Latent toxoplasmosis, Cytomegalovirus, and Herpes Simplex Virus infections and risk of motorcycle accidents: A case-control study in a county with a high rate of motorcycle injuries in Iran.

BACKGROUND: Road traffic injuries (RTIs) are among the most important issues worldwide. Several studies reported that infection with the neurotropic parasite Toxoplasma gondii (T. gondii) increased the risk of car accidents. In this study, our objective was to investigate the possible associations among latent T. gondii, Cytomegalovirus (CMV), and Herpes Simplex Virus (HSV) infections with the risk of motorcycle accidents in Jahrom (Fars Province), which is a county with a high rate of motorcycle accidents in Iran. METHODS: In the setting of a case-control study; 176 motorcyclist men, including 88 survivors of motorcycle accidents and 88 motorcyclist without accidents, were considered as case and control groups, respectively. Rates of latent infections with T. gondii, CMV, and HSV were assessed by an enzyme-linked immunosorbent assay (ELISA). RESULTS: Eleven of 88 (12.5%) in the case group and 22 of 88 (25.0%) in controls were positive for anti-T. gondii IgG antibodies, this difference was statistically significant (OR = 0.42; CI: 0.19-0.95, p = 0.03). The general seroprevalence of CMV (94.3% in the case group vs. 87.5% in the control group, OR = 2.37; CI: 0.78-7.13, p = 0.12) and HSV (63.6% in the case group vs. 62.5% in the control group, OR = 1.05; CI: 0.57-1.94, p = 0.87) were not significantly different between the case and control groups. CONCLUSIONS: Although latent toxoplasmosis has been associated with traffic accidents in recent reports, we found a negative association between latent toxoplasmosis and motorcycle accidents among survivors of these accidents. As such, latent CMV and HSV infections did not differ significantly between the cases compared to the control groups.

Pulmonary herpes simplex virus and cytomegalovirus in patients with acute respiratory distress syndrome related to COVID-19.

PURPOSE: Human herpesviruses, particularly cytomegalovirus (CMV) and herpes simplex virus (HSV), frequently reactivate in critically ill patients, including those with acute respiratory distress syndrome (ARDS) related to coronavirus disease 2019 (COVID-19). The clinical interpretation of pulmonary herpesvirus reactivation is challenging and there is ongoing debate about its association with mortality and benefit of antiviral medication. We aimed to quantify the incidence and pathogenicity of pulmonary CMV and HSV reactivations in critically ill COVID-19 patients. METHODS: Mechanically ventilated COVID-19 patients seropositive for CMV or HSV were included in this observational cohort study. Diagnostic bronchoscopy with bronchoalveolar lavage was performed routinely and analyzed for alveolar viral loads and inflammatory biomarkers. Utilizing joint modeling, we explored the dynamic association between viral load trajectories over time and mortality. We explored alveolar inflammatory biomarker dynamics between reactivated and non-reactivated patients. RESULTS: Pulmonary reactivation (> 104 copies/ml) of CMV occurred in 6% of CMV-seropositive patients (9/156), and pulmonary reactivation of HSV in 37% of HSV-seropositive patients (63/172). HSV viral load dynamics prior to or without antiviral treatment were associated with increased 90-day mortality (hazard ratio [HR] 1.24, 95% confidence interval [CI] 1.04-1.47). The alveolar concentration of several inflammatory biomarkers increased with HSV reactivation, including interleukin (IL)-6, IL-1ß, granulocyte colony stimulating factor (G-CSF), and tumor necrosis factor (TNF). CONCLUSION: In mechanically ventilated COVID-19 patients, HSV reactivations are common, while CMV reactivations were rare. HSV viral load dynamics prior to or without antiviral treatment are associated with mortality. Alveolar inflammation is elevated after HSV reactivation.

Acute cerebellitis caused by herpes simplex virus

Case presentation of acute cerebellitis caused by herpes simplex virus.

