred at various skin sites at six to seven months after the primary infection.

Herpesvirus hominis antibodies among children and young adults in Ibadan

A total of 422 sera collected from children and young adults living in Ibadan, Nigeria, has been examined for the presence of antibodies to type 1 and type 2 herpesvirus hominis. Type 1 antibodies were rapidly acquired from the age of 1 year onwards, reflecting the relatively poor living standards and the overcrowded accommodation among the population studied. Type 2 antibodies were acquired between the ages of 3 and 5 years. It is suggested that non-venereal spread of the virus must be responsible; prolonged survival of the virus on fomites, owing to the high environmental humidity, possibly accounts for this.

Incidence of recurrent herpes labialis and upper respiratory infection: a prospective study of the influence of biologic, social and psychologic predictors

In a 3-year prospective study of recurrent herpes labialis (RHL) in a population of 149 student nurses, 40 to 50 per cent of the variance in incidence could be explained by a small group of variables. Measures of previous experience with RHL accounted for the largest fraction of the explained variance, followed by upper respiratory infection (URI) rate, socioeconomic status, and mood trait, in order of declining influence. Timing of RHL episodes was not related to phase of the menstrual cycle.

Comparison of antibody-dependent cellular cytotoxicity and complement-dependent antibody lysis of herpes simplex virus-infected cells as methods of detecting antiviral antibodies in human sera

An antibody-dependent cellular cytotoxicity (ADCC) assay was used to detect antibodies to the herpes simplex viruses in humans sera. The assay utilized the release of 51Cr from BHK-21 cells infected with the viruses, hamster peritoneal exudate cells as effector cells, and antiviral antibodies in human sera. The technique was found to be far more sensitive than complement-dependent antibody lysis of infected cells and virus neutralization. The ADCC assay was useful in detecting antibodies in sera that had low titers or no antibodies detectable by other methods. In a sample of 100 sera from university students, 40 were positive by complement-dependent lysis whereas 73 were positive by ADCC. Of 400 sera from women with cervical cancer, 17 did not have detectable antibodies by microneutralization or complement-dependent lysis; however, all sera were positive by ADCC, suggesting that all of the women had been infected in the past with one or both types of herpes simplex virus.

Efficacy of herpes simplex virus type 1 immunization in protecting against acute and latent infection by herpes simplex virus type 2 in mice

ICR mice were immunized with herpes simplex virus type 1 (HSV-1) and later challenged with HSV-2 by footpad inoculation. Both immunized animals and age-matched, nonimmunized controls were observed for ascending neurological disease and latent infection of spinal ganglia resulting from the HSV-2 challenge. Control animals had a 78% incidence of acute and latent infection compared with a 1.7% incidence in immunized mice. The data show immunity to HSV-1 is protective against both acute and latent infection by HSV-2.

Cerebrospinal fluid immunoglobulin quotients, kappa/lambda ratios, and viral antibody titres in neurological disease

A description has been given of cerebrospinal fluid (CSF) immunoglobulins in 355 patients with demyelinating, infectious, neuropathic, and other neurological disorders. An increase in the CSF IgG/albumin quotient was observed in 19/36 (53%) cases of definite multiple sclerosis (MS), in 13/47 (28%) cases of probable or possible MS, in 6/9 (67%) cases of proven herpes simplex viral encephalitis (HSVE), in 3/4 (75%) cases of neurosyphilis, in 1/1 case of subacute sclerosing panencephalitis (SSPE), in 2/9 )22%) cases of other central nervous system infections, and in 2/12 (17%) cases of polyneuritis when compared with a group of 236 patients having other neurological disorders. In constrast, a relative increase in the CSF IgA of IgM was seen only in some of the patients with central nervous system infections. It was also found that the quotient CSF/serum IgG, expressed as a percentage of the CSF/serum albumin, was better in distinguishing patients with definite or suspected MS from those with other neurological disorders than the quotients IgG/albumin or IgG/total protein. The CSF K/lambda ratio and the CSF and serum complement-fixing antibody titre to measles and herpes simplex virus were measured in many of the patients. In general, abnormalities of these measurements were associated with raised IgG/albumin quotients. However, in eight patients with definite or suspected MS, a normal IgG/albumin quotient was found with abnormal CSF K/lambda ratios (6 cases) or abnormal CSF titres of measles antibody (7 cases). In addition, two patients, with HSVE had normal IgG/albumin ratios but detectable herpes antibody in the CSF. These findings suggest that the measurement of the relative concentration of CSF immunoglobulin in combination with the K/lambda ratio and antibody titre to various viruses may supplement each other in the endeavour to detect central nervous system immunglobulin sysnthesis in neurological diseases.

