Herpesviruses as co-factors in AIDS.
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AIDS-Related Complex↗
Biomedical subjects
F K Lee
Publications and source records attributed to F K Lee.
Prior herpes simplex virus type 2 infection as a risk factor for HIV infection.
Antibodies to cytomegalovirus (CMV), Epstein-Barr virus (EBV), and herpes simplex viruses types 1 and 2 (HSV-1, HSV-2) in three sequential serum samples from 62 men who did and 61 men who did not develop human immunodeficiency virus (HIV) infection at the time of the final (third) serum specimen were studied. Antibody titers to CMV, EBV, and HSV-1 did not significantly rise in or differ between men who did or did not get HIV infection. However, we found that 32 (68%) of 47 HIV seroconverters had antibodies to HSV-2 at the time the third specimen was drawn, whereas only 26 (46%) of 57 men who remained HIV seronegative had HSV-2 antibody positivity. Seroconversion to HSV-2 between any two serum specimens was found in 11 (42%) of the 26 HIV seroconverters but in only five (14%) of 35 men who remained HIV seronegative. The association between HSV-2 seropositivity (or seroconversion) and subsequent or concurrent HIV seroconversion remained when we controlled for factors known to influence HIV infection, including age, number of sexual partners, and percentage of sexual acts involving receptive anal intercourse. These serologic studies do not support the role of CMV, EBV, or HSV-1 in HIV infection but do suggest that HSV-2 infection is a risk factor for subsequent or concurrent HIV infection.
Acquired Immunodeficiency Syndrome↗
Physiologically responsive cardiac pacemakers. A role for electrical impedance?
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Electric Conductivity↗
A novel glycoprotein for detection of herpes simplex virus type 1-specific antibodies.
A novel herpes simplex virus type 1 (HSV-1)-specific glycoprotein reactive with monoclonal antibody H1379 was purified by affinity chromatography. This glycoprotein, provisionally designated as gG-1, forms two sets of bands with molecular weights of 40-44,000 and 60-88,000. When used in an immunodot enzymatic assay, gG-1 reacted strongly with rabbit antisera to HSV-1, but not with sera hyperimmune to HSV-2. Specificity of the assay was further established by the lack of reactivity of convalescent sera collected from 20 patients with primary genital HSV-2 infections, and from 100 sero-negative individuals. In contrast, antibodies to gG-1 were detected in 9 of 10 patients with primary HSV-1 infection, and in 63/67 patients with culture-positive, recurrent oral or genital HSV-1 infection. Reproducibility of the gG-1 immunodot assay for HSV-1 antibody detection was 96%. Serological assay with purified gG-1, done in parallel with the assay using purified gG-2 described in an earlier report, provides simple and reliable methods to detect type-specific HSV-1 and HSV-2 antibodies for seroepidemiological studies.
Animals↗
Detection of herpes simplex virus type 2-specific antibody with glycoprotein G.
A recently described herpes simplex virus (HSV) type 2 (HSV-2)-specific glycoprotein (gG-2) was purified on an immunoaffinity column prepared with monoclonal antibody. This purified antigen was used in an immunodot enzymatic assay on nitrocellulose paper for the detection of HSV-2 antibodies in human serum. The test was very sensitive in that HSV-2 antibodies were detected in the convalescent sera of 132 of 134 patients with recurrent genital infections in which HSV-2 had been isolated earlier. Antibodies to gG-2 were detected in 17% of sera obtained within 10 days after the onset of a primary HSV infection and in 95% of sera obtained more than 10 days after onset. The specificity of the immunodot assay was demonstrated by testing sera from 245 HSV-seronegative adults, 344 children, 29 nuns, and 13 patients with primary genital HSV-1 infections. None of these 631 sera was reactive with the gG-2 antigen. When compared with a microneutralization test, the immunodot assay was found to be more specific in detecting HSV-2 antibodies. Reproducibility of the gG-2 assay, obtained by retesting 391 sera, was 95%. Thus, this assay has the sensitivity, specificity, and reproducibility necessary for the measurement of HSV-2 antibodies in seroepidemiological studies.
Adult↗
Demonstration of virus particles within immune complexes by electron microscopy.
