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Hatami P, Aryanian Z, Asl HN, Khayyat A, Hatami D. Pregnancy and pityriasis rosea: Current concepts. J Cosmet Dermatol 2024; 23:2298-2300. [PMID: 38348731 DOI: 10.1111/jocd.16233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/05/2024] [Indexed: 05/19/2024]
Affiliation(s)
- Parvaneh Hatami
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Aryanian
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Dermatology, Babol University of Medical Sciences, Babol, Iran
| | - Hamed Nicknam Asl
- Department of Dentistry, Rafsanjan University of Medical Sciences (RUMS), Rafsanjan, Iran
| | - Azadeh Khayyat
- PGY2 resident physician, Pathology Department of Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Dorsa Hatami
- Student Research Center, Kharazmi University, Tehran, Iran
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Vilibic-Cavlek T, Belamaric M, Ferenc T, Navolan D, Kolaric B, Milasincic L, Antolasic L, Vujica Ferenc M, Vilibic M, Lukunic A, Bogdanic M. Seroepidemiology of Herpes Simplex Viruses Type 1 and 2 in Pregnant Women in Croatia. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:284. [PMID: 38399571 PMCID: PMC10890541 DOI: 10.3390/medicina60020284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: Herpes simplex viruses (HSV-1 and HSV-2) are one of the most widespread causes of human viral infections. In Croatia, only two published studies have analyzed the seroprevalence of HSV infections in childbearing-aged and pregnant women (2005-2010), while more recent data are lacking. This study aimed to analyze the prevalence and risk factors for HSV-1 and HSV-2 infections among pregnant women in Croatia in the period from 2011 to 2021. Materials and Methods: This study included 667 pregnant women aged 16-45 years submitted for HSV-1 and HSV-2 serology testing. Serum samples were initially screened for HSV-1 and HSV-2 IgM and IgG antibodies using a commercial ELISA test with a confirmation of HSV-2-positive samples using an immunoblot assay. Results: The overall IgG seroprevalence rates were 69.9% for HSV-1 and 3.8% for HSV-2. A significant gradual increase in the HSV-2 seroprevalence with age was observed from 0.5% in participants under 30 years to 8.3% in participants above 40 years. The HSV-1 seroprevalence was stable up to 40 years (70.0 and 68.3%, respectively), with an increase to 86.1%, but this difference did not reach statistical significance. Area of residence (urban or suburban/rural), geographic region (continental or coastal), and obstetric history (normal pregnancy or unfavorable obstetric history) were not associated with HSV-1 and HSV-2 seroprevalence. Older age was found to be a significant risk factor for HSV-2 seropositivity in both univariate and multivariate risk analysis. Conclusions: HSV-1 infection is widely prevalent among pregnant women with a stable trend over time. However, a declining trend in the HSV-2 seroprevalence was observed compared to 2005-2010. Serological screening in pregnant women is important in identifying seronegative women who are susceptible to HSV infection as well as seropositive women who are at risk for genital herpes recurrence during delivery.
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Affiliation(s)
- Tatjana Vilibic-Cavlek
- Department of Virology, Croatian Institute of Public Health, 10000 Zagreb, Croatia; (L.M.); (L.A.)
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Marko Belamaric
- Teaching Institute for Emergency Medicine, 10000 Zagreb, Croatia;
| | - Thomas Ferenc
- Department of Diagnostic and Interventional Radiology, University Hospital Merkur, 10000 Zagreb, Croatia;
| | - Dan Navolan
- Department of Obstetrics and Gynecology, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Branko Kolaric
- Andrija Stampar Teaching Institute of Public Health, 10000 Zagreb, Croatia;
- Department of Social Medicine and Epidemiology, Medical Faculty, University of Rijeka, 51000 Rijeka, Croatia
| | - Ljiljana Milasincic
- Department of Virology, Croatian Institute of Public Health, 10000 Zagreb, Croatia; (L.M.); (L.A.)
| | - Ljiljana Antolasic
- Department of Virology, Croatian Institute of Public Health, 10000 Zagreb, Croatia; (L.M.); (L.A.)
| | - Mateja Vujica Ferenc
- Department of Obstetrics and Gynecology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia;
| | - Maja Vilibic
- Department of Psychiatry, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia;
- School of Medicine, Catholic University of Croatia, 10000 Zagreb, Croatia
| | - Adriana Lukunic
- Department of Microbiology, University of Applied Health Sciences, 10000 Zagreb, Croatia;
| | - Maja Bogdanic
- Department of Virology, Croatian Institute of Public Health, 10000 Zagreb, Croatia; (L.M.); (L.A.)
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Kim WB, Lee SJ, Bae S, Ku JY, Oh TH, Oh MM, Yang SO, Choi JB. Korean sexually transmitted infection guidelines 2023 revision, guideline update of viral infections: Genital herpes and anogenital warts. Investig Clin Urol 2024; 65:9-15. [PMID: 38197746 PMCID: PMC10789539 DOI: 10.4111/icu.20230275] [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: 08/16/2023] [Revised: 10/15/2023] [Accepted: 11/06/2023] [Indexed: 01/11/2024] Open
Abstract
The Korean Association of Urogenital Tract Infection and Inflammation and the Korea Disease Control and Prevention Agency regularly update, revise, and develop new content for the Korean sexually transmitted infection (STI) guidelines. These professional bodies respond to changing epidemiological trends and evolving scientific evidence, and consider advances in laboratory diagnostics and research. The principal recommendations of the 2023 Korean STI guidelines in terms of viral infection follow: 1) If genital herpes recurs more than 4-6 times annually, suppressive therapy with acyclovir 400 mg orally 2 times/day or famciclovir 250 mg orally 2 times/day or valacyclovir 500 mg orally once a day (for patients with <10 episodes/year) or valacyclovir 1 g orally once daily (for patients with ≥10 episodes/year) is recommended to prevent recurrence; 2) molecular human papillomavirus (HPV) testing is not recommended as a routine test for STI status, nor for determination of HPV vaccination status; and 3) patients should inform their current sexual partners about anogenital warts because the types of HPV that cause such warts can be passed to partners. These guidelines will be updated every 5 years and will be revised when new knowledge on STIs becomes available and there is a reasonable need to improve the guidelines. Physicians and other healthcare providers can use the guidelines to assist in the prevention and treatment of STIs.
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Affiliation(s)
- Woong Bin Kim
- Department of Urology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Seung-Ju Lee
- Department of Urology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sangrak Bae
- Department of Urology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ja Yoon Ku
- Department of Urology, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea
| | - Tae Hoon Oh
- Department of Urology, Wonkwang University Hospital, Iksan, Korea
| | - Mi Mi Oh
- Department of Urology, Korea University Guro Hospital, Seoul, Korea
| | - Seung Ok Yang
- Department of Urology, Veterans Health Service Medical Center, Seoul, Korea
| | - Jin Bong Choi
- Department of Urology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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De Rose DU, Bompard S, Maddaloni C, Bersani I, Martini L, Santisi A, Longo D, Ronchetti MP, Dotta A, Auriti C. Neonatal herpes simplex virus infection: From the maternal infection to the child outcome. J Med Virol 2023; 95:e29024. [PMID: 37592873 DOI: 10.1002/jmv.29024] [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: 04/28/2023] [Revised: 07/03/2023] [Accepted: 07/27/2023] [Indexed: 08/19/2023]
Abstract
This review examines the recent literature on the management of herpes simplex virus (HSV) infections in neonates. We summarized the three clinical categories of maternal HSV infection during pregnancy (primary first episode, nonprimary first episode, or recurrent episode) and the mechanisms of fetal damage. Considering when the transmission of the infection from the mother to the fetus/newborn occurs, three types of neonatal infection can be distinguished: intrauterine infection (5% of cases), postnatal infection (10% of cases), and perinatal infections (85% of cases). Neonatal presentation could range from a limited disease with skin, eye, and mouth disease to central nervous system disease or disseminated disease: the treatment with acyclovir should be tailored according to symptoms and signs of infection, and virological tests. These children need a multidisciplinary follow-up, to timely intercept any deviation from normal neurodevelopmental milestones. Prevention strategies remain a challenge, in the absence of an available vaccine against HSV.
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Affiliation(s)
- Domenico Umberto De Rose
- Neonatal Intensive Care Unit, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy
- Faculty of Medicine and Surgery, "Tor Vergata" University of Rome, Rome, Italy
| | - Sarah Bompard
- Neurorehabilitation Unit, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy
| | - Chiara Maddaloni
- Neonatal Intensive Care Unit, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy
| | - Iliana Bersani
- Neonatal Intensive Care Unit, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy
| | - Ludovica Martini
- Neonatal Intensive Care Unit, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy
| | - Alessandra Santisi
- Neonatal Intensive Care Unit, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy
| | - Daniela Longo
- Neuroradiology Unit, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy
| | | | - Andrea Dotta
- Neonatal Intensive Care Unit, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy
| | - Cinzia Auriti
- Neonatal Intensive Care Unit, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy
- Saint Camillus International University, Rome, Italy
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Bonfim FFDO, Villar LM, Croda J, Silva SRD, Gonçalves CCM, de Castro VDOL, de Rezende Romeira GR, Cesar GA, Dos Santos Weis-Torres SM, Horta MA, Simionatto S, Motta-Castro ARC, de Paula VS. Epidemiological Survey of Human Alphaherpesvirus 2 (HSV-2) Infection in Indigenous People of Dourados Municipality, Central Brazil. Trop Med Infect Dis 2023; 8:tropicalmed8040197. [PMID: 37104324 PMCID: PMC10143357 DOI: 10.3390/tropicalmed8040197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/10/2023] [Accepted: 01/23/2023] [Indexed: 04/28/2023] Open
Abstract
Sexually transmitted Human alphaherpesvirus 2 (HSV-2) causes genital ulcers, especially among sexually active adolescents and adults. We estimated the exact prevalence of anti-HSV-2 antibodies and correlated it with the demographic and behavioral aspects of the Indigenous population of the Jaguapirú and Bororó villages (Dourados, Mato Grosso do Sul (MS), Brazil). In total, 1360 individuals (>18 years old) were administered serologic tests. The prevalence of anti-HSV-2 IgM was 12.9%, that of anti-HSV-2 IgG was 57.2%, and 8.5% cases tested positive for both HSV-2 IgM and IgG. The prevalence of anti-HSV-2 antibodies was higher in females (59.5%) compared to males (49%), with an OR of 0.64 (0.49-0.83). Anti-HSV-2 antibodies were found in 14.2%, 12.3%, 15.4%, and 14.5% of participants with urinary problems, genital wounds, genital warts, and urethral discharge, respectively. In summary, the seroprevalence of HSV-2 in the Indigenous population was five times higher than that reported in the general adult Brazilian population. Educational level, income level, smoking, condom use, incarceration, illicit drug abuse, the sharing of used needles and syringes without adequate disinfection, homosexual relationships, prostitution, the sexual practices among drug users, and avoidance of contraceptive methods could contribute to the facilitation of HSV-2 transmission in the Indigenous population. Our results may help develop culturally appropriate intervention programs that eliminate health-access barriers and improve the implementation of public health policies aimed at promoting information regarding and preventing, treating, and controlling HSV-2 infection in Brazilian Indigenous populations.
