Interest of human papillomavirus DNA quantification and genotyping in paired cervical and urine samples to detect cervical lesions.

BACKGROUND: Cervical cancer is caused by persistent infection with high-risk human papillomavirus (HR-HPV). Conventional human papillomavirus (HPV) testing requires cervical sampling. However, vaginal and urine self-sampling methods are more acceptable for patients and result in increased participation when they are available in screening programs. In this context, we have developed a non-invasive screening method via the detection of HPV DNA in urine samples. PURPOSE: To compare HPV viral loads and genotypes in paired cervical and urine samples, and to assess correlation between virological and cytological results in women seeking gynecological consultation. METHODS: Paired urine and cervical specimens were collected and analyzed from 230 of 245 women participating in the previously described prospective PapU study. HPV DNA detection and quantification were performed using a real-time PCR method with short fragment PCR primers. Genotyping was carried out using the INNO-LiPA HPV genotyping assay. RESULTS: The prevalence of HPV in the 230 paired urine and cervical smear samples was 42 and 49 %, respectively. Overall agreement for HPV positivity and negativity between the paired samples was 90 % (κ = 0.80). High HPV viral load in both cervical and urine samples was associated with cytological abnormalities. HPV-positive women were mostly infected with HR-HPV types. The agreement between high- and low-risk HPV (LR-HPV) detection in both samples was 97 % (κ = 0.95 for HR-HPV and κ = 0.97 for LR-HPV). CONCLUSIONS: High concordance rates for HPV-DNA quantification and high/low-risk HPV genotyping in paired urine/cervical samples suggest that urinary HPV DNA testing could be useful for cervical lesion screening.

Surveillance network for herpes simplex virus resistance to antiviral drugs: 3-year follow-up.

Herpes simplex virus (HSV) infections are very common in the general population and among immunocompromised patients. Acyclovir (ACV) is an effective treatment which is widely used. We deemed it essential to conduct a wide and coordinated survey of the emergence of ACV-resistant HSV strains. We have formed a network of 15 virology laboratories which have isolated and identified, between May 1999 and April 2002, HSV type 1 (HSV-1) and HSV-2 strains among hospitalized subjects. The sensitivity of each isolate to ACV was evaluated by a colorimetric test (C. Danve, F. Morfin, D. Thouvenot, and M. Aymard, J. Virol. Methods 105:207-217, 2002). During this study, 3900 isolated strains among 3357 patients were collected; 55% of the patients were immunocompetent. Only six immunocompetent patients excreted ACV-resistant HSV strains (0.32%), including one female patient not treated with ACV who was infected primary by an ACV-resistant strain. Among the 54 immunocompromised patients from whom ACV-resistant HSV strains were isolated (3.5%), the bone marrow transplantation patients showed the highest prevalence of resistance (10.9%), whereas among patients infected by human immunodeficiency virus, the prevalence was 4.2%. In 38% of the cases, the patients who excreted the ACV-resistant strains were treated with foscarnet (PFA), and 61% of them developed resistance to PFA. The collection of a large number of isolates enabled an evaluation of the prevalence of resistance of HSV strains to antiviral drugs to be made. This prevalence has remained stable over the last 10 years, as much among immunocompetent patients as among immunocompromised patients.

[Nosocomial infections due to human coronaviruses in the newborn]. / Infections nosocomiales à coronavirus humains chez le nouveau-né.

Human coronaviruses, with two known serogroups named 229-E and OC-43, are enveloped positive-stranded RNA viruses. The large RNA is surrounded by a nucleoprotein (protein N). The envelop contains 2 or 3 glycoproteins: spike protein (or protein S), matrix protein (or protein M) and a hemagglutinin (or protein HE). Their pathogen role remains unclear because their isolation is difficult. Reliable and rapid methods as immunofluorescence with monoclonal antibodies and reverse transcription-polymerase chain reaction allow new researches on epidemiology. Human coronaviruses can survive for as long as 6 days in suspension and 3 hours after drying on surfaces, suggesting that they could be a source of hospital-acquired infections. Two prospective studies conducted in a neonatal and paediatric intensive care unit demonstrated a significant association of coronavirus-positive nasopharyngal samples with respiratory illness in hospitalised preterm neonates. Positive samples from staff suggested either a patient-to-staff or a staff-to-patient transmission. No cross-infection were observed from community-acquired respiratory-syncitial virus or influenza-infected children to neonates. Universal precautions with hand washing and surface desinfection could be proposed to prevent coronavirus transmission.

Neonatal nosocomial respiratory infection with coronavirus: a prospective study in a neonatal intensive care unit.

