1
|
Piperi E, Papadopoulou E, Georgaki M, Dovrat S, Bar Illan M, Nikitakis NG, Yarom N. Management of oral herpes simplex virus infections: The problem of resistance. A narrative review. Oral Dis 2024; 30:877-894. [PMID: 37279074 DOI: 10.1111/odi.14635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/02/2023] [Accepted: 05/21/2023] [Indexed: 06/07/2023]
Abstract
Herpes Simplex Virus (HSV) type 1 (HSV-1) and type 2 (HSV-2) are among the most common human viral pathogens, affecting several billion people worldwide. Although in healthy patients clinical signs and symptoms of HSV infection are usually mild and self-limiting, HSV-infections in immunocompromised patients are frequently more aggressive, persistent, and even life-threatening. Acyclovir and its derivatives are the gold standard antiviral drugs for the prevention and treatment of HSV infections. Although the development of acyclovir resistance is a rather uncommon condition, it may be associated with serious complications, especially in immunocompromised patients. In this review, we aim to address the problem of drug resistant HSV infection and discuss the available alternative therapeutic interventions. All relative studies concerning alternative treatment modalities of acyclovir resistant HSV infection published in PubMed between 1989 to 2022 were reviewed. Long-term treatment and prophylaxis with antiviral agents predisposes to drug resistance, especially in immunocompromised patients. Cidofovir and foscarnet could serve as alternative treatments in these cases. Although rare, acyclovir resistance may be associated with severe complications. Hopefully, in the future, novel antiviral drugs and vaccines will be available in order to avoid the existing drug resistance.
Collapse
Affiliation(s)
- Evangelia Piperi
- Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Erofili Papadopoulou
- Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Maria Georgaki
- Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Sara Dovrat
- Central Virology Laboratory, Public Health Services, Ministry of Health, Sheba Medical Center, Tel-Hashomer, Israel
| | - Mor Bar Illan
- Oral Medicine Unit, Sheba Medical Center, Tel-Hashomer, Israel
| | - Nikolaos G Nikitakis
- Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Noam Yarom
- Oral Medicine Unit, Sheba Medical Center, Tel-Hashomer, Israel
- School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
2
|
Hoarau G, Haigh O, Vauloup-Fellous C, Boucher R, Rouquette A, Faure P, Limam L, Labetoulle M, Rousseau A. Diagnostic performance of real-time quantitative PCR in tear samples in various subtypes of herpes simplex keratitis. J Clin Microbiol 2023; 61:e0088523. [PMID: 38038483 PMCID: PMC10729708 DOI: 10.1128/jcm.00885-23] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/20/2023] [Indexed: 12/02/2023] Open
Abstract
Diagnosis of herpes simplex keratitis (HSK) is mostly based on clinical findings, yet biological confirmation supports management of challenging cases. This study evaluated the place of real-time quantitative PCR (RT-qPCR) on tear samplings in the management of HSK. Clinical records of patients who underwent tear sampling tested by RT-qPCR for herpes simplex virus type 1 for an acute episode of corneal inflammation or defect between January 2013 and December 2021 were retrospectively reviewed, and results were compared to clinical diagnosis (i.e., HSK or not) based on biomicroscopic findings and medical history. Of 465 tested tear samples from 364 patients, a clinical diagnosis of active (ongoing) HSK was recorded in 240 cases, among which 76 were RT-qPCR positive (global sensitivity of 31.6%, specificity of 99.5%). Sensitivity of RT-qPCR was higher in epithelial (97.4%) and stromal keratitis with ulceration (48.7%), compared to other types of HSK (23.5% in keratouveitis, 13.6% in endotheliitis, 11.1% in postherpetic neurotrophic keratopathy, and 8.1% in stromal keratitis without ulceration). The highest viral loads were detected from epithelial and stromal keratitis with ulceration, while in HSK with no epithelial involvement, the viral load detected was 196-fold lower, on average. The proportion of clinically characterized HSK patients with negative tear samples was higher in patients receiving antiviral treatment (P < 0.0001). RT-qPCR, performed on tear samples, can help in confirming diagnosis in case of presumed HSK, including clinical forms with no obvious epithelial involvement. The sensitivity of tear sampling is much higher whenever epithelial keratitis is present.