Evasión de la respuesta inmune por virus herpes simplex / Immune evasion by herpes simplex viruses

Herpes simplex viruses and humans have co-existed for tens of thousands of years. This long relationship has translated into the evolution and selection of viral determinants to evade the host immune response and reciprocally the evolution and selection of host immune components for limiting virus infection and damage. Currently there are no vaccines available to avoid infection with these viruses or therapies to cure them. Herpes simplex viruses are neurotropic and reside latently in neurons at the trigeminal and dorsal root ganglia, occasionally reactivating. Most viral recurrences are subclinical and thus, unnoticed. Here, we discuss the initial steps of infection by herpes simplex viruses and the molecular mechanisms they have developed to evade innate and adaptive immunity. A better understanding of the molecular mechanisms evolved by these viruses to evade host immunity should help us envision novel vaccine strategies and therapies that limit infection and dissemination.

Los virus herpes simplex y humanos co-existen desde decenas de miles de años. Esta prolongada relación se ha traducido en la evolución y selección de determinantes virales para evadir la respuesta inmune y recíprocamente la evolución y selección de componentes inmunes del hospedero para limitar la infección viral y el daño que producen. Actualmente no existen vacunas para evitar la infección de estos virus o terapias que la curen. Los virus herpes simplex son neurotrópicos y permanecen latentes en neuronas de ganglios trigémino y dorsales, reactivándose esporádicamente. La mayoría de las recurrencias por virus herpes simplex son sub-clínicas y por tanto pasan inadvertidas. Aquí discutimos los pasos iniciales de la infección porvirus herpes simplex y los mecanismos moleculares que estos virus han desarrollado para evadir la respuesta inmune innata y adaptativa. Una mejor comprensión de los mecanismos moleculares evolucionados por estos virus para evadir la respuesta inmune del hospedero deberían ayudarnos visualizar nuevas estrategias para desarrollar vacunas y terapias que limiten su infección y diseminación.

Infección intrauterina por Herpes virus simplex y aplasia cutis / Intrauterine Herpes simplex virus infection and aplasia cutis

Presentamos un caso de infección por Herpes virus simplex adquirido por vía transplacentaria en un neonato nacido a las 34 semanas de gestación por parto vaginal. La madre presentó un único episodio de infección genital por herpes virus en la décima semana de gestación.En el momento del nacimiento el niño presentódos ampollas y lesiones de aplasia cutis que semejaba una epidermólisis bullosa. Además, se evidenciaron múltiples anomalías congénitas del sistema nervioso central, oftalmológicas y cardíacas que sustentan la infección herpética intrauterina. El test de Tzanck y la serología para Herpes virus simplex 2 (IgG) fueron positivas. La infección intrauterina por virus herpes está asociada a alta morbilidad y mortalidad pero responde a la terapia antiviral. Este diagnóstico debe ser considerado en todo neonato con una enfermedad ampollar o piel erosionada.

We present a case of Herpes simplex virus infection acquired by transplacental route in a neonate born at 34 weeks of gestation by vaginal delivery. The mother presented a single episode of genital herpes simplex virus infection in the tenth week of pregnancy. At birth, the neonate presented two blisters and lesions of aplasia cutis resembling epidermolysis bullosa. In addition, he presented multiple congenital anomalies of the brain, eyes and heart, supporting the intrauterine infection. Tzanck test and serology for Herpes simplex virus 2(IgG) were positive. Intrauterine infection by herpes virus is associated with high morbidity and mortality, however it responds to antiviral therapy. This diagnosis should be considered in any neonate with blisters or denuded skin.

Hepatitis viruses: Not always what it seems to be / Los virus de las hepatitis no siempre son habituales