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Affiliation(s)
| | - Livia Melo Villar
- Viral Hepatitis Laboratory, Oswaldo Cruz Foundation, Rio de Janeiro 21040360, Brazil
| | - Julio Croda
- Brazilian Society of Tropical Medicine, Campo Grande 79070900, Brazil
| | | | - Crhistinne Cavalheiro Maymone Gonçalves
- Center for Biological and Health Sciences, Blood Center Sector, Federal University of Mato Grosso do Sul, Campo Grande 79070900, Brazil
- State Department of Health of Mato Grosso do Sul, Campo Grande 79031350, Brazil
| | | | | | - Gabriela Alves Cesar
- Center for Biological and Health Sciences, Blood Center Sector, Federal University of Mato Grosso do Sul, Campo Grande 79070900, Brazil
| | | | - Marco Aurélio Horta
- Biosafety Level 3 Platform (NB3), Oswaldo Cruz Foundation, Rio de Janeiro 21040360, Brazil
| | - Simone Simionatto
- College of Biological and Environmental Sciences, Federal University of Grande Dourados, Dourados 79070900, Brazil
| | - Ana Rita Coimbra Motta-Castro
- Center for Biological and Health Sciences, Blood Center Sector, Federal University of Mato Grosso do Sul, Campo Grande 79070900, Brazil
- Center for Health and Biological Sciences, Oswaldo Cruz Foundation, Rio de Janeiro 79070900, Brazil
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Shata MTM, Hetta HF, Sharma Y, Sherman KE. Viral hepatitis in pregnancy. J Viral Hepat 2022; 29:844-861. [PMID: 35748741 PMCID: PMC9541692 DOI: 10.1111/jvh.13725] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/17/2021] [Accepted: 06/13/2022] [Indexed: 12/09/2022]
Abstract
Viral hepatitis is caused by a heterogenous group of viral agents representing a wide range of phylogenetic groups. Many viruses can involve the liver and cause liver injury but only a subset are delineated as 'hepatitis viruses' based upon their primary site of replication and tropism for hepatocytes which make up the bulk of the liver cell population. Since their discovery, beginning with the agent that caused serum hepatitis in the 1960s, the alphabetic designations have been utilized. To date, we have five hepatitis viruses, A through E, though it is postulated that others may exist. This chapter will focus on those viruses. Note that hepatitis D is included as a subset of hepatitis B, as it cannot exist without concurrent hepatitis B infection. Pregnancy has the potential to affect all aspects of these viral agents due to the unique immunologic and physiologic changes that occur during and after the gestational period. In this review, we will discuss the most common viral hepatitis and their effects during pregnancy.
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Affiliation(s)
- Mohamed Tarek M. Shata
- Division of Digestive Disease, Department of Internal MedicineUniversity of CincinnatiCincinnatiOhioUSA
| | - Helal F. Hetta
- Division of Digestive Disease, Department of Internal MedicineUniversity of CincinnatiCincinnatiOhioUSA,Department of Medical Microbiology and Immunology, Faculty of MedicineAssiut UniversityAssiutEgypt
| | - Yeshika Sharma
- Division of Digestive Disease, Department of Internal MedicineUniversity of CincinnatiCincinnatiOhioUSA
| | - Kenneth E. Sherman
- Division of Digestive Disease, Department of Internal MedicineUniversity of CincinnatiCincinnatiOhioUSA
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Ahmed H, Abbu N, Saeed S, Abdalla W, MohammedSalih K, Abd Alla A, Hashim A. Seroprevalence of herpes simplex virus type-2 among pregnant women in Wad Madani-Sudan: a cross sectional study. F1000Res 2022; 11:752. [DOI: 10.12688/f1000research.111054.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
Background: Sexually transmitted diseases are known to pose a significant public health threat. Herpes simplex virus type 2 (HSV-2) is a viral infection with high prevalence in Sudan, particularly among pregnant women. The aim of this study was to determine the seroprevalence of HSV-2 among pregnant women as well as their associated potential risk factors in Wad Madani-Sudan. Methods: In total, 92 pregnant women who attended the Maternity Hospital and Dr. Altigani Sedeeg Fertility Center at Wad Madani, AL-Gezira State, between April and August 2018 were included in this study. HSV-2 Immunoglobulins (IgG and IgM) were assayed by the enzyme-linked immunosorbent assay technique. Results: The seroprevalence of HSV-2 IgM and IgG were 35(38%) and 90(97.8%), respectively. A Higher prevalence of HSV-2 IgG 45(48.9%) and 13(14.1%) for IgM was detected in pregnant women aged 15-24 years old with a significant association between HSV-2 IgM and age distribution group (p-value=0.001). HSV-2 IgM and IgG seropositivity were highest in the first trimester; 26(34.2%), and 75(81.5%), respectively. The highest rate of HSV-2 IgM was detected in 19 (20.7%) women with a history of abortion, while the highest rate of HSV-2 IgG was seen in 50 (54.3%) women without a history of abortion. The statistical analysis results did not reveal significant differences between gestational stages and history of abortion with the presence of HSV-2 antibodies. Conclusion: The prevalence of HSV-2 was significant among pregnant women in Wad Madani- Sudan. There was a strong association between HSV-2 IgM seropositivity and the age of pregnant women.
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ZIKV replication is differential in explants and cells of human placental which is suppressed by HSV-2 coinfection. Virology 2022; 570:45-56. [DOI: 10.1016/j.virol.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 02/25/2022] [Accepted: 03/17/2022] [Indexed: 11/19/2022]
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The Effect of HSV-1 Seropositivity on the Course of Pregnancy, Childbirth and the Condition of Newborns. Microorganisms 2022; 10:microorganisms10010176. [PMID: 35056624 PMCID: PMC8781575 DOI: 10.3390/microorganisms10010176] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/07/2022] [Accepted: 01/10/2022] [Indexed: 12/22/2022] Open
Abstract
The goal of this research was to evaluate seropositivity to HSV-1 among pregnant women and its effect on the course of pregnancy, childbirth and the condition of newborns. Methods: The serological status, socio-demographic characteristics, parity of pregnancy and childbirth and condition of newborns in women seronegative and seropositive to HSV-1 with recurrent infection and its latent course during pregnancy were analyzed. Newborns from these mothers made up the corresponding groups. Results: Low titers of IgG antibodies to HSV-1 in women in the first trimester of pregnancy are associated with threatened miscarriage, anemia in pregnancy and chronic placental insufficiency. High titers of IgG antibodies to HSV-1 in women in the second trimester of pregnancy are associated with late miscarriages and premature births, anemia in pregnancy, chronic placental insufficiency, labor anomalies, early neonatal complications (cerebral ischemia, respiratory distress syndrome) and localized skin rashes. Low titers of IgG antibodies to HSV-1 in women in the third trimester of pregnancy are associated with premature birth, anemia in pregnancy, chronic placental insufficiency, endometritis, complications of the early neonatal period and localized skin rashes. Conclusions: Our research showed that low or high titers of IgG antibodies to HSV-1, determined by the timing of recurrence of infection during pregnancy, are associated with a high incidence of somatic pathology and complications in pregnancy, childbirth and the neonatal period.
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Yadav S, Commiskey P, Kowalski RP, Jhanji V. Herpes Simplex Virus 2 Blepharokeratoconjunctivitis. Curr Eye Res 2021; 47:361-364. [PMID: 34802349 DOI: 10.1080/02713683.2021.2009518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To retrospectively review the clinical characteristics of patients with herpes simplex virus type 2 (HSV-2) blepharokeratoconjunctivitis. METHODS Laboratory-proven HSV-2 blepharokeratoconjunctivitis cases were reviewed between 1995 and 2021. RESULTS Ten of 725 (1.4%) patients had HSV-2 infection. Data were available for nine patients. Associated conditions included neonatal herpes (1/9, 11%), severe atopy (1/9, 11%), genital herpes (2/9, 22%), and systemic immune disorders (2/9, 22%). The most common presenting finding was pain and blurred vision (55.5%). Two patients (22%) had dendritic lesions and one patient (11%) had reduced corneal sensation. Complete resolution was reported in four patients (44.5%). Recurrence was noted in four patients (44.5%) despite antiviral prophylaxis. Corneal complications included scarring and neovascularization. The visual acuity at the last follow-up was 20/40 or worse in four patients (44.5%). CONCLUSIONS HSV-2 is an uncommon cause of keratitis. Dendrites and loss of corneal sensation were uncommon. Recurrence was noted despite antiviral prophylaxis.
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Affiliation(s)
- Sanya Yadav
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Patrick Commiskey
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.,The Charles T Campbell Ophthalmic Microbiology Laboratory, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Regis P Kowalski
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.,The Charles T Campbell Ophthalmic Microbiology Laboratory, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Vishal Jhanji
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.,The Charles T Campbell Ophthalmic Microbiology Laboratory, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
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Sexually Transmitted Infections in Pregnancy, Screening and Treatment. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2021. [DOI: 10.1007/s13669-021-00318-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Top 10 Pearls for the Recognition, Evaluation, and Management of Maternal Sepsis. Obstet Gynecol 2021; 138:289-304. [PMID: 34237760 PMCID: PMC8288480 DOI: 10.1097/aog.0000000000004471] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/23/2021] [Indexed: 12/13/2022]
Abstract
Maternal sepsis is a leading cause of preventable maternal mortality that requires early recognition, expedient evaluation, and appropriate management. Maternal sepsis is an obstetric emergency and a leading cause of maternal morbidity and mortality. Early recognition in a pregnant or postpartum patient can be a challenge as the normal physiologic changes of pregnancy may mask the signs and symptoms of sepsis. Bedside assessment tools may aid in the detection of maternal sepsis. Timely and targeted antibiotic therapy and fluid resuscitation are critical for survival in patients with suspected sepsis. Once diagnosed, a search for etiologies and early application of source control measures will further reduce harms. If the patient is in septic shock or not responding to initial treatment, multidisciplinary consultation and escalation of care is necessary. Health care professionals should be aware of the unique complications of sepsis in critically ill pregnant and postpartum patients, and measures to prevent poor outcomes in this population. Adverse pregnancy outcomes may occur in association with sepsis, and should be anticipated and prevented when possible, or managed appropriately when they occur. Using a standardized approach to the patient with suspected sepsis may reduce maternal morbidity and mortality.
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Auriti C, De Rose DU, Santisi A, Martini L, Piersigilli F, Bersani I, Ronchetti MP, Caforio L. Pregnancy and viral infections: Mechanisms of fetal damage, diagnosis and prevention of neonatal adverse outcomes from cytomegalovirus to SARS-CoV-2 and Zika virus. Biochim Biophys Acta Mol Basis Dis 2021; 1867:166198. [PMID: 34118406 PMCID: PMC8883330 DOI: 10.1016/j.bbadis.2021.166198] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 05/07/2021] [Accepted: 06/03/2021] [Indexed: 02/07/2023]
Abstract
Some maternal infections, contracted before or during pregnancy, can be transmitted to the fetus, during gestation (congenital infection), during labor and childbirth (perinatal infection) and through breastfeeding (postnatal infection). The agents responsible for these infections can be viruses, bacteria, protozoa, fungi. Among the viruses most frequently responsible for congenital infections are Cytomegalovirus (CMV), Herpes simplex 1–2, Herpes virus 6, Varicella zoster. Moreover Hepatitis B and C virus, HIV, Parvovirus B19 and non-polio Enteroviruses when contracted during pregnancy may involve the fetus or newborn at birth. Recently, new viruses have emerged, SARS-Cov-2 and Zika virus, of which we do not yet fully know the characteristics and pathogenic power when contracted during pregnancy. Viral infections in pregnancy can damage the fetus (spontaneous abortion, fetal death, intrauterine growth retardation) or the newborn (congenital anomalies, organ diseases with sequelae of different severity). Some risk factors specifically influence the incidence of transmission to the fetus: the timing of the infection in pregnancy, the order of the infection, primary or reinfection or chronic, the duration of membrane rupture, type of delivery, socio-economic conditions and breastfeeding. Frequently infected neonates, symptomatic at birth, have worse outcomes than asymptomatic. Many asymptomatic babies develop long term neurosensory outcomes. The way in which the virus interacts with the maternal immune system, the maternal-fetal interface and the placenta explain these results and also the differences that are observed from time to time in the fetal‑neonatal outcomes of maternal infections. The maternal immune system undergoes functional adaptation during pregnancy, once thought as physiological immunosuppression. This adaptation, crucial for generating a balance between maternal immunity and fetus, is necessary to promote and support the pregnancy itself and the growth of the fetus. When this adaptation is upset by the viral infection, the balance is broken, and the infection can spread and lead to the adverse outcomes previously described. In this review we will describe the main viral harmful infections in pregnancy and the potential mechanisms of the damages on the fetus and newborn.