Collapse
Affiliation(s)
- Gautier Hoarau
- Service d’Ophtalmologie, Hôpital Bicêtre, Université Paris-Saclay, CRMR OPHTARA, Le Kremlin Bicêtre, France
| | - Oscar Haigh
- Université Paris-Saclay, Inserm, CEA, Center for Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Fontenay-Aux-Roses, France
| | - Christelle Vauloup-Fellous
- Université Paris-Saclay, Inserm, CEA, Center for Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Fontenay-Aux-Roses, France
- Service de Virologie, Hôpital Paul Brousse, Université Paris-Saclay, Villejuif, France
| | - Rafaël Boucher
- Service d’Ophtalmologie, Hôpital Bicêtre, Université Paris-Saclay, CRMR OPHTARA, Le Kremlin Bicêtre, France
- Université Paris-Saclay, Inserm, CEA, Center for Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Fontenay-Aux-Roses, France
| | - Alexandra Rouquette
- Service d’Epidémiologie et de Santé Publique, Université Paris-Saclay, Le Kremlin Bicêtre, France
| | - Pascale Faure
- Service d’Ophtalmologie, Hôpital Bicêtre, Université Paris-Saclay, CRMR OPHTARA, Le Kremlin Bicêtre, France
| | - Lamia Limam
- Service de Virologie, Hôpital Paul Brousse, Université Paris-Saclay, Villejuif, France
| | - Marc Labetoulle
- Service d’Ophtalmologie, Hôpital Bicêtre, Université Paris-Saclay, CRMR OPHTARA, Le Kremlin Bicêtre, France
- Université Paris-Saclay, Inserm, CEA, Center for Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Fontenay-Aux-Roses, France
| | - Antoine Rousseau
- Service d’Ophtalmologie, Hôpital Bicêtre, Université Paris-Saclay, CRMR OPHTARA, Le Kremlin Bicêtre, France
- Université Paris-Saclay, Inserm, CEA, Center for Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Fontenay-Aux-Roses, France
| |
Collapse
|
3
|
Schalkwijk HH, Georgala A, Gillemot S, Temblador A, Topalis D, Wittnebel S, Andrei G, Snoeck R. A Herpes Simplex Virus 1 DNA Polymerase Multidrug Resistance Mutation Identified in a Patient With Immunodeficiency and Confirmed by Gene Editing. J Infect Dis 2023; 228:1505-1515. [PMID: 37224525 DOI: 10.1093/infdis/jiad184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/24/2023] [Accepted: 05/21/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Herpes simplex virus 1 can cause severe infections in individuals who are immunocompromised. In these patients, emergence of drug resistance mutations causes difficulties in infection management. METHODS Seventeen herpes simplex virus 1 isolates were obtained from orofacial/anogenital lesions in a patient with leaky severe combined immunodeficiency over 7 years, before and after stem cell transplantation. Spatial/temporal evolution of drug resistance was characterized genotypically-with Sanger and next-generation sequencing of viral thymidine kinase (TK) and DNA polymerase (DP)-and phenotypically. CRISPR/Cas9 was used to introduce the novel DP Q727R mutation, and dual infection-competition assays were performed to assess viral fitness. RESULTS Isolates had identical genetic backgrounds, suggesting that orofacial/anogenital infections derived from the same virus lineage. Eleven isolates proved heterogeneous TK virus populations by next-generation sequencing, undetectable by Sanger sequencing. Thirteen isolates were acyclovir resistant due to TK mutations, and the Q727R isolate additionally exhibited foscarnet/adefovir resistance. Recombinant Q727R mutant virus showed multidrug resistance and increased fitness under antiviral pressure. CONCLUSIONS Long-term follow-up of a patient with severe combined immunodeficiency revealed virus evolution and frequent reactivation of wild-type and TK mutant strains, mostly as heterogeneous populations. The DP Q727R resistance phenotype was confirmed with CRISPR/Cas9, a useful tool to validate novel drug resistance mutations.