The aim of this prospective study was to evaluate the incidence of viral respiratory infection in hospitalized premature newborn infants and to assess the role of coronaviruses. All hospitalized premature infants with a gestational age less than or equal to 32 weeks were included. Tracheal or nasopharyngal specimens were studied by immunofluorescence for coronaviruses, respiratory syncytial virus, adenoviruses, influenza and parainfluenza viruses. Forty premature infants were included; 13 samples were positive in 10 newborns (coronaviruses n = 10; influenza 1 n = 2; adenovirus n = 1). None was positive at admission. All premature infants infected with coronaviruses had symptoms of bradycardia, apnea, hypoxemia, fever or abdominal distension. Chest X-ray revealed diffuse infiltrates in two cases. However, no significant difference was observed between infected and non-infected premature infants for gestational age, birth weight, duration of ventilation, age at discharge, incidence of apnea or bradycardia. Nosocomial respiratory tract infection with coronaviruses appears to be frequent. The clinical consequences should be evaluated in a larger population.

Detection of antibodies against human papillomavirus (HPV) type 16 virions by enzyme-linked immunosorbent assay using recombinant HPV 16 L1 capsids produced by recombinant baculovirus.

The L1 major capsid protein of human papillomavirus type 16 (HPV-16) was expressed in Sf-21 insect cells with a recombinant baculovirus. Virus-like particles obtained were purified and used to develop an enzyme-linked immunosorbent assay for detection of anti-HPV-16 antibodies in sera from 76 women with evidence of genital HPV infection and 79 controls. HPV-16-infected individuals developed antibodies directed at HPV-16 virions since reactivity against recombinant HPV-16L1 capsids was observed in 50% of them compared with only 6% in the general adult population. However, some cross-reactivities with sera from women infected with others HPV types were observed.

Detection of antibodies to L1, L2, and E4 proteins of human papillomavirus types 6, 11, and 16 by ELISA using synthetic peptides.

Antibodies against eight synthetic peptides spanning different epitopes located on L1, L2, and E4 proteins of human papillomavirus (HPV) types 16, 6, and 11 were examined in sera from 73 women infected by HPV and from 139 healthy controls. Only three of these peptides were reactive. Two located on proteins L2 and E4 of HPV 16 seem type specific since antibodies to these peptides were detected, respectively, in 21% and 15% of the HPV 16 infected patients and in 2.5% and none of women infected by other HPVs. The third peptide located on the L1 protein of HPV 6 bears a common epitope since antibodies to this peptide were detected not only in 85% of women infected by HPV 6 or 11, but also in 82% of women infected by other HPVs, and in 74% and 71% of the control groups (10-12-year-old children and adults, respectively). In conclusion, none of the peptides investigated seems useful to develop ELISAs for serological diagnosis of HPV infection.

[Tick-transmitted arbovirus in Maghreb]. / Arbovirus transmis par des tiques au Maghreb.

The problem of arbovirus infections in Maghreb has been relatively neglected in the pst in spite of a rich diversity of biotopes, the presence of potential reservoirs and vectors, and their position on the flight path of the Palearctic-african bird migration systems, western branch. Moreover, West Nile virus has been isolated from southern Algeria since 1968. From 1979 to 1989, ticks were collected from wild birds, pigeons, bats, rodents, poultry, camels, wild boars, domestic mammals and man, and assayed for viruses. On the whole, 424 ticks were virologically studied from Morocco, 582 from Algeria and 601 from Tunisia. Four tick-borne arboviruses have been isolated so far: three from Morocco, Soldado (Nairovirus), Essaouria (Orbivirus) and Kala Iris (Orbivirus) from Ornithodoros (A.) maritimus ticks parasitizing marine birds, and one from Tunisia, Tunis (Phlebovirus), from Argas reflexus hermanni infesting domestic pigeons. Soldado virus may infect man working into colonies of gulls for ornithological or entomological purposes and this infection is associated with a self-limited febrile illness and pruritus. In addition, antibody to Essaouira virus was detected in a wild rodent in Morocco. On the contrary it is unlike that Tunis virus may infect man because A. r. hermanni is a strickly ornithophilic tick. However, Uukuniemi group antibody has been previously evidenced in wild rodents in Tunisia. Finally, it is not excluded that other, more pathogenic, arboviruses such as Congo-Crimean haemorrhagic fever might be accidentally introduced in this sensitive geographical area.

[Pathogen role of coronavirus in pediatric intensive care: retrospective analysis of 19 positive samples with indirect immunofluorescence]. / Rôle pathogène des coronavirus en réanimation pédiatrique: analyse rétrospective de 19 prélèvements positifs en immunofluorescence indirecte.