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Affiliation(s)
- Cinzia Auriti
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant - "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy.
| | - Domenico Umberto De Rose
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant - "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy.
| | - Alessandra Santisi
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant - "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy.
| | - Ludovica Martini
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant - "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy.
| | - Fiammetta Piersigilli
- Department of Neonatology, St-Luc University Hospital, Catholic University of Louvain, Brussels, Belgium.
| | - Iliana Bersani
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant - "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy.
| | - Maria Paola Ronchetti
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant - "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy.
| | - Leonardo Caforio
- Fetal and Perinatal Medicine and Surgery Unit, Medical and Surgical Department of Fetus, Newborn and Infant - "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy.
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Is the ZIKV Congenital Syndrome and Microcephaly Due to Syndemism with Latent Virus Coinfection? Viruses 2021; 13:v13040669. [PMID: 33924398 PMCID: PMC8069280 DOI: 10.3390/v13040669] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/02/2021] [Accepted: 04/10/2021] [Indexed: 01/04/2023] Open
Abstract
The emergence of the Zika virus (ZIKV) mirrors its evolutionary nature and, thus, its ability to grow in diversity or complexity (i.e., related to genome, host response, environment changes, tropism, and pathogenicity), leading to it recently joining the circle of closed congenital pathogens. The causal relation of ZIKV to microcephaly is still a much-debated issue. The identification of outbreak foci being in certain endemic urban areas characterized by a high-density population emphasizes that mixed infections might spearhead the recent appearance of a wide range of diseases that were initially attributed to ZIKV. Globally, such coinfections may have both positive and negative effects on viral replication, tropism, host response, and the viral genome. In other words, the possibility of coinfection may necessitate revisiting what is considered to be known regarding the pathogenesis and epidemiology of ZIKV diseases. ZIKV viral coinfections are already being reported with other arboviruses (e.g., chikungunya virus (CHIKV) and dengue virus (DENV)) as well as congenital pathogens (e.g., human immunodeficiency virus (HIV) and cytomegalovirus (HCMV)). However, descriptions of human latent viruses and their impacts on ZIKV disease outcomes in hosts are currently lacking. This review proposes to select some interesting human latent viruses (i.e., herpes simplex virus 2 (HSV-2), Epstein-Barr virus (EBV), human herpesvirus 6 (HHV-6), human parvovirus B19 (B19V), and human papillomavirus (HPV)), whose virological features and co-exposition with ZIKV may provide evidence of the syndemism process, shedding some light on the emergence of the ZIKV-induced global congenital syndrome in South America.
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15
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Disseminated herpes simplex virus 2 as a complication of pregnancy. IDCases 2021; 24:e01107. [PMID: 33889496 PMCID: PMC8047449 DOI: 10.1016/j.idcr.2021.e01107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/29/2021] [Accepted: 03/29/2021] [Indexed: 11/20/2022] Open
Abstract
Disseminated herpes simplex virus 2 (HSV-2) infection, is a rare but devastating infection in pregnancy women. We present the case of a 30-year-old gravida 3, para 2-0-0-2, at 26 weeks 2 days gestation who presented with eleven days of vague and indolent symptoms before a diagnosis of disseminated HSV-2 infection with associated hepatitis was made. While the patient clinically improved with empiric acyclovir treatment, possibility of significant harm to the fetus remained, and the patient request elective termination. The authors review the epidemiology, diagnosis, treatment, and prognosis of disseminated HSV-2 infection in pregnancy.
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16
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Qiao H, Guo M, Shang J, Zhao W, Wang Z, Liu N, Li B, Zhou Y, Wu Y, Chen P. Herpes simplex virus type 1 infection leads to neurodevelopmental disorder-associated neuropathological changes. PLoS Pathog 2020; 16:e1008899. [PMID: 33091073 PMCID: PMC7580908 DOI: 10.1371/journal.ppat.1008899] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/17/2020] [Indexed: 01/01/2023] Open
Abstract
Neonatal herpes simplex virus type 1 (HSV-1) infections contribute to various neurodevelopmental disabilities and the subsequent long-term neurological sequelae into the adulthood. However, further understanding of fetal brain development and the potential neuropathological effects of the HSV-1 infection are hampered by the limitations of existing neurodevelopmental models due to the dramatic differences between humans and other mammalians. Here we generated in vitro neurodevelopmental disorder models including human induced pluripotent stem cell (hiPSC)-based monolayer neuronal differentiation, three-dimensional (3D) neuroepithelial bud, and 3D cerebral organoid to study fetal brain development and the potential neuropathological effects induced by the HSV-1 infections. Our results revealed that the HSV-1-infected neural stem cells (NSCs) exhibited impaired neural differentiation. HSV-1 infection led to dysregulated neurogenesis in the fetal neurodevelopment. The HSV-1-infected brain organoids modelled the pathological features of the neurodevelopmental disorders in the human fetal brain, including the impaired neuronal differentiation, and the dysregulated cortical layer and brain regionalization. Furthermore, the 3D cerebral organoid model showed that HSV-1 infection promoted the abnormal microglial activation, accompanied by the induction of inflammatory factors, such as TNF-α, IL-6, IL-10, and IL-4. Overall, our in vitro neurodevelopmental disorder models reconstituted the neuropathological features associated with HSV-1 infection in human fetal brain development, providing the causal relationships that link HSV biology with the neurodevelopmental disorder pathogen hypothesis. HSV-1 is one of the most prevalent human pathogens that can spread into the fetal central nervous system by maternal-fetal transmission, and thus resulting in long-term neurological sequelae in adult, including cognitive dysfunction and learning disabilities. However, there is a very limited progress in understanding the role of HSV-1 on human fetal brain development due to limited access to fetal human brain tissue as well as the limitations of existing neurodevelopmental and infection models. Here, we generated the in vitro neurodevelopmental disorder models including hiPSC-based monolayer neuronal differentiation, three-dimensional (3D) neuroepithelial bud, and 3D cerebral organoid to study the neurodevelopmental disorder-associated neuropathological changes with HSV-1 infection in human fetal brain development. Our results revealed that HSV-1 infection led to impaired neural differentiation and dysregulated neurogenesis in the fetal neurodevelopment. Additionally, HSV-1 infection impaired neuronal differentiation and dysregulated brain regionalization in our cerebral organoid model. Furthermore, the cerebral organoid model showed that HSV-1 infection led to the abnormal microglial proliferation and activation, accompanied by the induction of inflammatory factors including TNF-α, IL-6, IL-10, and IL-4. Taken together, our study provides novel evidence that HSV-1 infection impaired human brain development and contributed to neurodevelopmental disorder pathogen hypothesis, and would have implications for raising the therapeutic opportunities for targeting of viral reservoirs relevant to neurodevelopmental disorder.
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Affiliation(s)
- Haowen Qiao
- Department of Biomedical Engineering, Wuhan University School of Basic Medical Sciences, Wuhan, Hubei, China
- Hubei Province Key Laboratory of Allergy and Immunology, Wuhan, Hubei, China
| | - Moujian Guo
- State Key Laboratory of Virology, Wuhan University, Wuhan, Hubei, China
- Institute of Medical Virology, Wuhan University School of Basic Medical Sciences, Wuhan, Hubei, China
| | - Jia Shang
- Department of Biomedical Engineering, Wuhan University School of Basic Medical Sciences, Wuhan, Hubei, China
| | - Wen Zhao
- Department of Biomedical Engineering, Wuhan University School of Basic Medical Sciences, Wuhan, Hubei, China
| | - Zhenyan Wang
- Department of Biomedical Engineering, Wuhan University School of Basic Medical Sciences, Wuhan, Hubei, China
| | - Nian Liu
- Department of Biomedical Engineering, Wuhan University School of Basic Medical Sciences, Wuhan, Hubei, China
| | - Bin Li
- Department of Biomedical Engineering, Wuhan University School of Basic Medical Sciences, Wuhan, Hubei, China
| | - Ying Zhou
- Research Center for Medicine and Structural Biology of Wuhan University, Wuhan University, Wuhan, Hubei, China
| | - Ying Wu
- Hubei Province Key Laboratory of Allergy and Immunology, Wuhan, Hubei, China
- State Key Laboratory of Virology, Wuhan University, Wuhan, Hubei, China
- Institute of Medical Virology, Wuhan University School of Basic Medical Sciences, Wuhan, Hubei, China
- * E-mail: (YW); (PC)
| | - Pu Chen
- Department of Biomedical Engineering, Wuhan University School of Basic Medical Sciences, Wuhan, Hubei, China
- Hubei Province Key Laboratory of Allergy and Immunology, Wuhan, Hubei, China
- State Key Laboratory of Virology, Wuhan University, Wuhan, Hubei, China
- * E-mail: (YW); (PC)
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17
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Herpes in the Heart: A Case of Widely Disseminated Intrauterine Herpes Simplex Virus Infection Involving Neonatal Myocardium in a 23-Week Gestationally Aged Neonate. Case Rep Infect Dis 2020; 2020:1305915. [PMID: 32908733 PMCID: PMC7474776 DOI: 10.1155/2020/1305915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 07/14/2020] [Accepted: 08/10/2020] [Indexed: 11/17/2022] Open
Abstract
We report a rare case of disseminated herpes simplex virus (HSV) infection in an extremely preterm neonate. Herpes Simplex Virus-2 (HSV-2) is the leading cause of genital ulcer disease in adults and is the most common cause of neonatal herpes, a rare infection associated with long-term neurologic impairment and high mortality. HSV-2 can be transmitted perinatally via direct mucosal or skin contact. Most neonates are infected intrapartum. However, intrauterine transmission does occur, though rarely. The pattern of dissemination described in our patient differs from previous case reports. Most reports indicate that intrauterine HSV infections have a typical triad of cutaneous manifestations, ophthalmologic findings, and neurologic involvement. However, we report the first case of intrauterine disseminated HSV infection in the heart.
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Dinkar A, Singh J. Seroprevalence of Toxoplasma, Rubella, CMV and HSV infection at a teaching hospital: A 7 year study from North India. J Family Med Prim Care 2020; 9:2253-2257. [PMID: 32754483 PMCID: PMC7380779 DOI: 10.4103/jfmpc.jfmpc_176_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/13/2020] [Accepted: 03/26/2020] [Indexed: 11/13/2022] Open
Abstract
Objectives: The present study was aimed to find seroprevalence in different age group population to explore the burden of TORCH (toxoplasma, rubella virus, cytomegalovirus [(CMV] and herpes simplex virus [HSV]) infection in the North Indian Population. Materials and Methods: It is a retrospective study carried out in the Microbiology Department, Institute of Medical Science, Banaras Hindu University (IMS, BHU), a tertiary care centre of North India. The blood samples of the suspected population of either sex or age group from different departments were analysed over a period of 7 years. The samples were tested for TORCH infections by the IgM ELISA kit following the manufactures instruction. Results: Out of total 4044 samples, 1353 (33.46%) cases were seropositive with maximum cases from the obstetrics and gynaecology department 39.46%. The highest seropositivity of TORCH (43.15%) was in the age group 15–25 years followed by 36.33% in the age group 25–35 years. This study revealed an overall male and female ratio of the total positive cases as 0.12 while it was 2.2 for pediatric cases (0–15 years). The overall seroprevalence was contributed as toxoplasma 1.38%, rubella 1.14%, CMV 13.63% and herpes 17.43%. The overall seropositivity (IgM) contributed as toxoplasma gondii with 4%, rubella with 3%, cytomegalovirus with 41% and herpes simplex virus with 52%. The coinfection of HSV with CMV was most abundant with 246 cases. Conclusions: The seropositivity of toxoplasma and rubella were comparatively more in infants while CMV and herpes were more prevalent in adults. Though, the incidence of TORCH has reduced over the past few years. Furthermore, knowing the epidemiology is an important aspect to develop strategies and appropriate implementation for the prevention of infection.
