Asymptomatic genital excretion of herpes simplex virus during early labor

Hankins, Gary D.V.; Cunningham, F. Gary; Luby, James P.; Butler, Sandra; Stroud, J. W.; Roark, Micki

doi:10.1016/s0002-9378(84)80119-2

Cited by 11 publications

(5 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Indeed, the involvement of CD4 ϩ T cells that produce Th1 cytokines (interleukin-2 [IL-2] and gamma interferon [IFN-␥]) in HSK has been established with the mouse model of ocular herpes, and corneal herpetic diseases can be abrogated by depletion of CD4 ϩ T cells or neutralization of Th1 cytokines (24,25,50,51,62,63). HSV-specific CD4 ϩ T cells are key participants in the development of recurrent herpetic sores in symptomatic individuals (14,21,39,46,47,65,75,79). Paradoxically, HSVspecific CD4…”

mentioning

confidence: 99%

Asymptomatic Human CD4⁺Cytotoxic T-Cell Epitopes Identified from Herpes Simplex Virus Glycoprotein B

Chentoufi

Binder

Berka

et al. 2008

J Virol

View full text Add to dashboard Cite

The identification of "asymptomatic" (i.e., protective) epitopes recognized by T cells from herpes simplex virus (HSV)-seropositive healthy individuals is a prerequisite for an effective vaccine. Using the PepScan epitope mapping strategy, a library of 179 potential peptide epitopes (15-mers overlapping by 10 amino acids) was identified from HSV type 1 (HSV-1) glycoprotein B (gB), an antigen that induces protective immunity in both animal models and humans. Eighteen groups (G1 to G18) of 10 adjacent peptides each were first screened for T-cell antigenicity in 38 HSV-1-seropositive but HSV-2-seronegative individuals. Individual peptides within the two immunodominant groups (i.e., G4 and G14) were further screened with T cells from HLA-DRgenotyped and clinically defined symptomatic (n ‫؍‬ 10) and asymptomatic (n ‫؍‬ 10) HSV-1-seropositive healthy individuals. Peptides gB [161][162][163][164][165][166][167][168][169][170][171][172][173][174][175] ؉ T cells from symptomatic patients preferentially recognized gB 661-675 (P < 0.0001). Thus, we identified three previously unrecognized CD4؉ CTL peptide epitopes in HSV-1 gB. Among these, gB 166-180 and gB 666-680 appear to be "asymptomatic" peptide epitopes and therefore should be considered in the design of future herpes vaccines.Herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) are ubiquitous viruses that infect a majority of people worldwide (3,22,68). Shedding of reactivated HSV is estimated to occur at rates of 3 to 28% in adults who harbor latent HSV in their sensory neurons (32,(66)(67)(68). However, the vast majority of these individuals do not experience recurrent herpetic disease and are designated "asymptomatic patients" (22,40,68). In contrast, in some individuals (symptomatic patients), reactivation of latent virus leads to induction of "pathogenic" HSVspecific CD4 ϩ and CD8 ϩ T cells (22, 68) and recurrent disease, ranging from rare episodes occurring every 5 to 10 years to outbreaks occurring monthly or even more frequently among a small proportion of subjects (22,26,60). Interestingly, for genital herpes, symptomatic and asymptomatic patients have similar virus shedding rates (68). It is likely that the same is true for ocular and oro-facial herpes, since shedding rates in tears and saliva of asymptomatic individuals have been reported to be as high as 33.5% (22,29,40,42). Latently infected patients are at risk of developing severe immunopathology, such as blinding herpetic stromal keratitis (HSK) (primarily due to HSV-1), painful genital ulcerations (primarily due to HSV-2), and in rare cases, fatal HSV encephalitis (reviewed in reference 72).Considering the wealth of data addressing the role of T cells in animal models, it is surprising how few reports explore the immunologic basis of symptomatic and asymptomatic HSV infections in humans. The HSV-1-specific CD4 ϩ T-cell responses in the cornea are much more likely to cause pathology than those in the genital tract or anus/buttocks region. Indeed, the involvement of CD4 ϩ T cells that produce Th1 cyt...

show abstract

mentioning

confidence: 99%

Asymptomatic Human CD4⁺Cytotoxic T-Cell Epitopes Identified from Herpes Simplex Virus Glycoprotein B

Chentoufi

Binder

Berka

et al. 2008

J Virol

View full text Add to dashboard Cite

show abstract

“…Herpes cultures were obtained only if the patient described prodromal symptoms or if a lesion was identified. The collection, handling and culture technique has been described previously 7,9 . Upon presentation for delivery, the patients were examined for genital lesions and questioned regarding prodromal symptoms.…”