A method has been developed to detect virus particles within immune complexes by electron microscopy (VICEM test). Radioiodinated or unlabeled adenovirus type 2 immune complexes (IC) in human serum were used to determine the optimal conditions. Best results were obtained when the immune complexes were precipitated with 5% polyethylene glycol 6000, adsorbed with 0.5% of protein A-containing Staphylococcus aureus (Cowan 1) and eluted, with brief sonication, in 2 M propionic acid. When the eluate was examined by the pseudoreplica method of electron microscopy, morphologically intact viruses, concentrated over five-fold and free from background serum proteins, were readily demonstrated. The method is applicable to virus IC with a wide-range of antigen-to-antibody ratios and requires a minimum of 10(4)--10(5) virus particles. This method should be useful for the characterization of IC in clinical specimens obtained from patients with viral infections and for the possible demonstration of viral agents in immune complex diseases of unknown etiology. A modification of the technique can also be used for the rapid serological identification of viruses by electron microscopy, as exemplified by studies using adeno- and herpes simplex viruses.
Adenoviruses, Human↗
Electron microscopy in the routine screening of newborns with congenital cytomegalovirus infection.
The pseudoreplica method of electron microscopy (EM) was evaluated as a rapid screening technique for the detection of cytomegaloviruria in 3056 neonates in a predominantly lower socioeconomic population. Virus isolation methods detected 49 (1.6%) CMV-positive individuals. When pools of three to five urines were tested, 26 (54%) of the culture-positive neonates were identified by EM; however, testing of individual urines increased EM detection to 33 (67%). Almost all of these urines, as well as urine or oral specimens obtained on follow-up visits, which had infectivity titers greater than or equal to 10(4)/ml were EM-positive, whereas only half of the specimens with titers less than 10(4)/ml were EM-positive. All the symptomatic neonates were detected by EM, suggesting that electron microscopy would be most valuable as a diagnostic aid in this group of CMV-infected neonates.
Cytomegalovirus↗
Electron microscopy for the diagnosis of ocular viral infections.
Tear samples obtained from patients with suspected viral conjunctivitis were examined by virus culture and by the pseudoreplica method for electron microscopy (EM). Adenoviruses were isolated in 13 of the 34 cases (38%) clinically diagnosed as adenovirus conjunctivitis. Characteristic adenoviral particles were demonstrated by electron microscopy in seven of the culture-positive, and two of the culture-negative samples. In cases of herpes simplex virus ocular infection, tears were virus positive by culture in one-third of the patients; two-thirds of the culture positive specimens were also positive by EM. This study demonstrates the potential of electron microscopy as a rapid, specific, and relatively inexpensive method for the laboratory diagnosis of ocular viral infections.
Adenoviridae Infections↗
Rapid detection of viruses in biopsy or autopsy specimens by the pseudoreplica method of electron microscopy.
A rapid pseudoreplica method of electron microscopy (EM) was used to detect viruses in brain tissues obtained from 57 patients suspected of having herpes simplex encephalitis (HSE). Herpesvirus particles were demonstrated in 18 of the 20 (90%) specimens from which herpes simplex virus was isolated in tissue culture. The procedure takes less than 2 hours, as compared to the time (greater than or equal to 2 days) usually required for virus isolation or standard thin-section electron microscopy. Although the immunofluorescence test has comparable rapidity, it was found to be less sensitive and to yield occasionally false-positive reactions. Our findings indicate that, until a brain biopsy can be replaced by less invasive procedures, examination of brain tissue by the pseudoreplica method offers a rapid diagnosis of a herpesvirus encephalitis. Furthermore, the demonstration of viruses in brain, lung and liver specimens obtained by biopsy or at autopsy suggests that this electron-microscopic method would be advantageous for detecting viruses in tissue samples, particularly in the case of viruses which may not be readily demonstrable by conventional methods.
Adult↗
Papovavirus excretion following marrow transplantation: incidence and association with hepatic dysfunction.
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Anemia, Aplastic↗
Rapid diagnosis of cytomegalovirus infection in infants by electron microscopy.