The classic hepatotropic viruses, hepatitis A through E, are not the only viral agents able to infect the liver. Other systemic viruses may cause hepatic injury that can range from mild and transient elevation of aminotransferases to acute hepatitis and occasionally acute liver failure and fulminant hepatitis. The clinical presentation may be indistinguishable from that associated with classic hepatotropic viruses. These agents include cytomegalovirus; Epstein-Barr virus; herpes simplex virus; varicella-zoster virus; human herpesvirus 6, 7, and 8; human parvovirus B19; adenoviruses among others. Wide spectrums of clinical syndromes are associated with cytomegalovirus disease. Unique clinical syndromes may present in neonates, young adults and immunocompromised hosts infected with cytomegalovirus. Cases of fulminant hepatitis have been reported in both immunocompromised and immunocompetent hosts infected with Epstein Barr virus. Occasionally, these patients with acute hepatic failure may need liver transplantation. Herpes simplex viruses may involve the liver in neonatal infections, pregnancy, immunocompromised hosts and occasionally, immunocompetent adults. Varicella-Zoster virus has also been associated with severe acute hepatitis and fulminant hepatitis in adults. The drug of choice for these conditions is intravenous acyclovir. These may also need liver transplantation in the more severe forms of clinical presentation. Typical liver biopsy findings can be useful in determining the diagnosis of these viral infections. Human herpesviruses 6, 7, and 8, human parvovirus B19, and adenoviruses can also be present with features of acute liver injury and occasionally as fulminant hepatitis. The clinical syndromes are less well delineated than those associated with herpesviruses. It is important to consider these viruses as possible etiologic agents in patients who have acute liver injury and their serologic markers for the classic hepatotropic viruses are not indicative of an active infection.

Los agentes de la hepatitis viral A, B, C, D y E no son los únicos virus que pueden causar un síndrome de daño hepático agudo. Agentes virales como el citomegalovirus, Epstein-Barr, herpes simplex 1 y 2, Varicella-Zoster, virus herpes humano 6, 7, y 8, parvovirus B19 y adenovirus pueden causar daño hepático agudo e inclusive presentarse como hepatitis fulminante. Los cuadros clínicos de daño hepático agudo por citomegalovirus, Epstein Barr y herpes simplex 1 y 2 han sido caracterizado mejor. Se ha intentado el uso de drogas antivirales específicas como el uso intravenoso de aciclovir. Ocasionalmente, se ha requerido el trasplante hepático para rescatar pacientes con hepatitis fulminantes por estos agentes virales. La biopsia hepática puede ser de utilidad en estos casos puesto que los hallazgos son bastante característicos. La expresión clínica asociada a infecciones por virus herpes humano 6, 7 y 8, parvovirus B19 y adenovirus son menos características. Ha habido varios casos de hepatitis fulminante causada por estos agentes virales. Estos agentes virales deben ser considerados en el diagnóstico de casos de daño hepático agudo e inclusive hepatitis fulminante cuando los marcadores virales para los virus de hepatitis A-E son negativos.

Prevalência e fatores de risco para a infecção pelo herpes simples vírus tipo-2 em uma coorte de homens que fazem sexo com homens no Rio de Janeiro / Prevalence and risk factors for herpes simplex type-2 virus in a cohort of men who have sex with men in Rio de Janeiro

O HSV-2 é a principal causa de herpes genital, sendo a maior parte destas infecções assintomática. A infecção pelo HSV-2 pode ser um fator de risco para a aquisição e transmissão de outras DST, inclusive da infecção causada pelo HIV. Objetivo: Estimar a prevalência e identificar os fatores de risco associados à infecção pelo HSV-2 em uma coorte de homens que fazem sexo com homens da Fundação Oswaldo Cruz, Rio de Janeiro, Brasil. Métodos: Estudo transversal, com avaliação de dados sócio-demográficos, comportamentais e laboratoriais referentes à linha de base de 403 voluntários incluídos na referida coorte, no período de 1994-1998. As amostras foram testadas através do ELISA para detecção de anticorpos tipo-específicos contra a gG2 do HSV-2 (HerpeSelect - Focus Technologies)Resultados: A prevalência para anticorpos anti-HSV-2 encontrada nesta população foi de 65,2 por cento. Após análise multivariada, os fatores que se mostraram independentemente associados à infecção pelo HSV-2 foram idade mais elevada (maior ou igual a 26 anos), raça não branca, ter sorologia positiva para sífilis (TPHA), ter feito sexo desprotegido com parceria sexual masculina e ter feito sexo desprotegido com parceria sexual feminina nos seis meses que antecederam a visita. Conclusão: Este estudo mostra uma elevada prevalência da infecção pelo HSV-2 neste grupo e associação dessa infecção com outras DST, em concordância com outros estudos. Estes dados podem ter uma importante contribuição no sentido de avaliar estratégias que possam contribuir para a prevenção desta infecção na população de homens que fazem sexo com homens, que é tida como uma população vulnerável e central à dinâmica da disseminação do HSV-2 em todo o mundo...

