Public Health Strategies to Prevent Genital Herpes: Where Do We Stand?

Antiviral Activity of Rosa damascena Mill. and Rosa alba L. Essential Oils against the Multiplication of Herpes Simplex Virus Type 1 Strains Sensitive and Resistant to Acyclovir

Simple Summary

Herpes simplex virus type 1 (HSV) is a coated DNA virus of the Herpesviridae family. It causes painful infections of the mouth, throat, face, eyes, central nervous system, as well as infections of the anal–genital area. The specific drugs for chemotherapy of HSV have been based on nucleoside analogues, with acyclovir (ACV) being the most widely used. The most serious problem in the application of nucleoside analogues is the rapid formation of resistant mutants, which also often leads to treatment failure. The search for new therapeutic alternatives for the treatment of HSV is necessary for the successful control of diseases caused by herpes infection. Rose essential oils are widely used in alternative medicine due to their many proven benefits for human health. In the treatment of bacterial and viral infections, they reduce the chance of developing resistance. In this study, we investigated the effects of the Bulgarian Rosa damascena Mill. and Rosa alba L. essential oils on the viral reproduction of susceptible (Victoria strain) and acyclovir-resistant (R-100) strains individually and in combination with acyclovir. When the rose oils were added after the virus entered the cell, co-administered with ACV at a concentration four times lower than the IC50, they contributed to a significant reduction in viral yield by more than 20% of the expected inhibition of viral replication in the Victoria strain and more than 10% of the previously presumptive inhibition in the R-100 strain.

Abstract

Background: The specific chemotherapeutics against herpes simplex virus type 1 (HSV) are nucleoside analogues such as acyclovir (ACV), but the most important problem is the formation of resistant mutants. The search for new therapeutic alternatives leads us to the purpose of investigating the effects of Rosa damascena Mill. and Rosa alba L. essential oils on the viral reproduction of susceptible (Victoria) and acyclovir-resistant (R-100) strains of HSV-1 replication in vitro, individually and in combination with acyclovir. Methods: Cytopathic effect inhibition test was used for assessment of antiviral activity of the oils, and the three-dimensional model of Prichard and Shipman was applied to evaluate the combined effect of oils with ACV on HSV-1 replication. Results: Both oils do not affect the replication of viral strains; they are able to influence only viral adsorption and extracellular virions and protect healthy cells from subsequent infection. In combination with lower doses of acyclovir, both oils demonstrate a significant synergistic effect on the replication of HSV-1, which is more contagious than the Victoria strain. Conclusions: The nonspecific mechanism of the reduction in viral reproduction caused by rose oils and the synergistic effect of their co-administration with the lower doses of specific inhibitor ACV makes them suitable therapeutics for overcoming viral resistance to HSV-1 infections.

Retrospective use of next-generation sequencing reveals the presence of Enteroviruses in acute influenza-like illness respiratory samples collected in South/South-East Asia during 2010-2013

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Next-generation Sequencing (NGS) was adopted in routine respiratory pathogen surveillance from South/South East (S/SE) Asia during 2010–2013.

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From 12,865 respiratory collections from ILI patients, 324 CPE-positive from 4,478 viral isolations were negative by standard assays.

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The CPE-positive samples were pooled, screened using NGS and validated the presence of the pathogens identified from NGS.

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Herpes simplex virus type 1, parainfluenza, adenovirus, coronavirus, human metapneumovirus, mumps virus and enterovirus genus were detected.

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NGS on pooled samples can be applied to surveillance work, identifying medically important viruses which may have missed by conventional methods.

Background

Emerging and re-emerging respiratory pathogens represent an increasing threat to public health. Etiological determination during outbreaks generally relies on clinical information, occasionally accompanied by traditional laboratory molecular or serological testing. Often, this limited testing leads to inconclusive findings.

The Armed Forces Research Institute of Medical Sciences (AFRIMS) collected 12,865 nasopharyngeal specimens from acute influenza-like illness (ILI) patients in five countries in South/South East Asia during 2010–2013. Three hundred and twenty-four samples which were found to be negative for influenza virus after screening with real-time RT-PCR and cell-based culture techniques demonstrated the potential for viral infection with evident cytopathic effect (CPE) in several cell lines.

Objective

To assess whether whole genome next-generation sequencing (WG-NGS) together with conventional molecular assays can be used to reveal the etiology of influenza negative, but CPE positive specimens.

Study design

The supernatant of these CPE positive cell cultures were grouped in 32 pools containing 2–26 supernatants per pool. Three WG-NGS runs were performed on these supernatant pools. Sequence reads were used to identify positive pools containing viral pathogens. Individual samples in the positive pools were confirmed by qRT-PCR, RT-PCR, PCR and Sanger sequencing from the CPE culture and original clinical specimens.