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Affiliation(s)
- Anju Dinkar
- Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Jitendra Singh
- Department of Medicine, Narayana Medical College, Sasaram, Bihar, India
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19
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Banerjee A, Kulkarni S, Mukherjee A. Herpes Simplex Virus: The Hostile Guest That Takes Over Your Home. Front Microbiol 2020; 11:733. [PMID: 32457704 PMCID: PMC7221137 DOI: 10.3389/fmicb.2020.00733] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 03/30/2020] [Indexed: 12/15/2022] Open
Abstract
Alpha (α)-herpesviruses (HSV-1 and HSV-2), like other viruses, are obligate intracellular parasites. They hijack the cellular machinery to survive and replicate through evading the defensive responses by the host. The viral genome of herpes simplex viruses (HSVs) contains viral genes, the products of which are destined to exploit the host apparatus for their own existence. Cellular modulations begin from the entry point itself. The two main gateways that the virus has to penetrate are the cell membrane and the nuclear membrane. Changes in the cell membrane are triggered when the glycoproteins of HSV interact with the surface receptors of the host cell, and from here, the components of the cytoskeleton take over. The rearrangement in the cytoskeleton components help the virus to enter as well as transport to the nucleus and back to the cell membrane to spread out to the other cells. The entire carriage process is also mediated by the motor proteins of the kinesin and dynein superfamily and is directed by the viral tegument proteins. Also, the virus captures the cell’s most efficient cargo carrying system, the endoplasmic reticulum (ER)–Golgi vesicular transport machinery for egress to the cell membrane. For these reasons, the host cell has its own checkpoints where the normal functions are halted once a danger is sensed. However, a cell may be prepared for the adversities from an invading virus, and it is simply commendable that the virus has the antidote to these cellular strategies as well. The HSV viral proteins are capable of limiting the use of the transcriptional and translational tools for the cell itself, so that its own transcription and translation pathways remain unhindered. HSV prefers to constrain any self-destruction process of the cell—be it autophagy in the lysosome or apoptosis by the mitochondria, so that it can continue to parasitize the cell for its own survival. This review gives a detailed account of the significance of compartmentalization during HSV pathogenesis. It also highlights the undiscovered areas in the HSV cell biology research which demand attention for devising improved therapeutics against the infection.
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Affiliation(s)
- Anwesha Banerjee
- Division of Virology, Indian Council of Medical Research-National AIDS Research Institute, Pune, India
| | - Smita Kulkarni
- Division of Virology, Indian Council of Medical Research-National AIDS Research Institute, Pune, India
| | - Anupam Mukherjee
- Division of Virology, Indian Council of Medical Research-National AIDS Research Institute, Pune, India
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20
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New Diagnostic Approaches to Viral Sexually Transmitted Infections. Sex Transm Infect 2020. [DOI: 10.1007/978-3-030-02200-6_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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21
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Lee JK, Oh SJ, Park H, Shin OS. Recent Updates on Research Models and Tools to Study Virus-Host Interactions at the Placenta. Viruses 2019; 12:E5. [PMID: 31861492 PMCID: PMC7020004 DOI: 10.3390/v12010005] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 12/16/2019] [Accepted: 12/16/2019] [Indexed: 12/11/2022] Open
Abstract
The placenta is a unique mixed organ, composed of both maternal and fetal tissues, that is formed only during pregnancy and serves as the key physiological and immunological barrier preventing maternal-fetal transmission of pathogens. Several viruses can circumvent this physical barrier and enter the fetal compartment, resulting in miscarriage, preterm birth, and birth defects, including microcephaly. The mechanisms underlying viral strategies to evade the protective role of placenta are poorly understood. Here, we reviewed the role of trophoblasts and Hofbauer cells in the placenta and have highlighted characteristics of vertical and perinatal infections caused by a wide range of viruses. Moreover, we explored current progress and future opportunities in cellular targets, pathogenesis, and underlying biological mechanisms of congenital viral infections, as well as novel research models and tools to study the placenta.
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Affiliation(s)
- Jae Kyung Lee
- Department of Biomedical Sciences, College of Medicine, Korea University Guro Hospital, Seoul 08308 Korea; (J.K.L.); (S.-J.O.)
| | - Soo-Jin Oh
- Department of Biomedical Sciences, College of Medicine, Korea University Guro Hospital, Seoul 08308 Korea; (J.K.L.); (S.-J.O.)
| | - Hosun Park
- Department of Microbiology, College of Medicine, Yeungnam University, 170 Hyeonchung-ro, Namgu, Daegu 42415, Korea
| | - Ok Sarah Shin
- Department of Biomedical Sciences, College of Medicine, Korea University Guro Hospital, Seoul 08308 Korea; (J.K.L.); (S.-J.O.)
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22
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Dhull D, Sharma V, Sharma Y, Kaushik S. Applicability of molecular assays for detection and typing of herpes simplex viruses in encephalitis cases. Virusdisease 2019; 30:504-510. [PMID: 31897415 DOI: 10.1007/s13337-019-00558-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 11/23/2019] [Indexed: 11/28/2022] Open
Abstract
Herpes simplex viruses (HSVs) cause a latent infection in humans which is mainly associated with characteristic cold sores or fever blisters and genital blisters. Large segments of the world population are suffering from the HSV infection and early diagnosis as well as treatments are needed to avoid further complications. HSV surveillance is very sparse, especially from developing countries including India. The aim of the present study is to develop and evaluate molecular assays for rapid detection and typing of HSV. In the present study, viral DNA was extracted from cerebro-spinal fluid from HSV suspected encephalitis patients. The conventional multiplex PCR for HSV-1 and HSV-2 was optimized and their comparative analysis was done with Real-Time qPCR for detection and typing of HSV. Out of 137 clinical samples, eleven samples (8.03%) were diagnosed as HSV positive by Real-Time qPCR while ten (7.3%) by conventional multiplex PCR which were further typed as subtyping HSV-1 (nine) and HSV-2 (two). Real-Time qPCR is highly sensitive and able to detect 9.4 × 101 to 3.1 × 106 copies/ml of HSV DNA. Conventional PCR was found to be having 99.21% specificity with 100% sensitivity. The positive predictive value was 90.91% whereas negative predictive value was 100%. Logistic regression indicates blisters with pain and skin rash as the most significant symptoms associated with HSV infection. The present study could be applied for rapid, specific, sensitive and cost-effective diagnosis of HSV-1 and HSV-2 thereby helpful in better patient management through early detection and treatment of HSV.
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Affiliation(s)
- Divya Dhull
- Centre for Biotechnology, Maharshi Dayanand University, Rohtak, Haryana 124001 India
| | - Vikrant Sharma
- Centre for Biotechnology, Maharshi Dayanand University, Rohtak, Haryana 124001 India
| | - Yashika Sharma
- Centre for Biotechnology, Maharshi Dayanand University, Rohtak, Haryana 124001 India
| | - Samander Kaushik
- Centre for Biotechnology, Maharshi Dayanand University, Rohtak, Haryana 124001 India
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23
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Joyce J, Embree J, Pymar H, Poliquin V. Should Caesarian Section Be Offered to Women With Recurrent Genital Herpes Simplex Lesions After >4 Hours of Ruptured Membranes? JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2019; 40:1054-1056. [PMID: 30103879 DOI: 10.1016/j.jogc.2018.01.001] [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: 09/03/2017] [Accepted: 01/02/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Neonatal herpes simplex virus (HSV) infection and its implications have been well defined. Several methods are recommended to mitigate the risk of maternal transmission of HSV to the neonate, including CS, suppressive antiviral therapy for the mother, and prophylaxis for the infant. The utility of CS in women who present with a duration of rupture of membranes greater than 4 hours remains a question. CASE We present a case of a woman who presented following 10 hours of rupture of membranes with HSV genital lesions, suspected to be the result of untreated recurrent infection. A CS was done. CONCLUSION Extensive studies for the presence of HSV by PCR of the placenta and infant failed to detect the virus.
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Affiliation(s)
- Joanna Joyce
- Adult Infectious Diseases Fellowship Program, University of Manitoba, Winnipeg, MB.
| | - J Embree
- Department of Pediatrics and Child Health; Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB
| | - H Pymar
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg, MB
| | - V Poliquin
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg, MB
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24
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Qi W, Luo JY, Li ZL, Zhang QJ, Liu ZD, Liao QP, Han Q, Yan JY. Clinical analysis of eight cases of fetal intracranial hemorrhage in pregnancy. J Matern Fetal Neonatal Med 2019; 34:2609-2615. [PMID: 31588836 DOI: 10.1080/14767058.2019.1670791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To explore the clinical characteristics, treatment and prognosis of fetal intracranial hemorrhage in pregnancy and to improve the level of diagnosis and treatment. METHODS We retrospectively analyzed the clinical data of eight cases of fetal intracranial hemorrhage in our hospital from 2014 to 2017, including the clinical manifestations, etiology, imaging features, treatment and prognosis. RESULTS All the cases were diagnosed by prenatal color ultrasound or magnetic resonance imaging (MRI); one of the cases had decreased fetal movements and abnormal fetal heart rate monitoring, and the remaining seven cases had no special clinical symptoms. No clear cause was found in all the cases. Two patients with grade I fetal intracranial hemorrhage and 1 patient with grade II had a cesarean delivery, and no neurological sequelae were found in these neonates after 6 months of follow-up. There was one patient with grade III and four patients with grade IV fetal intracranial hemorrhage; one of the patients with grade IV was stillborn at the time of the discovery, and cesarean section was selected due to scarring of the uterus; intra-amniotic injection of ethacridine lactate was selected to induce labor in three cases, and vaginal delivery was selected; one of the patients with grade IV chose vaginal delivery, and the neonatal cranial brain magnetic resonance imaging after delivery showed no increase in intracranial lesions but showed incomplete development of the remaining nervous system. CONCLUSION Fetal intracranial hemorrhage can be diagnosed by prenatal color ultrasound and MRI, yet it is often impossible to determine the cause. The prognosis of fetal intracranial hemorrhage is related to grade, and the prognosis of cerebral hemorrhage in patients with grades III-IV is poor.
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Affiliation(s)
- Wei Qi
- Obstetrics and Gynecology Department, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou City, China
| | - Jin-Ying Luo
- Obstetrics and Gynecology Department, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou City, China
| | - Ze-Long Li
- Obstetrics and Gynecology Department, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou City, China
| | - Qin-Jian Zhang
- Obstetrics and Gynecology Department, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou City, China
| | - Zhao-Dong Liu
- Obstetrics and Gynecology Department, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou City, China
| | - Qiu-Ping Liao
- Obstetrics and Gynecology Department, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou City, China
| | - Qing Han
- Obstetrics and Gynecology Department, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou City, China
| | - Jian-Ying Yan
- Obstetrics and Gynecology Department, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou City, China
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25
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Wang Y, Li S, Ma N, Zhang Q, Wang H, Cui J, Wang S. The association of ToRCH infection and congenital malformations: A prospective study in China. Eur J Obstet Gynecol Reprod Biol 2019; 240:336-340. [PMID: 31382146 DOI: 10.1016/j.ejogrb.2019.04.042] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 04/11/2019] [Accepted: 04/29/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE ToRCH infections (toxoplasmosis, rubella, cytomegalovirus and Herpes simplex virus) have long been known to be associated with bad obstetric outcomes. Little information is available about the impact of ToRCH infection on reproduction in china nearly for ten years. We designed a prospective study among 1863 pregnant women to investigate the association of ToRCH infection and congenital malformations. STUDY DESIGN All participants had set up a maternal health Handbook and were managed through the maternal and child health care system. They underwent regular pregnancy check-up, including physical measurements (weight, abdominal circumference and blood pressure), laboratory examinations (blood, urine) and ultrasound scan. ToRCH IgM antibodies were tested by chemiluminescence immunoassay. RESULTS 102 participants were infected with ToRCH and the total infection rate was 6.06% (102/1683). CMV infection rate (3.15%, 53/1683) was the highest. The positive rate of ToRCH IgM antibodies increased significantly in participant with upper respiratory tract infection (14.6%, 32/219) or with adverse pregnancy history (4.8%, 70/1464). Among 85 ToRCH infected participants, adverse pregnancy outcome were observed in 57 cases which included abortions (31.8%, 27/85), premature births (8.2%, 7/85), congenital malformations (12.9%, 11/85), and stillbirths (9.4%, 8/85). Furthermore, congenital malformations was much higher than that in those without ToRCH infection (1.1%, 17/1598) (P<0.001). CONCLUSION ToRCH infection was a significant risk factor of severe damage to the fetus, especially congenital malformations. ToRCH screening for pregnant women can reduce the incidence of adverse pregnancy and prevent birth defects in china.