Collapse
Affiliation(s)
| | - Aspasia Georgala
- Department of Infectious Diseases, Jules Bordet Institute, Université Libre de Bruxelles, Brussels
| | - Sarah Gillemot
- Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, KU Leuven
| | - Arturo Temblador
- Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, KU Leuven
| | - Dimitri Topalis
- Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, KU Leuven
| | - Sebastian Wittnebel
- Department of Hematology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - Graciela Andrei
- Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, KU Leuven
| | - Robert Snoeck
- Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, KU Leuven
| |
Collapse
|
4
|
Glasgow HL, Zhu H, Xie H, Kenkel EJ, Lee C, Huang ML, Greninger AL. Genotypic testing improves detection of antiviral resistance in human herpes simplex virus. J Clin Virol 2023; 167:105554. [PMID: 37586184 DOI: 10.1016/j.jcv.2023.105554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/28/2023] [Accepted: 07/28/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND Antiviral resistance in human herpes simplex viruses (HSV) remains a significant clinical challenge in immunocompromised populations. Although molecular tests have largely replaced viral culture for HSV diagnosis and molecular antiviral resistance testing is available for many viruses, HSV resistance testing continues to rely on phenotypic, viral culture-based methods, requiring weeks for results. Consequently, treatment of suspected HSV resistance remains largely empiric. METHODS We used HSV whole genome sequencing and a database of previously characterized HSV acyclovir and foscarnet resistance mutations to evaluate the performance of genotypic antiviral resistance testing among 19 control strains compared to in-house plaque reduction assay (PRA) and 25 clinical isolates sent for reference lab PRA antiviral resistance testing. RESULTS Among control strains, 23/29 (79.3%) results were concordant, 5 (17.2%) were indeterminate, and 1 (3.4%) was discordant. Indeterminate results were caused by variants of uncertain significance (VUS), including mutations without published phenotypes and mutations with contradictory results. Among clinical isolates, 14/40 (35%) results were concordant, 17 (42.5%) were indeterminate, and 9 (22.5%) were discordant. All discordant results were in reportedly phenotypically-susceptible HSV-1 strains yet possessed resistance mutations. Three contained resistant subpopulations. 6/8 (75%) discordant phenotypes were concordant with resistant genotypes upon repeat PRA. CONCLUSIONS These data support the combination of genotypic and phenotypic testing to diagnose HSV resistance more accurately and likely more rapidly than phenotypic testing alone. Genotypic context of resistance mutations and the ability of viral strains to form plaques in culture may affect phenotypic resistance results, highlighting the limitations of PRA alone as a gold standard method.
Collapse
Affiliation(s)
- Heather L Glasgow
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, 98195, United States.
| | - Haiying Zhu
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, 98195, United States
| | - Hong Xie
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, 98195, United States
| | - Elizabeth J Kenkel
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, 98195, United States
| | - Carrie Lee
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, 98195, United States
| | - Meei-Li Huang
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, 98195, United States
| | - Alexander L Greninger
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, 98195, United States
| |
Collapse
|
5
|
Lewin AC, Ineck NE, Mironovich MA, Marino ME, Liu CC, Emelogu U, Mills EP, Camacho-Luna P, Carter RT. Surveillance for feline herpesvirus type 1 mutation and development of resistance in cats treated with antiviral medications. Front Vet Sci 2023; 10:1197249. [PMID: 37275610 PMCID: PMC10232796 DOI: 10.3389/fvets.2023.1197249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 05/02/2023] [Indexed: 06/07/2023] Open
Abstract
Feline herpesvirus type 1 (FHV-1) commonly causes ocular surface disease in cats and is treated with antiviral medications targeting viral DNA polymerase (UL30/42). Herein, we describe a method to assess the FHV-1 genome for mutation development and to assess the functional impact of mutations, if present. Fourteen shelter-housed domestic cats with FHV-1 ocular surface disease were assigned to one of four treatment groups: placebo (n = 3), cidofovir 0.5% ophthalmic solution (n = 3), famciclovir oral solution (n = 5), or ganciclovir 0.15% ophthalmic solution (n = 3). Swabs were collected before (day 1) and after (day 8) 1 week of twice-daily treatments to isolate viable FHV-1. Viral DNA was extracted for sequencing using Illumina MiSeq with subsequent genomic variant detection between paired day 1 and day 8 isolates. Plaque reduction assay was performed on paired isolates demonstrating non-synonymous variants. A total of 171 synonymous and 3 non-synonymous variants were identified in day 8 isolates. No variants were detected in viral UL23, UL30, or UL42 genes. Variant totals were not statistically different in animals receiving antiviral or placebo (p = 0.4997). A day 8 isolate from each antiviral treatment group contained a single non-synonymous variant in ICP4 (transcriptional regulator). These 3 isolates demonstrated no evidence of functional antiviral resistance when IC50 was assessed. Most (10/14 pairs) day 1 and 8 viral isolate pairs from the same host animal were near-identical. While functional variants were not detected in this small sample, these techniques can be replicated to assess FHV-1 isolates suspected of having developed resistance to antiviral medications.
