ABSTRACT
OBJECTIVES: Vestibular neuronitis (VN) is an inflammatory disease of the vestibular nerve, presumably caused by reactivation of the herpes simplex virus type l (HSV-1). We hypothesized that HSV-1 might be detected in saliva of patients with VN due to migration of the reactivated virus from the vestibular ganglia to the parotid gland. METHODS: Twenty-one patients with VN and 15 healthy controls participated. HSV-1 DNA detection was performed using the real-time polymerase chain reaction method. Sera were collected and stored to be later analyzed for immunoglobulin (Ig) G and IgM antibody titers against HSV-1 by immunofluorescence and enzyme linked immunosorbent assay methods, respectively. RESULTS: HSV-1 was detected in saliva of 14% of VN patients and in 6% of controls (P>0.05). Serological testing revealed borderline IgM (optical density±10% average of 2 cut off serums) antibodies to HSV-1 in 75% of patients versus 13% of controls (P=0.01). The IgG antibody test was positive in 17 of 20 patients and borderline (IgG ≤1:16) in 2 of 20 patients tested whereas 13 of 15 controls had positive IgG test results (P>0.05). CONCLUSIONS: In this preliminary study we found serological evidence of higher exposure of patients with VN to HSV-1 in the past. We were not able to demonstrate that the virus can be detected in saliva of VN patients as evidence for herpetic infection or reactivation.
Subject(s)
Herpesvirus 1, Human/metabolism , Saliva/virology , Vestibular Neuronitis/virology , Adolescent , Adult , Aged , Aged, 80 and over , DNA, Viral/analysis , Female , Herpesvirus 1, Human/genetics , Humans , Male , Middle Aged , Vestibular Neuronitis/diagnosis , Vestibular Neuronitis/physiopathology , Virus Activation , Young AdultABSTRACT
BACKGROUND: Presence of viremia during primary herpes simplex virus (HSV) infections has been previously investigated, but the findings for immunocompetent individuals have only rarely been reported. METHODS: With use of polymerase chain reaction (PCR), we evaluated blood samples obtained from children with primary herpes simplex virus (HSV) gingivostomatitis for viremia. RESULTS: There were 16 girls and 16 boys, aged 9-44 months (median age, 19 months). Serological test results for HSV type 1 were positive for 3 subjects (10.3%), borderline for 7 (24.1%), and negative for 19 (65.5%). Results of PCR of peripheral blood samples were positive for 11 subjects (34.4%). Time from disease onset to specimen collection was 24-216 h (median, 72 h) and was longer for subjects with positive results of serological tests (P =.014) and shorter for subjects with positive PCR results (P=.42). No cases with positive results of both PCR and serological tests were found. CONCLUSION: PCR detected viremia in 34% of patients with primary herpetic gingivostomatitis. Presence of viremia may play a potential role in viral dissemination, providing a better understanding of the pathogenesis of HSV infections, especially of the central nervous system.