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Affiliation(s)
- Yuanyuan Wang
- Department of Gynaecology and Obstetrics, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453000, China
| | - Shaoping Li
- Department of Gynaecology and Obstetrics, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453000, China
| | - Nana Ma
- Department of Gynaecology and Obstetrics, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453000, China
| | - Quanhua Zhang
- Department of Gynaecology and Obstetrics, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453000, China
| | - Haiyan Wang
- Department of Ultrasound, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453000, China
| | - Jingjing Cui
- Department of Gynaecology and Obstetrics, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453000, China
| | - Shijin Wang
- Department of Gynaecology and Obstetrics, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453000, China.
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Arshad Z, Alturkistani A, Brindley D, Lam C, Foley K, Meinert E. Tools for the Diagnosis of Herpes Simplex Virus 1/2: Systematic Review of Studies Published Between 2012 and 2018. JMIR Public Health Surveill 2019; 5:e14216. [PMID: 31124465 PMCID: PMC6552407 DOI: 10.2196/14216] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 04/26/2019] [Accepted: 04/26/2019] [Indexed: 12/31/2022] Open
Abstract
Background Herpes simplex virus (HSV)-1 and HSV-2 are common infections affecting the global population, with HSV-1 estimated to affect 67% of the global population. HSV can have rare but severe manifestations, such as encephalitis and neonatal herpes, necessitating the use of reliable and accurate diagnostic tools for the detection of the viruses. Currently used HSV diagnostic tools require highly specialized skills and availability of a laboratory setting but may lack sensitivity. The numerous recently developed HSV diagnostic tools need to be identified and compared in a systematic way to make the best decision about which diagnostic tool to use. The diagnosis of HSV is essential for prompt treatment with antivirals. To select the best test for a patient, knowledge of the performance and limitations of each test is critical. Objective This systematic review has summarized recent studies evaluating HSV-1 and HSV-2 diagnostic tools. Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, selection criteria, data extraction, and data analysis were determined before the commencement of the study. Studies assessing the specificity/sensitivity of HSV-1 or HSV-2 diagnostic tools published between 2012 and 2018 were included. Quality assessment of included studies was performed using the quality assessment of diagnostic accuracy studies (QUADAS-2) tool. Results Searches of the PubMed database yielded 264 studies; 11 studies included 11 molecular assays, and 8 studies included 19 different serological assays for the detection of HSV-1, HSV-2, or both. A greater proportion of molecular assay–based tools are being developed by commercial entities. Studies that tested molecular assays mostly focused on cutaneous and mucosal HSV infections (n=13); 2 studies focused on ocular disease, whereas only 1 study focused on the central nervous system manifestations. The Simplexa HSV 1 & 2 Direct is currently the only Food and Drug Administration–approved device for use on cerebrospinal fluid. No tools focused on prenatal screening. We also present performance metrics of tests for benchmarking of future technology. Most of the included studies had a high risk of bias rating in half of the QUADAS-2 tool risk of bias domains. Conclusions The use of serologic tests to diagnose genital lesions is inappropriate because positive results may be due to chronic infection, whereas negative results may overlook recent infection. The incidence of acute infections is rising. As these infections present the greatest risk to fetuses, work needs to be done to prevent vertical transfer. Prenatal screening for primary infection and subsequent medical intervention will assist in lowering the rate of neonatal herpes. In conclusion, HSV diagnosis is moving away from culture-based methods to serology-based or polymerase chain reaction–based methods. Sensitive, rapid, and efficient HSV diagnostic tools should be adopted for the prevention of acute infections and neonatal herpes.
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Affiliation(s)
- Zeeshaan Arshad
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Abrar Alturkistani
- Global Digital Health Unit, Imperial College London, London, United Kingdom
| | - David Brindley
- Healthcare Translation Research Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Ching Lam
- Healthcare Translation Research Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Kimberley Foley
- Global Digital Health Unit, Imperial College London, London, United Kingdom
| | - Edward Meinert
- Healthcare Translation Research Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
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Induction of herpes simplex virus type 1 cell-to-cell spread inhibiting antibodies by a calcium phosphate nanoparticle-based vaccine. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2018; 16:138-148. [PMID: 30594660 DOI: 10.1016/j.nano.2018.12.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 11/23/2018] [Accepted: 12/10/2018] [Indexed: 11/20/2022]
Abstract
Herpes simplex viruses 1 and 2 are among the most ubiquitous human infections and persist lifelong in their host. Upon primary infection or reactivation from ganglia, the viruses spread by direct cell-cell contacts (cell-to-cell spread) and thus escape from the host immune response. We have developed a monoclonal antibody (mAb 2c), which inhibits the HSV cell-to-cell spread, thereby protecting from lethal genital infection and blindness in animal models. In the present study we have designed a nanoparticle-based vaccine to induce protective antibody responses exceeding the cell-to-cell spread inhibiting properties of mAb 2c. We used biodegradable calcium phosphate (CaP) nanoparticles coated with a synthetic peptide that represents the conformational epitope on HSV-1 gB recognized by mAb 2c. The CaP nanoparticles additionally contained a TLR-ligand CpGm and were formulated with adjuvants to facilitate the humoral immune response. This vaccine effectively protected mice from lethal HSV-1 infection by inducing cell-to-cell spread inhibiting antibodies.
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Zhang W, Wang F, Hu X, Liang J, Liu B, Guan Q, Liu S. Inhibition of colorectal cancer liver metastasis in BALB/c mice following intratumoral injection of oncolytic herpes simplex virus type 2 for the induction of specific antitumor immunity. Oncol Lett 2018; 17:815-822. [PMID: 30655834 PMCID: PMC6313052 DOI: 10.3892/ol.2018.9720] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 09/05/2018] [Indexed: 02/06/2023] Open
Abstract
Liver metastasis represents the most prominent metastasis of colorectal cancer (CRC) and is the leading cause of CRC mortality, making the early prevention of this event very important. While current CRC therapies include surgery, radiotherapy and chemotherapy, no effective treatment option for CRC liver metastasis (CRLM) exists. Furthermore, the effects of currently available metastatic CRC drugs are frequently limited by their toxicity and side effects. Oncolytic herpes simplex virus type 2 (oHSV2) selectively infects tumor cells and also induces an antitumor immune response. The present study investigated the cytopathic effects of oHSV2 on CT-26 cells in vitro and tested its inhibitory effect on CRLM. In vitro experimental data demonstrated that oHSV2 effectively inhibited the growth of CT-26 cells. In vivo study data demonstrated that treatment with oHSV2 alone slowed the growth of subcutaneous xenograft tumors without inducing weight loss and also inhibited CRLM by increasing the numbers of cluster of differentiation (CD)4+ T, CD8+ T and natural killer cells. In summary, oHSV2 shows potential as a safe and effective therapeutic agent for inhibiting the metastasis of CT-26 CRC cells to the liver.
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Affiliation(s)
- Wen Zhang
- Department of Immunology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, P.R. China
| | - Feifei Wang
- Department of Immunology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, P.R. China.,Inner Mongolia University For Nationalities, Tongliao, Inner Mongolia 028000, P.R. China
| | - Xiao Hu
- State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, P.R. China
| | - Jing Liang
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, P.R. China
| | - Binlei Liu
- Department of Immunology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, P.R. China.,Hubei Provincial Cooperative, Innovation Center of Industrial Fermentation, Hubei University of Technology, Wuhan, Hubei 30068, P.R. China
| | - Qi Guan
- Department of Hematology and Oncology, The Second Clinical Medical School of Inner Mongolia University for Nationalities, Yakeshi, Inner Mongolia 022150, P.R. China
| | - Shangmei Liu
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, P.R. China
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29
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Jabłońska A, Studzińska M, Suski P, Kalinka J, Paradowska E. Enhanced expression of IFI16 and RIG-I in human third-trimester placentas following HSV-1 infection. Clin Exp Immunol 2018; 193:255-263. [PMID: 29688572 PMCID: PMC6046492 DOI: 10.1111/cei.13143] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 04/13/2018] [Accepted: 04/20/2018] [Indexed: 12/17/2022] Open
Abstract
The innate immune response in the placenta depends on the ability of maternal immune cells and fetal trophoblast cells to detect and eliminate invading pathogens through germline-encoded pattern recognition receptors (PRRs). In the present study, we analysed the transcripts and protein expression of interferon (IFN)-inducible protein (IFI)16, melanoma differentiation-associated protein 5 (MDA5), RIG-I-like receptor (RIG-I) and Toll-like receptor (TLR)-3 in third-trimester human placentas and investigated cytokine profiles generated during herpes simplex type 1 (HSV-1) infection. Decidual and chorionic villous biopsies (38-42 weeks of gestation) were obtained from healthy women immediately after a caesarean section. The expression of the DDX58 (RIG-I), IFIH1 (MDA5), IFI16 and TLR3 transcripts was measured using quantitative real-time polymerase chain reaction (qRT-PCR). Extracellular cytokine and PRRs levels were then quantified by enzyme-linked immunosorbent assays (ELISAs). All examined PRRs genes, including DDX58, IFIH1, IFI16 and TLR3, were expressed constitutively at the mRNA and protein levels in the placental biopsies. The concentration of the IFI16 protein was increased in HSV-1-infected decidual and chorionic villous explants compared to those of mock-infected tissues (P = 0·029). Higher protein expression levels of RIG-I in both the maternal and fetal parts of the placenta were found (P = 0·009 and P = 0·004, respectively). In addition, increased production of IFN-β by HSV-1-infected tissues was noticed (P = 0·004 for decidua, P = 0·032 for chorionic villi). No significant differences in the IFN-α, interleukin (IL)-6 and IL-8 levels were found. These results showed that HSV-1 infection can enhance the expression of IFI16 and RIG-I proteins in the human term placenta.
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Affiliation(s)
- A. Jabłońska
- Laboratory of Molecular Virology and Biological ChemistryInstitute of Medical Biology, Polish Academy of Sciences
| | - M. Studzińska
- Laboratory of Molecular Virology and Biological ChemistryInstitute of Medical Biology, Polish Academy of Sciences
| | - P. Suski
- Laboratory of Molecular Virology and Biological ChemistryInstitute of Medical Biology, Polish Academy of Sciences
| | - J. Kalinka
- Department of Perinatology, First Chair of Gynecology and ObstetricsMedical University of LodzLodzPoland
| | - E. Paradowska
- Laboratory of Molecular Virology and Biological ChemistryInstitute of Medical Biology, Polish Academy of Sciences
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Bhatta AK, Keyal U, Liu Y, Gellen E. Vertikale Übertragung des Herpes-simplex-Virus: eine Aktualisierung. J Dtsch Dermatol Ges 2018; 16:685-693. [PMID: 29873927 DOI: 10.1111/ddg.13529_g] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 11/28/2017] [Indexed: 11/28/2022]
Abstract
Infektionen mit den Herpes-simplex-Viren (HSV)-1 und -2 haben weltweit eine hohe Prävalenz. Eine HSV-Infektion während der Schwangerschaft kann eine neonatale Herpes-Infektion verursachen, die durch eine lebenslange Infektion mit Latenz- und Reaktivierungsperioden gekennzeichnet ist. Ein Säugling kann sich in utero (5 %), peripartal (85 %) oder postnatal (10 %) mit dem HS-Virus infizieren. Herpes neonatorum ist eine seltene aber bedeutsame Infektion, die mit schwerer Morbidität und Mortalität assoziiert sein kann, insbesondere bei Dissemination oder Beteiligung des zentralen Nervensystems. Fortschritte bei Diagnose und Therapie haben zur Verringerung der Mortalität sowie, in geringerem Ausmaß, zu einem verbesserten neurologischen Outcome geführt. Dennoch sind weitere Verbesserungen wünschenswert. Dabei ist es entscheidend, Ärzte in die Lage zu versetzen, diejenigen Säuglinge, die einem erhöhten Risiko einer HSV-Infektion ausgesetzt sind, zu erkennen und die Mutter-Kind-Übertragung effektiver zu verhindern. Ein lohnendes Ziel für die Zukunft ist die Entwicklung neuer antiviraler Wirkstoffe mit höherer Wirksamkeit.