Section: Methodsmentioning

confidence: 99%

Acyclovir Suppression to Prevent Recurrent Genital Herpesat Delivery

Scott

Hollier

McIntire

et al. 2001

Infectious Diseases in Obstetrics and Gynecology

View full text Add to dashboard Cite

OBJECTIVE: To determine if suppressive acyclovir near term decreased the frequency of clinical recurrences at delivery in women with recurrent genital herpes simplex virus (HSV) infection. METHODS: We conducted a prospective, double-blind, randomized trial in 234 women with recurrent genital herpes. Women with genital infection of any frequency were enrolled. Patients received either suppressive oral acyclovir 400 mg three times daily or an identical placebo after 36 weeks' gestation. Clinical lesions were identified, and HSV cultures were obtained at delivery. The frequencies of clinical and subclinical HSV recurrences at delivery were evaluated. RESULTS: Six percent of patients treated with acyclovir, and 14% of patients treated with placebo had clinical HSV at delivery (p = 0.046). No patients in the acyclovir group had positive HSV cultures, compared with 6% of placebo-treated patients (p = 0.029). There was no significant difference in subclinical HSV shedding in the acyclovir group (0%) compared with the placebo-treated group (3%) (p = 0.102). CONCLUSIONS: Suppressive acyclovir therapy significantly decreased the incidence of clinical genital herpes and the overall incidence of HSV excretion at delivery in patients with previous herpes infection.

show abstract

“…HSV cultures were obtained only if the patient described prodromal symptoms or if a lesion was identified. The collection, handling, and culture techniques have been described previously 2,7 .…”

Section: Methodsmentioning

confidence: 99%

Acyclovir Suppression to Prevent Clinical Recurrences at Delivery After First Episode Genital Herpes in Pregnancy: An Open‐Label Trial

Scott

Hollier

McIntire

et al. 2001

Infectious Diseases in Obstetrics and Gynecology

View full text Add to dashboard Cite

Objective: To continue evaluation of the use of acyclovir suppression in late pregnancy after first episode genital herpes simplex virus (HSV) infection, using an open-label study design. Methods: Ninety-six women diagnosed with genital herpes for the first time in the index pregnancy were prescribed suppressive acyclovir 400 mg orally three times daily from 36 weeks until delivery in an open-label fashion. Herpes cultures were obtained when patients presented for delivery. Vaginal delivery was permitted if no clinical recurrence was present; otherwise a Cesarean delivery was performed. NeonatalHSV cultures were obtained and infants were followed clinically. Rates of clinical and asymptomatic genital herpes recurrences and Cesarean delivery for genital herpes were measured, and 95% confidence intervals were calculated. Results: In 82 patients (85%) compliant with therapy, only 1% had clinical HSV recurrences at delivery. In an intent to treat analysis of the entire cohort, 4% had clinical recurrences (compared with 18–37% in historical controls). Asymptomatic shedding occurred in 1% of women without lesions at delivery. Two of the four clinical recurrences were HSV-culture positive. No significant maternal or fetal side-effects were observed. Conclusions: In clinical practice the majority of patients are compliant with acyclovir suppression at term. The therapy appears to be effective at reducing clinical recurrences after a first episode of genital herpes complicating a pregnancy.

show abstract

Asymptomatic genital excretion of herpes simplex virus during early labor

Cited by 11 publications

References 2 publications

Asymptomatic Human CD4⁺Cytotoxic T-Cell Epitopes Identified from Herpes Simplex Virus Glycoprotein B

Asymptomatic Human CD4⁺Cytotoxic T-Cell Epitopes Identified from Herpes Simplex Virus Glycoprotein B

Acyclovir Suppression to Prevent Recurrent Genital Herpesat Delivery

Acyclovir Suppression to Prevent Clinical Recurrences at Delivery After First Episode Genital Herpes in Pregnancy: An Open‐Label Trial

Contact Info

Product

Resources

About

Asymptomatic genital excretion of herpes simplex virus during early labor

Cited by 11 publications

References 2 publications

Asymptomatic Human CD4+Cytotoxic T-Cell Epitopes Identified from Herpes Simplex Virus Glycoprotein B

Asymptomatic Human CD4+Cytotoxic T-Cell Epitopes Identified from Herpes Simplex Virus Glycoprotein B

Acyclovir Suppression to Prevent Recurrent Genital Herpesat Delivery

Acyclovir Suppression to Prevent Clinical Recurrences at Delivery After First Episode Genital Herpes in Pregnancy: An Open‐Label Trial

Contact Info

Product

Resources

About

Asymptomatic Human CD4⁺Cytotoxic T-Cell Epitopes Identified from Herpes Simplex Virus Glycoprotein B

Asymptomatic Human CD4⁺Cytotoxic T-Cell Epitopes Identified from Herpes Simplex Virus Glycoprotein B