Results

WG-NGS was an effective way to expand pathogen identification in surveillance studies. This enabled the identification of a viral agent in 71.3% (231/324) of unidentified surveillance samples, including common respiratory pathogens (100/324; 30.9%): enterovirus (16/100; 16.0%), coxsackievirus (31/100; 31.0%), echovirus (22/100; 22.0%), human rhinovirus (3/100; 3%), enterovirus genus (2/100; 2.0%), influenza A (9/100; 9.0%), influenza B, (5/100; 5.0%), human parainfluenza (4/100; 4.0%), human adenovirus (3/100; 3.0%), human coronavirus (1/100; 1.0%), human metapneumovirus (2/100; 2.0%), and mumps virus (2/100; 2.0%), in addition to the non-respiratory pathogen herpes simplex virus type 1 (HSV-1) (172/324; 53.1%) and HSV-1 co-infection with respiratory viruses (41/324; 12.7%).

The epidemiology of herpes simplex virus type 2 infection in low-income urban populations in coastal Peru

OBJECTIVE

The objective of this study was to determine the epidemiology of herpes simplex virus type 2 (HSV-2) in general and socially marginalized populations of low-income, urban, coastal Peru.

STUDY

Two low-income populations were administered an epidemiologic survey and serologic tests, determining risk behavior, HSV-2, and HIV prevalence.

RESULTS

In the socially marginalized population, HSV-2 prevalence was 72.3% in men who have sex only with men (MSOM), 42.5% in women, and 20.7% in men. In the general population, HSV-2 prevalence was 20.5% in women and 7.1% in men. In all groups except the male general population, HSV-2 prevalence increased with age or number of sexually active years (both P <0.001). HSV-2 infection was associated with HIV infection in MSOM (P <0.023) and other socially marginalized men (P <0.01).

CONCLUSION

HSV-2 was common in both low-income populations, and control programs are needed in Peru given high prevalence and association with HIV infection. Prevention of HSV-2 infection should target individuals before they become sexually active.

Time course of seroconversion by HerpeSelect ELISA after acquisition of genital herpes simplex virus type 1 (HSV-1) or HSV-2

BACKGROUND

HerpeSelect HSV-1 and HSV-2 ELISAs are glycoprotein G-based, type-specific antibody detection tests that are approved by the US Food and Drug Administration for diagnosis of genital herpes.

GOAL

The goal was to determine seroconversion times by means of HerpeSelect ELISAs.

STUDY DESIGN

Four-hundred thirteen sera from 113 patients with recently acquired genital herpes were tested by HerpeSelect ELISAs and Western blot (WB). Thirty-one patients had primary genital HSV-1 (group 1), 56 had primary HSV-2 (group 2), and 26 had prior HSV-1 antibodies and newly acquired HSV-2 (group 3).

RESULTS

Median interval from onset of symptoms to seroconversion was 25 days, as determined by HerpeSelect HSV-1, versus 33 days by WB for group 1; 21 days by HerpeSelect HSV-2 versus 40 days by WB (group 2; P = 0.0005); and 23 days by HerpeSelect HSV-2 ELISA versus 47 days by WB (group 3; P = 0.02). In long-term follow-up, transient reversion to HerpeSelect negativity occurred in 3 of 31 HSV-1-infected subjects (10%) and in 2 of 82 HSV-2-infected subjects (2%).

CONCLUSION

Seroconversion to HSV-2 was determined faster by HerpeSelect than by WB.

Challenges in genital herpes simplex virus management

Development of serologic assays to detect antibodies to herpes simplex virus (HSV) glycoproteins (g)G1 and (g)G2 has allowed accurate definition of the seroprevalence of HSV-2 worldwide. Studies from all continents indicate epidemic proportions of HSV-2 infection. In the United States, 1 in 5 sexually active adults is infected. In Africa and the Caribbean, HSV prevalence is higher. Since the development of the acyclic nucleoside derivatives acyclovir, famciclovir, and valacyclovir, treatment of mucocutaneous HSV is a practice of everyday medical care. Yet, despite effective drugs, there is widespread discontent by clients and providers about care of patients with genital herpes. Much of this relates to transmission complexities and the varied natural history of the infection. However, over time, most patients adjust to their disease and the medical and psychosocial complications. Recent studies show condoms reduce transmission, providing an important tool for counseling the patient with newly diagnosed genital herpes.

Sorting out the new HSV type specific antibody tests

This review will delineate performance characteristics and limitations, as far as they are known, of the new glycoprotein G based, type specific HSV serologies. Several of these tests have been FDA approved in the United States for use in adults. With the departure of Gull/Meridian from the HSV serology market, it is important for clinicians to understand the sources and claims of the remaining type specific tests. Moreover, inaccurate tests using crude antigen preparations remain on the market. These tests are identified based on product insert information provided by company representatives.