Age-specific incidence of neutralization antibodies of Herpes simplex virus

Sera of 1255 individuals from Novi Sad, varying in age from less than 1 month to 69 years, have been tested for neutralization antibodies to Herpes implex virus type 1. The eight newborns tested and 97% of the 507 adults were positive, with titres ranging from 1/4 to 1/256. The titres in newborns were significantly lower than the titres in adults. After birth the maternal antibodies declined rapidly and 94% of infants at the age of greater than 6 months and less than 2 years were negative. After the first year infants in Novi Sad start to acquire herpes-neutralizing antibodies actively, reaching a 50% incidence of positives between the 2nd and 3rd year of age. Age-specific incidence rates of herpes positives found in Novi Sad have been compared with those reported from Edinburgh, Freiburg i. Br. and Louisiana. Possible influences of several circumstances upon the incidence rate of positives detected by the neutralization test are discussed.

Viral-specific humoral immunity to herpes simplex-induced antigens in patients with squamous carcinoma of the head and neck

Serum antibodies to herpes simplex virus-induced antigens (HSVIA) were quantitated in 122 patients with head and neck squamous carcinoma, 93 patients tumor-free after treatment for these malignant lesions, 27 patients with nonsquamous malignant lesions, 30 heavy smokers, and 36 nonsmokers. Serum IgA anti-HSVIA antibodies were detected in a greater percentage of sera of patients with squamous carcinoma (61 per cent), patients previously treated for these malignant lesions (56 per cent), and heavy smokers (57 per cent) than in patients with nonsquamous malignant lesions (11 per cent) or nonsmokers (8 per cent). Furthermore, titers of these antibodies were higher in patients with squamous carcinoma than in smokers. In patients tumor-free more than three years after treatment, the percentage of positive sera was significantly lower than that in untreated patients and in patients three years or less after treatment. This study demonstrates for the first time a high frequency of antibodies to HSV-induced antigens confined to subjects at high risk of developing head and neck squamous carcinoma and in patients with these malignancies as well as a correlation between the levels of these antibodies and clinical course after treatment.

Herpes simplex virus-an obstetric hospital problem

The incidence of morbidity from herpes simplex virus among nurses of an obstetric teaching hospital is reported. The absence of local epidemiological data regarding this important infection is noted in an analysis of the influence on rostering and sick leave of the nurses.

Humoral immunity to herpes simplex viral-induced antigens in smokers

Antibodies to herpes simplex viral-induced antigens (HSVIA) were assayed by an indirect immunofluorescent technique in 93 regular cigarette smokers, 75 of whom also imbibed alcoholic beverages. Controls were 94 nonsmoking, nondrinking volunteers matched with the smoker for age and sex. IgA antibodies to HSVIA were detected six times more frequently in the sera of smokers than in nonsmoking controls, p less than .0005. IgG and IgM anti-HSVIA were detected with comparable frequencies in both groups, but the antibody titers were significantly higher in the smoking group than in controls, p less than .05. IgA anti-HSVIA was detected more frequently in smokers with 10 or more pack-years of cigarette exposure than in smokers with 10 or more pack-years of smoking (p less than .05) or in matched nonsmokers (p less than .02). IgA antibody titers to HSVIA were significantly higher in cigarette smokers who drank alcoholic beverages than in smokers who did not drink, p less than .025. This study demonstrates that cigarette smoking and the use of alcoholic beverages are associated with heightened humoral immunity to HSV-induced antigens in a population at high risk for development of squamous cell carcinomas of the head and neck region.

Herpes simplex: the primary infection

A primary infection with herpes simplex virus (HSV) occurs at some time in the life of almost every member of the population, especially among those living in crowded, unsanitary conditions. In many cases the lesions are subclinical, and in most cases they are self-limited even when clinical. In a few patients, such as the newborn infant, the patient with concomitant eczema, or the patient with reduced immunity, the primary infection may become severe, generalized, and life-threatening. Type 1 HSV has a predilection for a number of sites, including the oral cavity, the eye, and the skin; and type 2 HSV has a predilection for the genital area and for the newborn.

A clinical study for the control of facial mucocutaneous herpes virus infections. I. Characterization of natural history in a professional school population

One thousand thirty-one dental and dental hygiene students, faculty and staff at The University of Michigan School of Dentistry were interviewed in order to identify those with a past history of perioral mucocutaneous herpetic infection. Subsequently, the population was followed for 9 (+/- 3) months in order to determine various parameters of disease expression. Analysis of the results indicate the following: 1. In this professional population, 20.5 per cent described prior experience with perioral herpes. No sex difference was noted. 2. Prevalence increased with age. In the faculty-staff group (mean age 32.9 years +/ 11.8) prevalence was 30.7 per cent, whereas in the student -roup (mean age, io.6 years+/- 3.8) prevalence was 17.7 per cent. Occupational and/or socioeconomic factors did not appear to account for the age-related difference in prevalence. 3. Only 40 per cent of those who related prior disease experience developed lesions within the observation period of 9 (+/-3) months. 4. The recurrence rate, based upon an observation period of 9 (+/-3) months, in those persons who related prior disease experience was found to be 1.3 episodes per year (0.1 per month). 5. Duration of lesions ranged between 3 and 17 days, with a mean of 9 days. 6. The lower lip was the most common site of a lesion. 7. Triggering factors associated with development of a lesion in order of decreasing frequency were found to be; emotional stress, exposure to sun, and illness.