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Affiliation(s)
- Anil Kumar Bhatta
- Department of Dermatopathology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Uma Keyal
- Department of Dermatopathology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yeqiang Liu
- Department of Dermatopathology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Emese Gellen
- Department of Dermatology, Faculty of Medicine University of Debrecen, Ungarn
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31
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Bhatta AK, Keyal U, Liu Y, Gellen E. Vertical transmission of herpes simplex virus: an update. J Dtsch Dermatol Ges 2018; 16:685-692. [PMID: 29762896 DOI: 10.1111/ddg.13529] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 11/28/2017] [Indexed: 11/30/2022]
Abstract
Herpes simplex virus (HSV)-1 and -2 infections are highly prevalent worldwide. HSV infection during pregnancy can result in neonatal herpes infection, which is characterized by lifelong infection with periods of latency and reactivation. HSV can be acquired by an infant during one of three periods: in utero (5 %), peripartum (85 %), or postnatal (10 %). Neonatal HSV is a rare but significant infection that may be associated with severe morbidity and mortality, especially if there is dissemination or central nervous system involvement. Diagnostic and therapeutic advances have led to a reduction in mortality and, to a lesser extent, improvement of neurodevelopmental outcomes, but further developments are still needed. It is essential to improve the clinician's ability to identify infants who are at increased risk of HSV infection and to prevent mother-to-child transmission. The development of novel antiviral agents with higher efficacy is a worthwhile aim for the future.
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Affiliation(s)
- Anil Kumar Bhatta
- Department of Dermatopathology Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Uma Keyal
- Department of Dermatopathology Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yeqiang Liu
- Department of Dermatopathology Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Emese Gellen
- Department of Dermatology Faculty of Medicine University of Debrecen, Hungary
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32
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Bauer D, Alt M, Dirks M, Buch A, Heilingloh CS, Dittmer U, Giebel B, Görgens A, Palapys V, Kasper M, Eis-Hübinger AM, Sodeik B, Heiligenhaus A, Roggendorf M, Krawczyk A. A Therapeutic Antiviral Antibody Inhibits the Anterograde Directed Neuron-to-Cell Spread of Herpes Simplex Virus and Protects against Ocular Disease. Front Microbiol 2017; 8:2115. [PMID: 29163407 PMCID: PMC5671610 DOI: 10.3389/fmicb.2017.02115] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 10/17/2017] [Indexed: 12/17/2022] Open
Abstract
Herpes simplex virus (HSV) is a leading cause of blindness and viral encephalitis in the developed world. Upon reactivation from sensory neurons, HSV returns via axonal transport to peripheral tissues where it causes, e.g., severe, potentially blinding ocular diseases. In the present study we investigated whether the HSV-1/2 glycoprotein B-specific antibody mAb 2c or its humanized counterpart mAb hu2c can protect from ocular disease in a mouse model of HSV-1-induced acute retinal necrosis (ARN). In this model the viral spread from the initially infected to the contralateral eye resembles the routes taken in humans upon HSV reactivation. Systemic antibody treatment prior or early after infection effectively protected the mice from the development of ARN. These observations suggest that the antibody potently neutralized the infection and inhibited the viral transmission, since there was almost no virus detectable in the contralateral eyes and trigeminal ganglia of antibody treated mice. Besides of neutralizing free virus or limiting the infection via activating the complement or cellular effector functions, blocking of the anterograde directed neuron-to-cell spread of HSV represents a viable mode of action how mAb 2c protected the mice from ARN. We proved this hypothesis using a microfluidic chamber system. Neurons and epithelial cells were cultured in two separate compartments where the neurons sent axons via connecting microgrooves to the epithelial cells. Neurons were infected with a reporter HSV-1 strain expressing mCherry, and the co-culture was treated with neutralizing antibodies. In contrast to commercial polyclonal human HSV-neutralizing immunoglobulins, mAb 2c effectively blocked the anterograde directed neuron-to-cell transmission of the virus. Our data suggest that the humanized HSV-1/2-gB antibody protects mice from ocular disease by blocking the neuronal spread of HSV. Therefore, mAb hu2c may become a potent novel therapeutic option for severe ocular HSV infections.
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Affiliation(s)
- Dirk Bauer
- Department of Ophthalmology, Ophtha Lab, St. Franziskus-Hospital, Münster, Germany
| | - Mira Alt
- Institute of Virology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Miriam Dirks
- Institute of Virology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Anna Buch
- Institute of Virology, Hannover Medical School, Hannover, Germany
| | | | - Ulf Dittmer
- Institute of Virology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Bernd Giebel
- Institute for Transfusion Medicine, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - André Görgens
- Institute for Transfusion Medicine, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Vivien Palapys
- Institute of Virology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Maren Kasper
- Department of Ophthalmology, Ophtha Lab, St. Franziskus-Hospital, Münster, Germany
| | | | - Beate Sodeik
- Institute of Virology, Hannover Medical School, Hannover, Germany
| | - Arnd Heiligenhaus
- Department of Ophthalmology, Ophtha Lab, St. Franziskus-Hospital, Münster, Germany.,Department of Ophthalmology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Michael Roggendorf
- Institute of Virology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Adalbert Krawczyk
- Institute of Virology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
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33
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Odak Z, Roje D, Vulić M. Disseminated genital herpes and mode of delivery. CASE REPORTS IN PERINATAL MEDICINE 2017. [DOI: 10.1515/crpm-2016-0071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Genital herpes in pregnancy is associated with increased perinatal morbidity and mortality. Maternal primary infection with herpes simplex virus (HSV) prior to labor usually does not affect the fetus (1/200,000 deliveries) The greatest risk associated with intrapartum HSV exposure is neonatal herpes infection. Neonatal risk occurs in the case of a primary or reccurent HSV infection. The risk of neonatal HSV infection in case of non-genital herpes is low. The American Congress of Obstetricians and Gynecologists (ACOG) recommends elective cesarean delivery for women with demonstrable genital herpes or prodromal symptoms in labor.
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Finger-Jardim F, Avila EC, da Hora VP, Gonçalves CV, de Martinez AMB, Soares MA. Prevalence of herpes simplex virus types 1 and 2 at maternal and fetal sides of the placenta in asymptomatic pregnant women. Am J Reprod Immunol 2017; 78. [PMID: 28440579 DOI: 10.1111/aji.12689] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 03/20/2017] [Indexed: 12/30/2022] Open
Abstract
PROBLEM Herpes simplex virus 1 (HSV-1) commonly causes orolabial infection, but can also infect the genital mucosa. In contrast, HSV-2 is usually genital. Genital herpes can transmit the virus vertically to the fetus during pregnancy. We sought to estimate the prevalence of HSV-1/2 on the maternal and fetal sides of the placenta. METHOD OF STUDY Placental tissues were collected from pregnant women seen at the Rio Grande University Hospital. HSV-1 and HSV-2 were detected by nested PCR. RESULTS The prevalence of HSV-1 and HSV-2 was, respectively, 28% and 12.6% (maternal side) and 29.9% and 8.3% (fetal side). All HSV-positive women were asymptomatic. Sexual behavior, vaginal delivery, and presence of HSVs on one side of the placenta were risk factors associated with HSV infection. CONCLUSION The occurrence of HSVs in placental tissue was high, especially for HSV-1. Novel strategies need to be implemented for the management of asymptomatic women who might transmit HSV to their newborns.
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Affiliation(s)
- Fabiana Finger-Jardim
- Molecular Biology Laboratory, School of Medicine, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Emiliana C Avila
- Molecular Biology Laboratory, School of Medicine, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Vanusa P da Hora
- Molecular Biology Laboratory, School of Medicine, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Carla V Gonçalves
- Center for Obstetrics and Gynecology, School of Medicine, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Ana Maria B de Martinez
- Molecular Biology Laboratory, School of Medicine, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Marcelo A Soares
- Oncovirology Program, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Rio de Janeiro, Brazil
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Mirchandani D, Jawed R, Khawar N, Narula P, John M. Effectiveness of Early Antiviral Therapy in Disseminated Neonatal Herpes Simplex Virus 2 (HSV-2) with Fulminant Hepatic Failure. Am J Case Rep 2017; 18:381-385. [PMID: 28392553 PMCID: PMC5395135 DOI: 10.12659/ajcr.902418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Patient: Male, 11-day-old Final Diagnosis: Disseminated neonatal herpes simplex virus-2 Symptoms: Feeding problems • lethargy • rash Medication: — Clinical Procedure: — Specialty: Pediatrics and Neonatology
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Affiliation(s)
- Divya Mirchandani
- Department of Pediatrics, New York Presbyterian Healthcare System – New York Methodist Hospital, Brooklyn, USA
| | - Rafia Jawed
- Department of Pediatrics, New York Presbyterian Healthcare System – New York Methodist Hospital, Brooklyn, USA
| | - Nayaab Khawar
- Department of Pediatrics, New York Presbyterian Healthcare System – New York Methodist Hospital, Brooklyn, USA
| | - Pramod Narula
- Department of Pediatrics, New York Presbyterian Healthcare System – New York Methodist Hospital, Brooklyn, USA
| | - Minnie John
- Department of Pediatrics, New York Presbyterian Healthcare System – New York Methodist Hospital, Brooklyn, USA
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Nakubulwa S, Kaye DK, Bwanga F, Tumwesigye NM, Nakku-Joloba E, Mirembe F. Effect of suppressive acyclovir administered to HSV-2 positive mothers from week 28 to 36 weeks of pregnancy on adverse obstetric outcomes: a double-blind randomised placebo-controlled trial. Reprod Health 2017; 14:31. [PMID: 28253893 PMCID: PMC5335854 DOI: 10.1186/s12978-017-0292-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 02/14/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Acyclovir (ACV) given to HSV-2 positive women after 36 weeks reduces adverse outcomes but its benefit at lower gestation was undocumented. We determined the effect of oral acyclovir administered from 28 to 36 weeks on premature rupture of membranes (PROM) primarily and preterm delivery risk. METHODS This was a randomized, double-blind placebo-controlled trial among 200 HSV-2 positive pregnant women at 28 weeks of gestation at Mulago Hospital, Uganda. Participants were assigned randomly (1:1) to take either acyclovir 400 mg orally twice daily (intervention) or placebo (control) from 28 to 36 weeks. Both arms received acyclovir after 36 weeks until delivery. Development of Pre-PROM by 36 weeks and preterm delivery were outcomes. RESULTS One hundred women were randomised to acyclovir and 100 to placebo arms between January 2014 and February 2015. There was tendency towards reduction of incidence of PROM at 36 weeks but this was not statistically significant (4.0% versus 10.0%; RR 0.35; 95% 0.11-1.10) in the acyclovir and placebo arms respectively. However, there was a significant reduction in the incidence of preterm delivery (11.1% versus 23.5%; RR 0.41; 95% 0.20-0.85) in the acyclovir and placebo arms respectively. CONCLUSIONS Oral acyclovir given to HSV-2 positive pregnant women from 28 to 36 weeks reduced incidence of preterm delivery but did not significantly reduce incidence of pre-PROM. TRIAL REGISTRATION www.pactr.org, PACTR201311000558197 .
