Analysis of gastrointestinal virus infection in immunocompromised hosts by multiplex virus PCR assay

Abstract

Regarding viral infection of intestinal mucosa, there have been only a few studies on limited diseases, targeting a few herpes family viruses. In this study, we analyzed 12 kinds of DNA viruses including 8 species of herpes family viruses in the gastrointestinal mucosa of patients with hematologic malignancies, inflammatory bowel diseases, collagen diseases, or other miscellaneous forms of gastroenteritis using the multiplex virus PCR assay, which we recently developed. The virus PCR assay yielded positive results in 63 of 102 patients; Epstein-Barr virus (EBV) was the most frequently detected, followed by cytomegalovirus (CMV), human herpes virus 6 (HHV-6), HHV-7, parvovirus B19, and herpes simplex virus type 1. The frequencies of viral detection in the 4 diseases were similar involving these 6 viruses. Regarding CMV colitis, the multiplex virus PCR assay was superior to the immunohistopathologic method in detecting CMV. All viruses were more efficiently detected in the mucosa than in the blood in individual patients. These results suggest that CMV, EBV, and HHV-6 were commonly detected in the gastrointestinal mucosa of patients with these 4 diseases, and our multiplex virus PCR assay was useful for the early diagnosis of gastrointestinal virus infection, especially CMV colitis.

A Rare Case of Herpes Simplex Virus and Cytomegalovirus Dual Infection Inducing Unremitting Ulcerative Colitis

“…They found zero instances of HSV-1 colitis. The combination of EBV and CMV was the most significantly reported co-infection in these patients [28].…”

Gastric herpes simplex virus type 1 infection is associated with functional gastrointestinal disorders in the presence and absence of comorbid fibromyalgia: a pilot case–control study

“…The presence of the nonstructural viral protein ICP8 in gastric mucosa specimens indicates HSV-1 identified in the biopsied regions was undergoing active replication at the time of tissue collection. Although several herpesviruses are known to infect the gastric mucosa [24][25][26][27][28][29][30][31][32][33][34], HSV-1 was the only herpesvirus detected in the gastric biopsy specimens from our patient population. Careful examination of sequencing trace reports showed none of the other 8 human herpesviruses were present in PCR products derived from the gastric biopsies examined for this study.…”

“…Parasitic, bacterial, and viral infections have been proposed as etiologic agents for overlapping FGIDs [17,[21][22][23]. Human herpesviruses are viable etiologic candidates as they establish persistent infections, affect the relevant pathophysiological pathways, and readily infect the GI tract [24][25][26][27][28][29][30][31][32][33][34].…”

“…A hallmark of all herpesviruses is their ability to establish life-long quiescent infections, termed latency, in one or more cell types. Although several herpesviruses infect the GI mucosa [24][25][26][27][28][29][30][31][32][33][34], only herpes simplex virus types 1 and 2 (HSV-1/-2) and varicella zoster virus are known to establish latency in ganglionic neurons that innervate the GI tract [35][36][37][38][39][40][41]. These neurotropic herpesviruses initially infect and replicate within mucosal epithelial cells.…”

Infectious Colitis

“…Stool studies and endoscopic evaluation with biopsies can be helpful [97,102]. A new generation of stool tests such as the multiplex PCR assay can detect many various types of viral as well as bacterial and parasitic infections [94,103]. The use of highly active antiretroviral therapy (HAART) for HIV improves the immune system response by increasing the CD4+ count [104,105].…”