Collapse
|
6
|
Leuzinger K, Stolz D, Gosert R, Naegele K, Prince SS, Tamm M, Hirsch HH. Comparing cytomegalovirus diagnostics by cell culture and quantitative nucleic acid testing in broncho-alveolar lavage fluids. J Med Virol 2021; 93:3804-3812. [PMID: 33136288 DOI: 10.1002/jmv.26649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/23/2020] [Accepted: 10/30/2020] [Indexed: 12/13/2022]
Abstract
Many clinical laboratories have replaced virus isolation in cell-culture (VIC) for cytomegalovirus (CMV) by quantitative-nucleic-acid testing (QNAT), rendering clinically relevant CMV-replication difficult to distinguish from CMV-shedding or latent infection. We compared direct VIC in 1109 consecutive bronchoalveolar lavage fluids (BALFs) and a well-validated CMV-QNAT (Basel-CMV-UL111a-77bp). In the retrospective Group 1 (N = 694) and Group 2 (N = 303), CMV-QNAT was performed within 48 h from 2-fold and 10-fold concentrated total nucleic acid (TNA) eluates, respectively. In Group 3 (N = 112), 2-fold and 10-fold concentrated TNA eluates were prospectively analyzed in parallel to VIC. CMV was detected by VIC in 79 of 694 (11%) and 26 of 303 (9%) of Groups 1 and 2, but in 114 of 694 (16%) and 57 of 303 (17%) by CMV-QNAT, respectively. Median CMV loads were significantly higher in VIC-positive than in VIC-negative BALF. The likelihood for CMV detection by VIC was 85% for BALF CMV- loads >4 log10 copies/ml. In the prospective Group 3, CMV was detected by VIC in 10 of 112 (9%), and in 14 of 112 (13%) and 20 of 112 (18%) by CMV-QNAT, when using 2-fold and 10-fold concentrated TNA eluates, respectively. Notably, CMV was undetectable by CMV-QNAT in 10 VIC-positive cases of Groups 1 and 2, but in none of Group 3. We conclude that CMV-QNAT can be adopted to BALF diagnostics but requires several careful steps in validation. CMV-QNAT loads >10 000 copies/ml in BALF may indicate significant CMV replication as defined by VIC, if short shipment and processing procedures can be guaranteed. Discordance of detecting CMV in time-matched plasma samples emphasises the role of local pulmonary CMV replication, for which histopathology remains the gold standard of proven CMV pneumonia.
Collapse
Affiliation(s)
- Karoline Leuzinger
- Clinical Virology, Laboratory Medicine, University Hospital Basel, Basel, Switzerland
- Transplantation & Clinical Virology, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Daiana Stolz
- Medical Faculty, University of Basel, Basel, Switzerland
- Clinic of Pneumology and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland
| | - Rainer Gosert
- Clinical Virology, Laboratory Medicine, University Hospital Basel, Basel, Switzerland
- Transplantation & Clinical Virology, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Klaudia Naegele
- Clinical Virology, Laboratory Medicine, University Hospital Basel, Basel, Switzerland
- Transplantation & Clinical Virology, Department of Biomedicine, University of Basel, Basel, Switzerland
| | | | - Michael Tamm
- Medical Faculty, University of Basel, Basel, Switzerland
- Clinic of Pneumology and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland
| | - Hans H Hirsch
- Clinical Virology, Laboratory Medicine, University Hospital Basel, Basel, Switzerland
- Transplantation & Clinical Virology, Department of Biomedicine, University of Basel, Basel, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
- Infectious Diseases & Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| |
Collapse
|
7
|
Anton-Vazquez V, Mehra V, Mbisa JL, Bradshaw D, Basu TN, Daly ML, Mufti GJ, Pagliuca A, Potter V, Zuckerman M. Challenges of aciclovir-resistant HSV infection in allogeneic bone marrow transplant recipients. J Clin Virol 2020; 128:104421. [DOI: 10.1016/j.jcv.2020.104421] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/22/2020] [Accepted: 05/03/2020] [Indexed: 11/27/2022]
|
8
|
