Seroprevalence of HSV-1 and HSV-2 in Barbados

Disturbed Yin-Yang balance: stress increases the susceptibility to primary and recurrent infections of herpes simplex virus type 1

Herpes simplex virus type 1 (HSV-1), a neurotropic herpes virus, is able to establish a lifelong latent infection in the human host. Following primary replication in mucosal epithelial cells, the virus can enter sensory neurons innervating peripheral tissues via nerve termini. The viral genome is then transported to the nucleus where it can be maintained without producing infectious progeny, and thus latency is established in the cell. Yin–Yang balance is an essential concept in traditional Chinese medicine (TCM) theory. Yin represents stable and inhibitory factors, and Yang represents the active and aggressive factors. When the organism is exposed to stress, especially psychological stress caused by emotional stimulation, the Yin–Yang balance is disturbed and the virus can re-engage in productive replication, resulting in recurrent diseases. Therefore, a better understanding of the stress-induced susceptibility to HSV-1 primary infection and reactivation is needed and will provide helpful insights into the effective control and treatment of HSV-1. Here we reviewed the recent advances in the studies of HSV-1 susceptibility, latency and reactivation. We included mechanisms involved in primary infection and the regulation of latency and described how stress-induced changes increase the susceptibility to primary and recurrent infections.

Herpes simplex virus type 1 epidemiology in Latin America and the Caribbean: Systematic review and meta-analytics

OBJECTIVES

To investigate the epidemiology of herpes simplex virus type 1 (HSV-1) in Latin America and the Caribbean.

METHODS

Systematic review and meta-analytics guided by the Cochrane Collaboration Handbook and reported following the PRISMA guidelines.

RESULTS

Thirty-three relevant reports were identified including 35 overall (and 95 stratified) seroprevalence measures, and five and nine proportions of virus isolation in genital ulcer disease (GUD) and in genital herpes, respectively. Pooled mean seroprevalence was 57.2% (95% CI: 49.7-64.6%) among children and 88.4% (95% CI: 85.2-91.2%) among adults. Pooled mean seroprevalence was lowest at 49.7% (95% CI: 42.8-56.6%) in those aged ≤10, followed by 77.8% (95% CI: 67.9-84.8%) in those aged 10-20, 82.8% (95% CI: 73.1-90.8%) in those aged 20-30, 92.5% (95% CI: 89.4-95.1%) in those aged 30-40, and 94.2% (95% CI: 92.7-95.5%) in those aged ≥40. Age was the strongest source of heterogeneity in seroprevalence, explaining 54% of variation. Evidence was found for seroprevalence decline over time. Pooled mean proportion of HSV-1 isolation was 0.9% (95% CI: 0.0-3.6%) in GUD and 10.9% (95% CI: 4.4-19.4%) in genital herpes.

CONCLUSIONS

HSV-1 is a widely prevalent infection in this region, but its epidemiology may be slowly transitioning, with still limited contribution for HSV-1 in genital herpes.

Evaluation of an Automated Chemiluminescent Immunoassay in Typing Detection of IgG Antibodies Against Herpes Simplex Virus

BACKGROUD

Herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) are common infectious agents worldwide and the primary infection of HSV remains a major problem in the pregnant women in China nowadays. At present, typing detection of HSV is mainly based on ELISA in China.

METHODS

In this study, we evaluated the performance of a newly introduced chemiluminescent immunoassay assay (CLIA) for the determination of serum HSV-1 and HSV-2 immunoglobulin G (IgG) antibodies.

RESULTS

The functional sensitivity of detecting HSV-1 and HSV-2 IgG were 0.7 Index and 0.6 Index, respectively. The repeatability and the total imprecision coefficient of variations were both below 10%, and the recoveries of these assays ranged from 90% to 110%. High concentration of hemoglobin, lipids, and bilirubin in samples did not affect the results. The infective rates of HSV-1 and HSV-2 were 919 (87.5%) and 169 (16.1%), respectively. HSV-1 seroprevalence was significantly higher than that of HSV-2 (P < 0.001).

CONCLUSION

CLIA is an excellent method for HSV-1 and HSV-2 IgG measurement and can be used as a routine screening test. The infective rate of HSV was pretty high among women before pregnancy or in the period of pregnancy in Beijing.

Seroprevalence and Influence of Torch Infections in High Risk Pregnant Women: A Large Study from South India

BACKGROUND

The increased complications to the mother and fetus during or after pregnancy and birth are often caused by a wide array of pathogenic organisms mostly belonging to the TORCH group [toxoplasmosis, rubella, cytomegalovirus (CMV), and herpes simplex virus (HSV)]. These agents cause asymptomatic or mild infection in the mother while serious consequences in fetus. The present study was aimed to find significant etiological pathogens in the causation of high risk pregnancy (HRP) in South Indian population.