HSV-2 is the primary cause of genital herpes and most of the infections are asymptomatic. The infection by HSV-2 may be a risk factor to acquisition and transmission of other sexually transmitted diseases (STD), including infection by HIV virus. Objective: Estimate the prevalence and identify the risk factors associated of infection by HSV-2 in a cohort of men who have sex with men (MSM) in Fundação Oswaldo Cruz [Oswaldo Cruz Foundation], Rio de Janeiro, Brazil.Methods: Cross-sectional study, evaluating sociodemographic, behavioral, and laboratorialdata from baseline of 403 volunteers included in this cohort, in the period of 1994-1998. The samples were tested by ELISA to detect type-specific antibodies against HSV-2 gG2 (HerpeSelect - Focus Technologies). Results: The prevalence to antibodies anti-HV2-2 observed in this population was 65.2 percent.After multivariate analysis, the factors independently associated to HSV-2 infection were older age (> 26 years), non-white race, positive serology for syphilis (TPHA), history of unprotected sex with male partners and history of unprotected sex with female partners inthe last six months before the visit.Conclusion: This study shows a high prevalence of HSV-2 infection in this group and association with other STD, consistent with other studies. This data may have a significant contribution to evaluate strategies that may contribute to prevent this infection amongMSM, as this is considered a vulnerable core-population to the dynamics of HSV-2 spreading all over the world...

Rol del virus herpes simplex en la queratitis inmune estromal / Role of herpes simplex virus in the immune stromal keratitis

Background: Herpes simplex virus (HSV) infection of the cornea is a leading cause of blindness in occidental countries and a common recurrent manifestation of it is the immune stromal keratitis (ISK). However, it is not known whether active viral replication occurs during the acute phase of the disease, because isolation of the virus by conventional culture techniques has not been accomplished. Aim: To establish the presence of HSV in patients with ISK. Material and methods : Fourteen corneal swabbing samples, from active diseased eyes of patients with clinical diagnosis of ISK, were submitted to Herpchek© and PCR for the identification of HSV antigens and genome. Results: All ISK samples were negative by both techniques. Conclusions : It was not possible to identify HSV antigens nor their genome by the methodology used. It is likely that, they can't be detected in corneal superficial layers or probably there is no viral replication at this stage of the disease, so antiviral therapy should be reconsidered

Infecciones recurrentes por virus herpes simplex / Herpes simplex virus recurrent infections

En el tratamiento de esta patología es muy importante efectuar un diagnóstico correcto. Revisamos fundamentalmente la terapia de la recurrencia herpética. En la terapia el fármaco clásico ha sido aciclovir, medicamento seguro y efectivo, pero con el inconveniente de tener una baja biodisponibilidad. Los nuevos antivirales, como valaciclovir, han mejorado la biodisponibilidad permitiendo una igual o mejor respuesta clínica con una dosificación mucho más cómoda. Estos fármacos pueden ocuparse también para terapia abortiva o supresiva. mejoraba la recurrencia del paciente con el tratamiento antiviral, será importante tratar de evitar, hasta donde se pueda, la aparición de nuevas recurrencias. Para esto, se debe tratar de identificar y controlar las causas gatillantes y mejorar la condición inmunológicas local y/o general. También es importante considerar esta enfermedad integralmente en el paciente, entregando educación y las medidas necesarias para prevención

Secuelas oculares debidas a infección herpética en un grupo de niños chilenos / Ocular sequels caused by herpetic infection in chilean children