Caliaro O, Barbani MT, Klenja S, Morfin F, Frobert E, Gorgievski M, Steinlin-Schopfer J, Suter-Riniker F. Phenotypic testing of patient herpes simplex virus type 1 and 2 isolates for acyclovir resistance by a novel method based on real-time cell analysis. J Clin Virol 2020; 125:104303. [PMID: 32163870 DOI: 10.1016/j.jcv.2020.104303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/17/2020] [Accepted: 02/18/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND Acyclovir (ACV) is the most commonly used drug for herpes simplex virus (HSV) infection therapy. Prolonged antiviral therapy or prophylaxis in immunocompromised patients may promote the development of drug-resistant strains. Due to the high polymorphism in genes involved in drug resistance, phenotypic methods, although work-intensive, are still required to test drug susceptibility. Real-time cell analysis (RTCA) based methods could offer a rapid and less labor-intensive alternative for phenotypic testing of ACV resistance. OBJECTIVE To investigate the utility of a new RTCA based assay (RTCAA) to test acyclovir susceptibility of HSV clinical isolates. STUDY DESIGN Four reference strains and 93 clinical isolates (60 HSV-1 and 33 HSV-2) were tested by RTCAA. In the presence of ACV concentrations from 2.2 to 140.8 μM, Vero cells were infected with different virus dilutions. IC50 values were calculated by dose-response curve (DRC) with area-under-curve (AUC) method. The reference strains and 22 clinical isolates were additionally tested by dye-uptake assay, and IC50 values of both methods were compared. RESULTS IC50 values from RTCAA and dye-uptake assays were positively correlated (Spearman's rho = 0.897, p < 0.001) and quantitatively agreed (Bland-Altman plot). Based on a cut-off of 4 μM for HSV-1 and 13 μM for HSV-2, 87 isolates were classified as ACV-sensitive and 6 isolates as ACV-resistant. The reference strains showed the expected results of ACV susceptibility. CONCLUSION RTCAA agrees well with the dye-uptake assay. Compared with other phenotypic methods, RTCAA requires less manipulation, reduces the workload and the turnaround time, and appears to be an objective and reliable method to test ACV susceptibility.
Collapse
Affiliation(s)
- Oliver Caliaro
- Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, 3001 Bern, Switzerland
| | - Maria Teresa Barbani
- Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, 3001 Bern, Switzerland.
| | - Shkipe Klenja
- Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, 3001 Bern, Switzerland
| | - Florence Morfin
- Laboratoire de Virologie, Institut des Agents Infectieux, Centre de Biologie et Pathologie Nord, Hospices Civils de Lyon, France; Laboratoire Virpath, Centre International de Recherche en Infectiologie (CIRI) (INSERM U1111 CNRS UMR 5308, ENS, Université de Lyon), Lyon, France
| | - Emilie Frobert
- Laboratoire de Virologie, Institut des Agents Infectieux, Centre de Biologie et Pathologie Nord, Hospices Civils de Lyon, France; Laboratoire Virpath, Centre International de Recherche en Infectiologie (CIRI) (INSERM U1111 CNRS UMR 5308, ENS, Université de Lyon), Lyon, France
| | - Meri Gorgievski
- Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, 3001 Bern, Switzerland
| | | | - Franziska Suter-Riniker
- Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, 3001 Bern, Switzerland
| |
Collapse
|
9
|
Lavaee F, Moshaverinia M, Rastegarfar M, Moattari A. Evaluation of the effect of hydro alcoholic extract of cinnamon on herpes simplex virus-1. Dent Res J (Isfahan) 2020. [DOI: 10.4103/1735-3327.280889] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
10
|
|
11
|
Parra-Sánchez M. Genital ulcers caused by herpes simplex virus. Enferm Infecc Microbiol Clin 2018; 37:260-264. [PMID: 30580877 DOI: 10.1016/j.eimc.2018.10.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 10/09/2018] [Accepted: 10/11/2018] [Indexed: 12/31/2022]
Abstract
Genital herpes is a sexually transmitted disease caused by herpes simplex virus type1 (HSV-1) and type2 (HSV-2) belonging to the alphaherpesvirus family, that includes the varicella zoster virus. HSV infection continues to be the most common cause of vulvar ulcers among the sexually active population. Its incidence increases every year. This review summarises the microbiology of the virus, pathogenesis and infection in genitalia, clinical manifestations and correct identification, the different laboratory diagnostic methods, and choice of the correct treatment according to the first infection, recurrence or special cases. Finally, the cost of routine herpes simplex virus infection is analysed.