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Affiliation(s)
- Sarah Nakubulwa
- Department of Obstetrics and Gynaecology, School of Medicine, Makerere University College of Health Sciences, P. O. Box 7072, Kampala, Uganda
| | - Dan K. Kaye
- Department of Obstetrics and Gynaecology, School of Medicine, Makerere University College of Health Sciences, P. O. Box 7072, Kampala, Uganda
| | - Freddie Bwanga
- Department of Microbiology, Makerere University College of Health Sciences, P.O.Box 7072, Kampala, Uganda
| | - Nazarius Mbona Tumwesigye
- School of Public Health, Makerere University College of Health Sciences, P.O.Box 7072, Kampala, Uganda
| | - Edith Nakku-Joloba
- School of Public Health, Makerere University College of Health Sciences, P.O.Box 7072, Kampala, Uganda
| | - Florence Mirembe
- Department of Obstetrics and Gynaecology, School of Medicine, Makerere University College of Health Sciences, P. O. Box 7072, Kampala, Uganda
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Arabsalmani M, Behzadifar M, Baradaranmd HR, Toghae M, Beyranvand G, Olyaeemanesh A, Behzadifar M. Is Herpes Simplex virus (HSV) a sign of Encephalitis in Iranian Newborns? Prevalence of HSV Infection in Pregnant Women in Iran: A Systematic Review and Meta-Analysis. IRANIAN JOURNAL OF CHILD NEUROLOGY 2017; 11:1-7. [PMID: 28698721 PMCID: PMC5493823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 04/04/2016] [Accepted: 04/24/2016] [Indexed: 10/30/2022]
Abstract
OBJECTIVE Herpes Simplex virus (HSV) is one of the most common sexually transmitted diseases in the world. This study aimed to determine the prevalence of herpes simplex virus in pregnant women in Iran. MATERIALS & METHODS A systematic literature review was conducted to study the HSV subtypes in Persian and English papers through several databases. We searched Pub Med, Scopus, Ovid, Science Direct and national databases as Magiran, Iranmedex and Science Information Database (SID) up to October 2015. Random-effects model were applied to calculate the pooled prevalence of HSV subtypes. RESULTS Five eligible studies were identified, including 1140 participants. The pooled prevalence of HSV infection in pregnant women was 0.64% (95% CI: 0.10- 1.18) in Iran. The pooled prevalence of studies on both HSV-1 and HSV-2 was 0.91% (CI: 0.81-1.02) and studies on only HSV-2 was 0.23% (CI: -0.61-0.63), respectively. CONCLUSION The prevalence of HSV infection in pregnant women in Iran was higher. HSV infection of the central nervous system, especially with HSV-2, can also cause recurrent aseptic meningitis and monophasic, as well as radiuculitis or myelitis. The performance of screening to detect infection in pregnant women can play an important role in the prevention and treatment of patients and help to prevent the transmission of HSV infection to infants in Iran.
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Affiliation(s)
- Masoumeh Arabsalmani
- Department of Health, Faculty of Health, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Meysam Behzadifar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
- Department of Epidemiology, Faculty of Health & Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Hamid Reza Baradaranmd
- Endocrine Research Center Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Mansoureh Toghae
- Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholam Beyranvand
- Department of Health, Faculty of Health, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Alireza Olyaeemanesh
- National Institute for Health Research,Tehran University of Medical Sciences,Tehran,Iran
| | - Masoud Behzadifar
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
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Sauerbrei A. Herpes Genitalis: Diagnosis, Treatment and Prevention. Geburtshilfe Frauenheilkd 2016; 76:1310-1317. [PMID: 28017972 DOI: 10.1055/s-0042-116494] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 08/15/2016] [Accepted: 09/01/2016] [Indexed: 01/13/2023] Open
Abstract
Herpes genitalis is caused by the herpes simplex virus type 1 or type 2 and can manifest as primary or recurrent infection. It is one of the most common sexually transmitted infections and due to associated physical and psychological morbidity it constitutes a considerable, often underestimated medical problem. In addition to providing the reader with basic knowledge of the pathogen and clinical presentation of herpes genitalis, this review article discusses important aspects of the laboratory diagnostics, antiviral therapy and prophylaxis. The article is aimed at all health-care workers managing patients with herpes genitalis and attempts to improve the often suboptimal counselling, targeted use of laboratory diagnostics, treatment and preventive measures provided to patients.
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Affiliation(s)
- A Sauerbrei
- Institut für Virologie und Antivirale Therapie, Konsiliarlabor für HSV und VZV, Universitätsklinikum Jena, Jena, Germany
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Aldo P, You Y, Szigeti K, Horvath TL, Lindenbach B, Mor G. HSV-2 enhances ZIKV infection of the placenta and induces apoptosis in first-trimester trophoblast cells. Am J Reprod Immunol 2016; 76:348-357. [PMID: 27613665 DOI: 10.1111/aji.12578] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 08/23/2016] [Indexed: 12/29/2022] Open
Abstract
PROBLEM Zika virus (ZIKV) has gained public concern for its association with microcephaly in infants born to ZIKV-infected mothers. To reach the fetus the virus must overcome the defense mechanisms provided by trophoblast cells. Additionally, in the first trimester, the integrity of the placenta is critical for fetal protection as damage to differentiating trophoblast can affect placental formation and function. We sought to investigate the effect of ZIKV infection on trophoblast cells and the factors that might increase the risk for ZIKV infection during pregnancy. METHODS First-trimester human trophoblast cells, Swan 7.1, were infected with ZIKV, herpes simplex virus-2 (HSV-2), and yellow fiver (YFV). C57BL/6 pregnant mice were infected with HSV-2, ZIKV, or coinfection. Placental viral titers were determined by RT-PCR. RESULTS ZIKV infection induces apoptosis in first-trimester trophoblasts and prevents differentiation of these cells. Furthermore, HSV-2 infection enhances placental sensitivity to ZIKV by enhancing the expression of TAM receptors, which facilitate ZIKV cell entry. CONCLUSION These findings may explain the mechanism by which ZIKV breaches the placental barrier to access the fetus. Furthermore, our results suggest that patients with HSV-2 infection are at a higher risk for the teratogenic effects induced by ZIKV.
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Affiliation(s)
- Paulomi Aldo
- Division of Reproductive Sciences, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA
| | - Yuan You
- Division of Reproductive Sciences, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA
| | - Klara Szigeti
- Department of Comparative Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Tamas L Horvath
- Division of Reproductive Sciences, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA.,Department of Comparative Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Brett Lindenbach
- Department of Microbial Pathogenesis, Yale University School of Medicine, New Haven, CT, USA
| | - Gil Mor
- Division of Reproductive Sciences, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA.
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Ramyadevi D, Rajan KS, Vedhahari BN, Ruckmani K, Subramanian N. Heterogeneous polymer composite nanoparticles loaded in situ gel for controlled release intra-vaginal therapy of genital herpes. Colloids Surf B Biointerfaces 2016; 146:260-70. [PMID: 27351137 DOI: 10.1016/j.colsurfb.2016.06.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Revised: 05/23/2016] [Accepted: 06/14/2016] [Indexed: 10/21/2022]
Abstract
Herpes simplex virus causes serious and contagious genital infections in high percentage of female population world-wide. Acyclovir is a clinically successful antiviral molecule till date, in-spite of limitations as poor solubility, low half-life, reduced oral bioavailability and side effects at higher doses. In the present work, controlled release in situ gelling system loaded with polymeric nanoparticles of acyclovir containing a dose of drug equivalent to 105mg/day has been developed. The formulation containing drug loaded polyvinyl pyrrolidone-Eudragit RSPO hybrid polymeric nanoparticles (Size ∼99±3nm, Zeta ∼+26.1±1.5mV) in 15% Pluronic F-127 gel exhibited improved permeability through vaginal membrane (KP=2.20±0.19×10(-6)cm/s). The nanoparticles showed enhanced viability for vaginal epithelial cell lines up to concentration of 100-250μg/mL. The formulation was evaluated for bioavailability and biodistribution through intra-vaginal administration in rat models. The nanoparticle in situ gel formulation maintained an average therapeutic drug level of 0.6±0.2μg/mL in plasma for 24h. Significant improvement in mean residence time of the drug (12.52±1.12h) was observed with a two-fold increase in the relative bioavailability (AUC0-24h=14.92±2.44μgh/mL) compared to that of the pure drug (7.18±1.79μgh/mL). The tissue distribution was 2-3 folds higher in animals treated with nanoparticles in situ gel compared to that of pure drug. Sustained release of drug in vivo was demonstrated, ensuring the suitability of the formulation for clinical therapy in female population.
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Affiliation(s)
- D Ramyadevi
- School of Chemical and Biotechnology (SCBT), SASTRA University, Thanjavur, 613 401 Tamil Nadu, India.
| | - K S Rajan
- School of Chemical and Biotechnology (SCBT), SASTRA University, Thanjavur, 613 401 Tamil Nadu, India.
| | - B N Vedhahari
- School of Chemical and Biotechnology (SCBT), SASTRA University, Thanjavur, 613 401 Tamil Nadu, India.
| | - K Ruckmani
- Department of Pharmaceutical Technology, Anna University, BIT Campus, Trichy, 620 024 Tamil Nadu, India.
| | - N Subramanian
- Department of Pharmaceutical Technology, Anna University, BIT Campus, Trichy, 620 024 Tamil Nadu, India.
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Abstract
As one of the most common sexually transmitted diseases, genital herpes is a global medical problem with significant physical and psychological morbidity. Genital herpes is caused by herpes simplex virus type 1 or type 2 and can manifest as primary and/or recurrent infection. This manuscript provides an overview about the fundamental knowledge on the virus, its epidemiology, and infection. Furthermore, the current possibilities of antiviral therapeutic interventions and laboratory diagnosis of genital herpes as well as the present situation and perspectives for the treatment by novel antivirals and prevention of disease by vaccination are presented. Since the medical management of patients with genital herpes simplex virus infection is often unsatisfactory, this review aims at all physicians and health professionals who are involved in the care of patients with genital herpes. The information provided would help to improve the counseling of affected patients and to optimize the diagnosis, treatment, and prevention of this particular disease.
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Affiliation(s)
- Andreas Sauerbrei
- Institute of Virology and Antiviral Therapy, German Consulting Laboratory for Herpes Simplex Virus and Varicella-Zoster Virus, Jena University Hospital, Friedrich-Schiller University of Jena, Jena, Germany
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42
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Seroprevalence of Herpes Simplex Virus Type 1 and Type 2 and Coinfection With HIV and Syphilis: The First National Seroprevalence Survey in Saudi Arabia. Sex Transm Dis 2016; 42:526-32. [PMID: 26267880 DOI: 10.1097/olq.0000000000000336] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Herpes simplex virus (HSV) infection is one of the most common viral infections worldwide. Genital herpes is associated with other sexually transmitted infections (STIs) including HIV. Data on prevalence of HSV infections and other STIs in the Kingdom of Saudi Arabia are limited. METHODS We conducted the first national seroprevalence survey to determine the prevalence and epidemiology of HSV infection among adult Saudis and coinfection with other STIs. Serology was used to detect HSV-1, HSV-2, HIV, and syphilis infections among 4985 participants recruited from across the Kingdom. RESULTS The overall prevalence of HSV-1 and HSV-2 in the enrolled population was 88.8% and 1.26%, respectively. Although not significant for HSV-2, HSV infection was more prevalent among females, those working, and those who were married (married, divorced, or widowed), especially those married at a younger age. Prevalence of both viruses was statistically significantly higher among those with low education and increased with age. Prevalence of Treponema pallidum antibodies and HIV in the sampled population was very low (0.55% and 0.06%, respectively), as was their prevalence among HSV-2-positive participants (1.6% for both). The correlation between HSV-2 infection and other STIs was significant for HIV (P < 0.0001) but not for T. pallidum antibodies (P = 0.25). CONCLUSIONS Herpes simplex virus type 1 infection is highly prevalent in Saudi Arabia and mostly acquired before adulthood. Herpes simplex virus type 2 prevalence is very low, acquired in adulthood, and increased with age. Monitoring the prevalence of HSV infection can help inform targeted strategies to prevent new infections, neonatal transmission, and the spread of other STIs in the Kingdom.