MATERIAL AND METHODS

A total of 1,158 HRP women (2010-2013) from Modern Government Maternity Hospital, Hyderabad were considered. Two milliliter of blood was obtained and the serum was analyzed for IgG and IgM antibodies against TORCH agents by ELISA.

RESULTS

Twenty-five percent of the study group had fetal congenital malformation in the present pregnancy (Group 1; N = 291) while 75 % showed bad obstetric history (BOH) (Group 2; N = 867). Maternal age of ≤25 years, primi gravida, and consanguinity showed predisposing role for Group 1 while maternal age ≥30 years and ≥ 3 gravida were contributing risk for Group 2. The seropositvity in HRP women for toxoplasma, rubella, CMV, and HSV was 28, 84, 92, and 61 %, respectively for IgG while it was 6, 3, 4, and 3 % for IgG + IgM. Total seropositvity of toxoplasma, rubella, CMV, and HSV in Group 1 was 29, 97, 97, and 62 % while it was 36, 84, 97, and 65 % in Group 2, respectively.

CONCLUSION

Maternal age of ≤25 years, primi gravida, and consanguinity contributed to fetal congenital malformation in the present pregnancy while maternal age of ≥30 years and ≥ 3 gravida towards BOH. Toxoplasma is protective while rubella and CMV are the infectious agents for HRP. Among the groups, toxoplasma and rubella conferred a predisposing risk towards Group 2 and Group 1, respectively. Sixty-one percent seropositvity of HSV in relation to bad obstetric outcome is the highest prevalence reported so far in India.

Herpes simplex virus type 2 and cancer: a medical geography approach

Herpes simplex virus type-2 (HSV-2) has been identified as a possible aetiological agent of cancer in humans, especially prostate cancer, but results remain controversial. Here, we have addressed this question using a medical geography approach based on the national incidence of various cancers and seroprevalence of HSV-2 in 64 countries worldwide. We corrected reports of cancer incidence for national gross domestic product (GDP) because living in a wealthy nation likely increases the probability of having a cancer detected. Data were also corrected for latitude and diet. Our analysis not only confirms that prostate cancer and HSV-2 seroprevalence are positively associated, but it also reveals the existence of a positive relationship between HSV-2 and melanoma incidence in both men and women. These results, though correlational, suggest that HSV-2 should continue to be investigated as a possible oncogenic pathogen of humans.

Genital herpes

Genital herpes is the main cause of genital ulcers worldwide; the prevalence of herpes simplex virus (HSV) type 2 infections in the general population ranges from 10% to 60%. Most genital herpes is caused by HSV-2, although HSV-1 accounts for about half of new cases in developed countries. The risk of HIV acquisition is three times higher in people with HSV-2. Neonatal herpes is an uncommon but serious complication of genital herpes. Most genital HSV-2 infections are unrecognised and undiagnosed; infected individuals, even with mild symptoms, shed HSV, and can infect sexual partners. Since clinical diagnosis is neither sensitive nor specific, virological and type-specific serological tests should be used routinely. Oral antiviral drugs for HSV infections are safe and effective and can be used both to treat episodes and to prevent recurrences. Antiviral treatment of the infected partners and condom use reduce the risk of sexual transmission of HSV-2.

[Serological response to herpes simplex virus type 1 and 2 infection among women of reproductive age]

INTRODUCTION

Herpes simplex viruses type 1 and 2 (HSV-1 and HSV-2) are alpha herpes viruses. Humans are the only natural host and they can be transmitted through oral or genital secretions. These viruses are ubiquitous all over the world, with different percentage rates. The aims of this paper were to determine the serological response to HSV-1 and HSV-2 infection among pregnant women and women of reproductive age and seroprevalence of HSV-1 and HSV-2 antibodies among pregnant women and women of reproductive age.

MATERIAL AND METHODS

A total of 81 serum samples were analyzed. 32 sera were collected from pregnant women, and 49 sera were from non-pregnant women of reproductive age. Serum samples were tested for IgM antibodies to both herpes simplex viruses by use of immunoenzymatic assay (Bioelisa HSV IgM Immunocapture; Biokit, Spain)). Sero-type specific ELISA tests: Bioelisa HSV-1 IgG and Bioelisa HSV-2 IgG (Biokit, Spain) were used for detection of IgG antibodies to HSV-1 and HSV-2, respectively.

RESULTS

Type-common IgM antibodies were found in 6.25% of pregnant women, and in 4.08% of women of reproductive age. Type-specific IgG antibodies to HSV-1 were detected in 68.75% of pregnant women, and in 81.63% of non-pregnant women. The seroprevalence of HSV-1 in our sample was 76.5%. Type-specific IgG antibodies to HSV-2 were detected in 12.5% of pregnant women, and in 12.24% of non-pregnant women of reproductive age. The seroprevalence of HSV-2 in the whole sample was 12.35%.