Estudio prospectivo, multicéntrico, en el cual investigadores entrenados seleccionaron y siguieron clínica y virológicamente (aislamiento viral, anticuerpos monoclonales y PCR) pacientes de 0 a 18 años de edad con diagnóstico clínico de infección ocular por HSV. Se efectuó determinación de la agudeza visual (AV) por el Test de Mirada Preferencial, HOTV, E Snellen u optotipos de Snellen, con la mejor corrección óptica, examen refractivo bajo cicloplegia, estudio completo de estrabismo, topografía, paquimetría y fotografía. Se enrolaron entre 1993 a 1997 16 niños, dos de ellos con compromiso bilateral (18 ojos). En todos salvo un niño, se identificó HSV tipo I. Mediana de edad 5 años. El diagnóstico de ingreso fue el edema disciforme en 45 por ciento y en 33 por ciento de los casos una queratitis epitelial dendrítica. El 87,5 por ciento de los pacientes con edema disciforme presentó al menos una recurrencia por año. Los pacientes con compromiso epiteliar presentaron en todos los casos AV > 20/40, a diferencia de los pacientes con edema disciforme en que 71,4 por ciento presentaron AV final < de 20/50. El leucoma corneal fue severo en 62,5 por ciento de los ojos con edema disciforme y desarrollaron estrabismo 50 por ciento de los casos. En tres casos se requiere trasplante corneal. La enfermedad ocular herpética afecta principalmente a población joven y sana. El diagnóstico más frecuente fue el edema disciforme que presentó evolución crónica, requirió un gran número de consultas médicas y de tratamiento prolongado (entre 3 y 6 meses) y presentaron la mayor frecuencia de secualas. En general, el 78 por ciento de los pacientes estudiados desarrolló algún tipo de secuela visual

Gengivoestomatite herpética aguda primária / Acute primary herpetic gingivostomatitis

A gengivoestomatite herpética aguda primária é uma manifestaçäo clínica causada pelo vírus Herpesvirus hominis (HVH). Trata-se de manifestaçäo que compromete a cavidade bucal, muito comum em crianças de 4 a 6 anos, de real interesse estomatológico e de grande conotaçäo pediátrica. Neste trabalho, säo relatados 2 casos de gengivoestomatite herpética aguda primária, evidenciando seus aspectos clínicos e valorizando as medidas paliativas, indispensáveis para que näo ocorra disseminaçäo do processo

SIDA y saliva. Aspectos actuales / AIDS and saliva. Current aspects

El sindrome de inmunodeficiencia adquirida (SIDA) se caracteriza por una marcada disminución inmunológica, teniendo como consecuencia una mayor susceptibilidad a enfermedades oportunistas, pasando por varios estadios hasta llegar invariablemente a la muerte. Dentro de las enfermedades oportunistas características del sindrome, existen varias trasmitidas por saliva: hepatitis B, tuberculosis, herpes zoster, herpes simple, citomegalovirus y mononucleosis. Por otra parte, aunque la evidencia ocupacional, familiar y prácticas sexuales establecen que el SIDA no se trasmite por vía oral (saliva), muchos individuos continúan expresando miedo acerca del contagio de VIH por esta vía. Para tratar de esclarecer y conocer los aspectos actuales acerca de este rubro, el principal objetivo de este trabajo es conocer y discutir la relación que guarda la saliva con el virus de inmunodeficiencia humana (VIH)

Inhibition of three alphaherpesviruses (Herpes simplex 1 and 2 and pseudorabies virus) by heparin, heparan and other sulfated polyelectrolytes

The first step of the herpes virus infection is the attachment to heparan sulfate molecules on the cellular membrane. In order to improve the characterization of this phenomenon, we compared the inhibitory effect of six sulfated polyelectrolytes (PE): heparin, heparan, low molecular wight heparin, chondroitin, dextran and protamine on plaque formation by pseudorabies virus (PRV) were compared. The PE with the highest antiherpetic effect was heparin, followed by dextran sulfate. Heparan sulfate, which has been proposed as the initial receptor of herpes virus on the cell surface showed and effect 100-fold lower than heparin. Comparative inhibition curves of heparin and heparan sulfate against three herpes viruses: herpes simplex virus 1 (HSV-1), HSV 2 and PRV showed similar kinetics of inhibition of plaque formation, suggesting these viruses could share similar cell adsorption mechanisms