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Avila-Alvarez A, Devesa LI, Mosteiro Pereira F, Clavero Fernández E. Encefalitis por virus herpes simple durante la gestación: evolución materna y neonatal. Med Clin (Barc) 2016; 146:374-5. [DOI: 10.1016/j.medcli.2015.10.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 10/07/2015] [Accepted: 10/15/2015] [Indexed: 11/29/2022]
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44
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Zverev VV, Makarov OV, Khashukoeva AZ, Svitich OA, Dobrokhotova YE, Markova EA, Labginov PA, Khlinova SA, Shulenina EA, Gankovskaya LV. In vitro studies of the antiherpetic effect of photodynamic therapy. Lasers Med Sci 2016; 31:849-55. [PMID: 27003896 DOI: 10.1007/s10103-016-1912-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 02/10/2016] [Indexed: 11/29/2022]
Abstract
The number of viral infection cases in the Department of Gynecology and Obstetrics has tended to increase over last few years. Viruses form herpesvirus and cytomegalovirus families are associated with an increased risk for recurrent pregnancy loss. Photodynamic therapy (PDT) is a promising new approach to treat viral infections in which viral particles are inactivated. It exhibits great therapeutic potential, particularly among this group of patients. This study examined the use of PDT to treat herpesvirus infection (HVI) using an in vitro model. In this study, we used the Vero сell lineage as a suitable model of HVI, strains of HSV-1 (strain VR-3) and HSV-2 (strain MS) obtained from The National Virus Collection (London, UK), the photosensitizer Fotoditazine (Veta-Grand, Russia), an AFS physiotherapeutic device (Polironic Corporation, Russia). Laser light irradiation and the photosensitizer had different cytotoxic effects on the Vero cell cultures depending on the doses used. The optimal laser light and photosensitizer doses were determined. PDT had an antiviral effect on an in vitro model of HVI in cell culture. PDT has been shown to be effective treatment for HVI in vitro, leading to a reliable decrease of viral titer.
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Affiliation(s)
- V V Zverev
- Mechnikov Scientific Research Institute of Vaccines and Serums, Maly Kazeynny per., 5A, 105064, Moscow, Russia
| | - O V Makarov
- Department of Obstetrics and Gynecology of Medical Faculty, Pyrogov Russian National Research Medical University, Str. Ostrovityanova, 1, 117997, Moscow, Russia
| | - A Z Khashukoeva
- Department of Obstetrics and Gynecology of Medical Faculty, Pyrogov Russian National Research Medical University, Str. Ostrovityanova, 1, 117997, Moscow, Russia
| | - O A Svitich
- Mechnikov Scientific Research Institute of Vaccines and Serums, Maly Kazeynny per., 5A, 105064, Moscow, Russia
| | - Y E Dobrokhotova
- Department of Obstetrics and Gynecology of Medical Faculty, Pyrogov Russian National Research Medical University, Str. Ostrovityanova, 1, 117997, Moscow, Russia
| | - E A Markova
- Department of Obstetrics and Gynecology of Medical Faculty, Pyrogov Russian National Research Medical University, Str. Ostrovityanova, 1, 117997, Moscow, Russia.
| | - P A Labginov
- Mechnikov Scientific Research Institute of Vaccines and Serums, Maly Kazeynny per., 5A, 105064, Moscow, Russia
| | - S A Khlinova
- Department of Obstetrics and Gynecology of Medical Faculty, Pyrogov Russian National Research Medical University, Str. Ostrovityanova, 1, 117997, Moscow, Russia
| | - E A Shulenina
- Mechnikov Scientific Research Institute of Vaccines and Serums, Maly Kazeynny per., 5A, 105064, Moscow, Russia
| | - L V Gankovskaya
- Department of Immunology, Pyrogov Russian National Research Medical University, Str. Ostrovityanova, 1, 117997, Moscow, Russia
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Abstract
Throughout pregnancy, the placenta acts as a physical and immunological barrier against the hematogenous transmission of viruses from mother to fetus. Despite this, very little is known regarding the specific mechanisms by which the placenta shields the developing fetus from viral infections or about the strategies utilized by select viruses to bypass and/or weaken the placental barrier. In this review, we summarize studies regarding virus-host interactions at the placental interface and explore key areas for future investigation. We focus our review on placental trophoblasts, which form the barrier between maternal and fetal circulations and thus govern the cross talk between the maternal and fetal microenvironments.
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Affiliation(s)
- Elizabeth Delorme-Axford
- Department of Microbiology and Molecular Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania 15219;
| | - Yoel Sadovsky
- Department of Microbiology and Molecular Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania 15219; .,Magee-Womens Research Institute, Department of Obstetrics, Gynecology, and Reproductive Science, University of Pittsburgh, Pittsburgh, Pennsylvania 15219
| | - Carolyn B Coyne
- Department of Microbiology and Molecular Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania 15219; .,Magee-Womens Research Institute, Department of Obstetrics, Gynecology, and Reproductive Science, University of Pittsburgh, Pittsburgh, Pennsylvania 15219
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Infektionsschutz und spezielle Hygienemaßnahmen in klinischen Disziplinen. KRANKENHAUS- UND PRAXISHYGIENE 2016. [PMCID: PMC7152143 DOI: 10.1016/b978-3-437-22312-9.00005-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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47
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Primary Genital Herpes Simplex Virus Type I in Preterm Prelabour Rupture of Membranes at 30 Weeks' Gestation. Case Rep Obstet Gynecol 2015; 2015:198547. [PMID: 26649212 PMCID: PMC4662966 DOI: 10.1155/2015/198547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 10/26/2015] [Accepted: 11/02/2015] [Indexed: 11/17/2022] Open
Abstract
Background. Disseminated herpes simplex virus (HSV) in the neonate is associated with significant morbidity and mortality. Current guidelines recommend caesarean in third-trimester maternal primary genital HSV outbreaks to prevent transmission from mother to fetus. In the premature fetus, however, expectant management is often necessary to reduce morbidity of prematurity. The benefit of performing caesarean after 6 hrs of rupture of membranes (ROM) to reduce maternal-fetal transmission is unclear. Case. A female patient with primary genital HSV type 1 outbreak coinciding with preterm, prelabour rupture of membranes (PPROM) at 30 + 3 weeks' gestation. An immediate caesarean section was not performed after multidisciplinary team discussion due to the benefits of glucocorticoids on immune complications of prematurity. The patient had expectant management for 5 days with intravenous (IV) aciclovir and then delivered an infant vaginally with disseminated neonatal HSV. Conclusion. We address the rare presentation of primary HSV infection associated with PPROM and the dilemma of how to manage these patients given the limited literature. We discuss the role of intrauterine compartment monitoring with amniocentesis, the mode of delivery when ROM has occurred for 120 hours, expectant management to reduce prematurity, and the effectiveness of aciclovir to reduce viral shedding in the prevention of neonatal HSV.
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Demeulemeester V, Voeten M, Jacquemyn Y, Mahieu L. A rare infectious cause of severe neonatal skin lesions. BMJ Case Rep 2015; 2015:bcr-2015-209460. [PMID: 26452409 DOI: 10.1136/bcr-2015-209460] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We present a case of a preterm infant of 28 weeks' gestation with unique cutaneous lesions characteristic of a congenital herpes simplex virus (HSV) type 1 infection. The infant was prematurely delivered due to intractable labour. The mother had no history or clinical signs of genital infection before or during pregnancy. The infant's skin lesions were described as rough white-yellow plaques; a skin biopsy demonstrated calcified plaques and absent epidermis. HSV type 1 was later determined using PCR on the infant's skin biopsy and cerebral spinal fluid as well as the mother's vaginal swab and the placenta. Calcifications have already been described by Allee et al, alongside a diagnosis of HSV type 2. As is well known, the morbidity and mortality of congenital herpes infections are very high.
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Affiliation(s)
| | - Michiel Voeten
- Department of Neonatology, Antwerp University Hospital UZA, Edegem, Belgium
| | - Yves Jacquemyn
- Department of Obstetrics, Antwerp University Hospital, UZA, Edegem, Belgium
| | - Ludo Mahieu
- Department of Neonatology, Antwerp University Hospital UZA, Edegem, Belgium
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49
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Agelidis AM, Shukla D. Cell entry mechanisms of HSV: what we have learned in recent years. Future Virol 2015; 10:1145-1154. [PMID: 27066105 DOI: 10.2217/fvl.15.85] [Citation(s) in RCA: 126] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
HSV type-1 and -2 are widespread pathogens producing lifelong infection with multiple sequelae, including oral, ocular and genital disease. The process of herpesvirus entry is a highly complex process involving numerous viral and cellular factors. Entry begins with attachment of virus to the cell surface followed by interactions between viral glycoproteins and cellular receptors to facilitate capsid penetration. The nucleocapsid is then transported along microtubules to the nuclear membrane, where viral DNA is released for replication in the nucleus. The work reviewed here comprises the most recent advancements in our understanding of the mechanism involved in the herpesvirus entry process.
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Affiliation(s)
- Alex M Agelidis
- Ocular Virology Laboratory, Department of Ophthalmology & Visual Sciences, University of Illinois at Chicago, 1855 West Taylor Street, M/C 648, Chicago, IL 60612, USA; Department of Microbiology and Immunology, College of Medicine, E-704 Medical Sciences Building, University of Illinois at Chicago, M/C 790, 835 South Wolcott Avenue, Chicago, IL 60612, USA
| | - Deepak Shukla
- Ocular Virology Laboratory, Department of Ophthalmology & Visual Sciences, University of Illinois at Chicago, 1855 West Taylor Street, M/C 648, Chicago, IL 60612, USA; Department of Microbiology and Immunology, College of Medicine, E-704 Medical Sciences Building, University of Illinois at Chicago, M/C 790, 835 South Wolcott Avenue, Chicago, IL 60612, USA
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50
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Prasoona KR, Srinadh B, Sunitha T, Sujatha M, Deepika MLN, Vijaya Lakshmi B, Ramaiah A, Jyothy A. Seroprevalence and Influence of Torch Infections in High Risk Pregnant Women: A Large Study from South India. J Obstet Gynaecol India 2015; 65:301-9. [PMID: 26405399 PMCID: PMC4579149 DOI: 10.1007/s13224-014-0615-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 09/16/2014] [Indexed: 01/15/2023] Open
Abstract
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.
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Affiliation(s)
- K Rebekah Prasoona
- Institute of Genetics and Hospital for Genetic Diseases, Osmania University, Begumpet, Hyderabad, 500016 India
| | - B Srinadh
- Institute of Genetics and Hospital for Genetic Diseases, Osmania University, Begumpet, Hyderabad, 500016 India
| | - T Sunitha
- Institute of Genetics and Hospital for Genetic Diseases, Osmania University, Begumpet, Hyderabad, 500016 India
| | - M Sujatha
- Institute of Genetics and Hospital for Genetic Diseases, Osmania University, Begumpet, Hyderabad, 500016 India
| | - M L N Deepika
- Institute of Genetics and Hospital for Genetic Diseases, Osmania University, Begumpet, Hyderabad, 500016 India
| | - B Vijaya Lakshmi
- Institute of Genetics and Hospital for Genetic Diseases, Osmania University, Begumpet, Hyderabad, 500016 India
| | - Aruna Ramaiah
- Modern Government Maternity Hospital, Hyderabad, India
| | - A Jyothy
- Institute of Genetics and Hospital for Genetic Diseases, Osmania University, Begumpet, Hyderabad, 500016 India
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