Collapse
Affiliation(s)
- Manuel Parra-Sánchez
- Molecular Diagnostics Deparment, Vircell Microbiologists, Parque Tecnológico de la Salud, Granada, España.
| |
Collapse
|
12
|
Brunnemann AK, Hoffmann A, Deinhardt-Emmer S, Nagel CH, Rose R, Fickenscher H, Sauerbrei A, Krumbholz A. Relevance of non-synonymous thymidine kinase mutations for antiviral resistance of recombinant herpes simplex virus type 2 strains. Antiviral Res 2018; 152:53-57. [PMID: 29427675 DOI: 10.1016/j.antiviral.2018.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 02/02/2018] [Accepted: 02/05/2018] [Indexed: 11/27/2022]
Abstract
Therapy or prophylaxis of herpes simplex virus type 2 (HSV-2) infections with the nucleoside analog aciclovir (ACV) can lead to the emergence of drug-resistant HSV-2 strains, particularly in immunocompromised patients. In this context, multiple amino acid (aa) changes can accumulate in the ACV-converting viral thymidine kinase (TK) which hampers sequence-based diagnostics significantly. In this study, the so far unknown or still doubted relevance of several individual aa changes for drug resistance in HSV-2 was clarified. For this purpose, ten recombinant fluorescent HSV-2 strains differing in the respective aa within their TK were constructed using the bacterial artificial chromosome (BAC) pHSV2(MS)Lox. Similar TK expression levels and similar replication behavior patterns were demonstrated for the mutants as compared to the unmodified BAC-derived HSV-2 strain. Subsequently, the resulting strains were tested for their susceptibility to ACV as well as penciclovir (PCV) in parallel to a modified cytopathic effect (CPE) inhibition assay and by determining the relative fluorescence intensity (quantified using units, RFU) as a measure for the viral replication capacity. While aa changes Y53N and R221H conferred ACV resistance with cross-resistance to PCV, the aa changes G25A, G39E, T131M, Y133F, G150D, A157T, R248W, and L342W maintained a susceptible phenotype against both antivirals. The CPE inhibition assay and the measurement of relative fluorescence intensity yielded comparable results for the phenotypic testing of recombinant viruses. The latter test showed some technical advantages. In conclusion, the significance of single aa changes in HSV-2 TK on ACV/PCV resistance was clarified by the construction and phenotypic testing of recombinant viral strains. This was facilitated by the fluorescence based method.
Collapse
Affiliation(s)
- Anne-Kathrin Brunnemann
- Institute for Infection Medicine, Christian-Albrecht University of Kiel and University Medical Center Schleswig-Holstein, Brunswiker Straße 4, 24105 Kiel, Germany
| | - Anja Hoffmann
- Section of Experimental Virology, Institute for Medical Microbiology, Jena University Hospital, Hans-Knöll-Straße 2, 07745 Jena, Germany
| | - Stefanie Deinhardt-Emmer
- Section of Experimental Virology, Institute for Medical Microbiology, Jena University Hospital, Hans-Knöll-Straße 2, 07745 Jena, Germany
| | - Claus-Henning Nagel
- Heinrich Pette Institute, Leibniz-Institute for Experimental Virology, Martinistraße 52, 20251 Hamburg, Germany
| | - Ruben Rose
- Institute for Infection Medicine, Christian-Albrecht University of Kiel and University Medical Center Schleswig-Holstein, Brunswiker Straße 4, 24105 Kiel, Germany
| | - Helmut Fickenscher
- Institute for Infection Medicine, Christian-Albrecht University of Kiel and University Medical Center Schleswig-Holstein, Brunswiker Straße 4, 24105 Kiel, Germany
| | - Andreas Sauerbrei
- Section of Experimental Virology, Institute for Medical Microbiology, Jena University Hospital, Hans-Knöll-Straße 2, 07745 Jena, Germany
| | - Andi Krumbholz
- Institute for Infection Medicine, Christian-Albrecht University of Kiel and University Medical Center Schleswig-Holstein, Brunswiker Straße 4, 24105 Kiel, Germany.
| |
Collapse
|