Incidence of Herpesvirus hominis antibodies among blood donor populations

The microneutralization test was used to determine the occurrence of antibodies to Herpesvirus hominis Type 1 and Type 2 in sera from patients attending the Special Clinic, Bristol Royal Infirmary, with proven herpes genitalis, and in sera taken from blood donors in Bath, Dursley, and Bristol, as well as from donors in three different prison populations. The findings in patients with herpes genitalis indicate that the test accurately reflects the antibody response expected in relation to the type of herpes virus isolated from the lesions. The incidence of Type 2 antibodies among the blood donors ranged from 5 per cent. for donors from the Bath area up to 60 per cent. among donors from Dartmoor prison. The findings suggested that Type 2 herpes infection could spread among longterm prison populations, and it is postulated that this may be due to both homosexual contact, and also by non-sexual contact, either directly or via fomites.

Herpes zoster and recurrent herpes simplex

87 patients with the clinical diagnosis of herpes zoster were seen during a one-year period in 8 general practices in Glasgow, the rate per 1 000 practice population being approximately 2.4. Of these, 78 (90%) had serological evidence of active infection with herpes zoster. A history of recurrent herpes simplex was obtained in 25 (32%) of the 78 patients with confirmed herpes zoster; 63 (81%) of these 78 had complement-fixing (CF) antibodies to herpes simplex. Thus, latent herpes simplex infection did not prevent herpes zoster nor modify the severity of herpes zoster. In most of the patients CF antibodt to varicella-zoster was not detected within 5 days from appearance of the rash. After the acute phase of the illness CF antibody titres fell fairly rapidly, the geometric mean titre being 189 at 2-4 weeks after the rash, 27 from 3-6 months, and 8 from 12-18 months. The rapid rise and decline in CF antibody after herpes zoster infection compared with the unchanging CF titres associated with recurrent herpes simplex infection suggest that varicella-zoster and herpes simplex virus differ in their mechanism of latency.

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.

Characterization of genital strains of Herpesvirus hominis

Images

Prediction of the incidence of recurrent herpes labialis and systemic illness from psychological measurements

About a third of variance in a year's incidence of recurrent herpes labialis (RHL) was predicted from combinations of psychological and sociometric variables. Measures of social assets and psychological discomfort added significant predictive information when used in combination with measures of susceptibility to RHL (antibody titer or frequency of RHL determined by history).

Herpesvirus hominis infection in patients with myeloproliferative and lymphoproliferative disorders

Infection with Herpesvirus hominis, often associated with oral ulceration, was found to be more frequent in patients with myeloproliferative and lymphoproliferative disorders than in normal populations or patients with other diseases. This increased frequency was not associated with any deficiency of the humoral antibody response, suggesting a possible impairment of cell-mediated immunity. The otherwise untreatable oral lesions appeared to respond effectively to local irradiation.

Cell-mediated immunity in Herpesvirus hominis infections

The cell-mediated and antibody responses to Herpesvirus hominis type 1 were investigated in patients with primary and recurrent herpetic infections. Stimulation of lymphocyte transformation with the virus and the complement fixing antibody titre did not differ significantly between patients and controls. However, macrophage migration inhibition and lymphocyte cytotoxicity were impaired in patients. The defects were specific to H. hominis, as Candida oblicans, which was used as an unrelated antigen, failed to show a similar abnormality. These results and preliminary sequential studies suggest that the susceptibility to recurrent herpesvirus infection may be due to an impaired production of macrophage migration inhibition factor and lymphocyte cytotoxicity in the presence of intact lymphocyte sensitization and antibody formation.

Virucidal activity of chlorhexidine on strains of Herpesvirus hominis, poliovirus, and adenovirus

The infectivity titre of two strains of Herpesvirus hominis was reduced by not more than six log(10) units by 90 minutes' exposure to chlorhexidine at a final concentration of 0.02% at room temperature. Under identical conditions the compound was ineffective against a vaccine strain of poliovirus and against an adenovirus. Experimental conditions are described whereby the toxic effect of the disinfectant on the tissue culture assay systems are minimized.

The incidence of complement-fixing antibody to varicella-zoster virus in hospital patients and blood donors

The sera of 308 patients, not suffering from varicella or zoster infections, and the sera of 183 blood donors were examined for complement-fixing antibody to varicella-zoster virus. In both groups about 70% of sera from persons aged 11-40 years had antibody titres >/= 1/4; the incidence was less in the age range 41-60 years and increased in later decades. Antibody titres of 1/16 or 1/32 were noticeably less frequent in those aged 41-60 years than in younger or older groups.It was concluded that an unchanging titre of 1/16 or 1/32 was of no diagnostic significance. The age distribution of antibody was consistent with the theory that zoster only occurs when antibody has declined.

Trench mouth in children

Images