During herpes simplex virus type 1 (HSV-1) neuronal latency, the only viral RNA detected is from the latency-associated transcript (LAT) gene. We have made a LAT deletion mutant of McKrae, an HSV-1 strain with a very high in vivo spontaneous reactivation rate. This mutant (dLAT2903) lacks the LAT promoter and the first 1.6 kb of the 5' end of LAT. dLAT2903 was compared with its parental virus and with a rescued virus containing a restored LAT gene (dLAT2903R). Replication of the LAT mutant in tissue culture, rabbit eyes, and rabbit trigeminal ganglia was similar to that of the rescued and parental viruses. On the basis of semiquantitative PCR analysis of the amount of HSV-1 DNA in trigeminal ganglia, the LAT mutant was unimpaired in its ability to establish latency. In contrast, spontaneous reactivation of dLAT2903 in the rabbit ocular model of HSV-1 latency and reactivation was decreased to approximately 33% of normal. This decrease was highly significant (P < 0.0001) and demonstrates that in an HSV-1 strain with a high spontaneous reactivation rate, deletion of LAT can dramatically decrease in vivo spontaneous reactivation. We also report here that deletion of LAT appeared to eliminate rather than just reduce in vivo induced reactivation.

This was an inductive descriptive study of supportive behaviors and sources of supportive behaviors in 20 critically ill, adult, pretransplant liver patients. Data were collected using a demographic tool and a semistructured interview schedule focusing on sources of support and supportive behaviors. Demographic data were analyzed by using frequencies, and interview data were analyzed utilizing content analysis. Participants were 28 to 68 years of age and considered themselves to be supported and critically ill. Family was mentioned most frequently as a support source. Supportive behaviors included visits, telephone calls, prayers, cards, and talking with the participants. Major themes from the interview data included family, spontaneous support, loss of supporters, encouragement, and the importance of the presence of someone else. Validation interviews were undertaken with a randomly drawn subset. Data underscore the differences in perception of important behaviors between health professionals and patients. Implications for practice are reviewed.

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