CONCLUSION

Most women have antibodies to HSV-1, which is partially protective against HSV-2 infection. The seroprevalence of HSV-2 in our sample is relatively low, and similar to seroprevalence in developed European countries. However, there is a high risk of acquiring primary genital HSV infection during pregnancy. Our sample was small, therefore further investigations are required for valid evaluation of seroprevalence of HSV-1 and HSV-2 in Serbia.

Interactions and management issues in HSV and HIV coinfection

Significant synergistic interactions have been observed between HIV and herpes simplex virus (HSV). HIV-induced immune compromise can cause frequent and persistent HSV disease, while poorly controlled HSV replication may influence HIV pathogenicity and transmission. HSV-2 seroprevalence is high in HIV-infected cohorts worldwide, with rates of over 80% for HSV-1 and ranging from 33% to more than 80% for HSV-2. As seen in HIV-negative individuals, HSV-2 coinfection is associated with female gender, older age and black ethnicity. HSV infection is commonly under-diagnosed in HIV-infected individuals, although the use of PCR for HSV detection in mucocutaneous swabs and HSV type-specific serology can improve the diagnostic yield. In HIV-1-infected patients with frequent clinical episodes of HSV reactivation, suppressive antiviral therapy may prove beneficial in controlling HSV disease while also reducing HSV-mediated promotion of HIV replication. Antiretroviral therapy leads to a gradual recovery of HSV-specific T-cell responses and a reduction in HSV-related morbidity, indicating that successful management of coinfection should target both HIV and HSV replication. The aim of this review is to address the more speculative issues surrounding the management of HSV/HIV coinfection and to summarize the data that inform them.

High prevalence of multiple human herpesviruses in saliva from human immunodeficiency virus-infected persons in the era of highly active antiretroviral therapy

Human immunodeficiency virus (HIV) infection is associated with an increased risk for human herpesviruses (HHVs) and their related diseases. Methods for limiting the transmission of HHVs require a better understanding of the prevalence and infectiousness of oral HHVs in HIV-infected patients. We performed quantitative PCR to investigate the prevalence, quantity, risk, and correlates of salivary HHVs from 58 HIV-seropositive individuals in a case control study. HHVs were significantly more prevalent in the salivas of HIV-seropositive persons than in those of the controls (odds ratios [ORs], 4.2 to 26.2; P<or=0.008). In HIV-infected patients, Epstein-Barr virus (EBV), human herpesvirus 8 (HHV-8), cytomegalovirus (CMV), and herpes simplex virus type 1 (HSV-1) were detected in 90%, 57%, 31% and 16% of samples, respectively, compared with 48%, 24%, 2%, and 2%, respectively, of samples from controls. Multiple HHVs were observed in 71% of HIV-seropositive persons and only 16% of controls (OR, 13.0; 95% confidence interval, 5.29 to 32.56). HIV-positive patients had significantly higher EBV loads than HIV-negative persons (P<0.0001). HIV-infected patients with CD4 counts above 200 cells/microl had increased probability for having HHV-8 in saliva (P=0.009) compared with patients whose counts were less than 200. In contrast, HSV-1, EBV, and CMV were detected more often when CD4 counts were low. High salivary HHV loads were detected for those (n=7) with oral lesions. These findings suggest that saliva is a potential risk factor for the acquisition of multiple HHVs, and several host factors may function to accelerate HHV reactivation or replication in patients with HIV infection.

Herpes simplex virus type 2 (HSV-2) seroprevalence at the time of HIV-1 diagnosis and seroincidence after HIV-1 diagnosis in an ethnically diverse cohort of HIV-1-infected persons

OBJECTIVE

The objective of this study was to determine herpes simplex virus type 2 (HSV-2) seroprevalence at HIV-1 diagnosis and seroincidence > or =1 year after HIV-1 diagnosis.

METHODS

HSV type-specific antibodies were detected by enzyme immunoassay.

RESULTS

The cohort comprised 850 adults diagnosed HIV-positive in 1986-2001 and followed for a median of 3 years. HSV-2 seroprevalence was 63% (95% confidence interval [CI], 60-66%) and was associated with female gender, heterosexual risk group, black ethnicity, and older age. HSV-2 seroincidence was 1.8 per 100 person-years (95% CI, 0.8-2.8) and was associated with other sexually transmitted diseases, including human papilloma virus infection (P = 0.005) and gonorrhea (P = 0.05). A diagnosis of genital herpes was made in 21% HSV-2-seropositive persons and was more likely in those who tested HIV-positive before 1997 (adjusted odds ratio, 5.11; 95% CI, 3.28-7.98; P = 0.0001).

CONCLUSIONS

Results confirm the epidemiologic association between HIV-1 and HSV-2. HSV-2 seroconversion was a marker of high-risk sexual behavior. The likelihood of developing symptoms of genital herpes declined from 1997 onward.