BACKGROUND: Coronaviruses (CV) are ARN-containing agents that are responsible for mild upper respiratory tract infections in adults and children. Their pathogenicity in neonates is not wellknown. POPULATION AND METHODS: Eighty five samples of tracheal or nasopharyngeal secretions were obtained from January to October 1991 from 53 children (29 less than 1 month of age; 19 from 1 month to 1 year; five older than 1 year). They were examined for respiratory syncytial virus, adenovirus, myxovirus influenza and parainfluenza and coronavirus by immunofluorescence (IF). RESULTS: Nineteen samples from nine newborns and three infants were positive for coronavirus. The mean birth weight of the nine neonates was 2100 +/- 840 g; their mean gestational age was 34 +/- 5 weeks and their mean age at diagnosis was 21 +/- 9 days. Apnea and bradycardia were the main symptoms in this group. Blood C-reactive protein was not elevated and blood cultures were sterile. One infant was admitted for near-miss; the two others were admitted at birth because they suffered from chronic lung disease (pulmonary hypoplasia and bronchopulmonary dysplasia). An acute episode of pulmonary deterioration occurred at the time of coronavirus infection. Both died one at 4 months and the other at 10 months. CONCLUSION: Coronaviruses seem to be responsible for respiratory tract infections in hospitalized neonates and chronically ventilated infants.

A rickettsia-like organism from Ixodes uriae ticks collected on the Kerguelen Islands (French Subantarctic Territories).

A rickettsia-like microorganism was isolated in suckling mice from Ixodes uriae ticks collected from penguins breeding on Mayes Island, Kerguelen Archipelago, French Subantarctic Territories. At isolation, this agent mimicked a tick-borne arbovirus. Finally, electron microscopy studies of infected suckling mouse livers showed the presence of inclusions filled with pleomorphic microorganism in the cytoplasm of some hepatocytes, sometimes dividing by binary fission and thus of obviously non-viral nature. No firm serological relationship was demonstrated with Chlamydia psittaci, C. trachomatis, C. pneumoniae, Coxiella burnetti, Cowdria ruminentium, Ehrlichia canis, E. phagocytophila, E. risticii or the WSU/1044 agent. The exact taxonomic position of the "Mayes" agent remains to be clarified.

Endothelium, mechanical compliance, and cGMP content in the carotid artery from spontaneously hypertensive rats.

An experimental model of in situ isolated carotid arteries has been used to evaluate the static mechanical properties of the arterial wall in 12-week-old Wistar-Kyoto (WKY) rats and spontaneously hypertensive rats (SHRs). The effects of endothelium removal on the carotid compliance (CC) were compared to the effects of total abolition of the vascular smooth muscle tone by potassium cyanide (KCN). CC measured for pressures ranging from 50 to 175 mm Hg had maximal values (0.22 +/- 0.07 and 0.13 +/- 0.03 microliters/mm Hg, respectively, for WKY rats and SHRs, p < 0.001) for pressure close to the mean arterial pressure (operating pressures). Operating values of CC were increased by 35 and by 45% in WKY rats and SHRs, respectively, after KCN poisoning (p < 0.01). The endothelium removal induced a significant increase in CC compared to their control values (+37%, p < 0.01 and +25%, p < 0.01, respectively, in WKY rats and SHRs). With intact endothelium, carotid cGMP level was higher in SHRs than in WKY rats (30.3 +/- 3.7 vs. 19.7 +/- 2.3 fmol/mg tissue, p < 0.02). After endothelium removal, tissue cGMP was reduced by 28% in WKY rats (p < 0.02) and by 90% in SHRs (p < 0.001). The present results suggest that the mechanical properties of the wall of the carotid artery are endothelium-dependent. CC for operating pressure was significantly increased after endothelium removal in both strains. Furthermore, the cGMP pathway seems to be more activated in the carotid wall from SHRs than from WKY rats.(ABSTRACT TRUNCATED AT 250 WORDS)

[Idiopathic hypereosinophilic syndrome with predominant digestive manifestations or eosinophilic gastroenteritis? Apropos of 2 cases]. / Syndrome hyperéosinophilique idiopathique à manifestations digestives prédominantes ou gastroentérite à éosinophiles? A propos de deux observations.

We report two cases of hypereosinophilic syndrome with predominant gastrointestinal signs, which could have been mistaken for eosinophilic gastroenteritis. In the first case, the patient presented with eosinophilic ascites; documentation of pulmonary involvement allowed to easily establish the diagnosis. In the second case, the patient presented with diarrhea and malabsorption; gastrointestinal and pancreatic involvement seemed isolated. Cases reported as eosinophilic gastroenteritis in the literature with polyvisceral involvement raise the possibility of hypereosinophilic syndrome. We suggest that diffuse eosinophilic gastroenteritis could in fact be an isolated manifestation of the idiopathic hypereosinophilic syndrome.