Electron microscopy was applied to the diagnosis of cytomegalovirus infection in infants; we used the pseudoreplica method, which permits detection of herpesvirus particles within 15 to 30 minutes. Viruses were most readily detectable in urines with infectivity titers greater than or equal to 10(4) per milliliter (95 per cent correlation with the tissue-culture method). Virus particles were detected in 18 of 20 urines obtained from symptomatic or asymptomatic, congenitally or postnatally acquired cytomegalovirus infections in infants younger than six months. Viruses were demonstrated in six of 14 infants older than six months, whose urines usually contained greater than 10(4) per milliliter. All five oral specimens examined by electron microscopy were also positive. Viruses were readily detectable in specimens stored or shipped at 4 degrees C for several days, thus permitting physicians anywhere to obtain confirmation of a herpesvirus infection (presumably cytomegalovirus) within one to two days.
Cytomegalovirus↗
Secondary empty sella syndrome.
Etiology and pathogenesis of empty cella syndrome remains undetermined in some cases (primary or idiopathic type), while in others it is related to treatment of pituitary and parasellar disease (secondary type). Ten patients with empty sellae, secondary to treatment of pituitary adenomas (five cases), granulomas (three cases), craniopharyngioma (one case), and optic glioma (one case) are presented. Pathogenesis of empty sella is discussed and the importance of neuroradiologic evaluation of this syndrome is stressed.
Adenoma, Acidophil↗
Herpes simplex type II and Mycoplasma genitalium as risk factors for heterosexual HIV transmission: report from the heterosexual HIV transmission study.
OBJECTIVES: Two hundred twenty-four human immunodeficiency virus (HIV) discordant couples (one HIV negative, one HIV positive) were compared with 78 seroconcordant heterosexually infected couples with HIV with regard to sexually transmitted diseases. METHODS: Serologic testing and cultures were used to determine exposure of participants to sexually transmitted pathogens. These data were compared with HIV concordance of partners to investigate possible risk factors for HIV transmission. RESULTS: Syphilis, chlamydia, and hepatitis B virus (HBV) serologies did not distinguish between concordant and discordant couples nor did cultures for Neisseria gonorrhoeae and Trichomonas or Chlamydia enzyme immunoassay (EIA). Risk of transmission increased with positive serologies for herpes simplex virus (HSV)-2 (P = 0.002), cytomegalovirus (CMV) (P = 0.04), and Mycoplasma genitalium (P = 0.01), but not with Mycoplasma fermentans or Mycoplasma penetrans. Cytomegalovirus was not a significant risk factor when controlled for HSV-2 status. Examination by partner status showed increased risk of concordance with: HSV-2 positive serology in both partners (odds ratio [OR] = 3.14; confidence interval [CI] = 1.62-6.09; P = 0.007); HSV-2 in female secondary partner (OR = 2.10; CI = 1.12-3.93; P = 0.02) or the male primary partner (OR = 2.15; CI = 1.15-4.02; P = 0.017); M. genitalium antibody in both partners (OR = 3.44; CI = 1.68-7.04; P < 0.001); M. genitalium antibody in the primary male partner (OR = 2.51, CI = 1. 27-4.91; P = 0.008) and M. genitalium antibody in the secondary female partner (OR = 2.52; CI = 1.21-5.23; P = 0.01). CONCLUSIONS: These data support the role of HSV-2 in transmission of HIV and, for the first time, suggest a role for M. genitalium as an independent risk factor.
Adult↗
Underestimation of HSV-2 seroprevalence in a high-risk population by microneutralization assay.
BACKGROUND: Complement independent neutralizing antibody assays (CINA) have been used in seroepidemiologic studies and in diagnostic laboratories to distinguish between antibodies to herpes simplex virus types 1 (HSV-1) and 2 (HSV-2). The accuracy of CINA has not been rigorously tested against protein-specific typing assays, such as Western blot. GOAL OF THIS STUDY: To determine the ability of CINA to identify HSV-2 antibodies alone or in the presence of HSV-1 antibodies. STUDY DESIGN: Sera from randomly selected women at the Seattle King County Sexually Transmitted Disease Clinic were tested by CINA and Western blot. RESULTS: Of 521 women tested, 81% had HSV antibodies by Western blot and 76% had neutralizing antibodies. Of 220 sera with HSV-2 antibodies by Western blot, 106 (48%) were serotyped correctly by CINA. Of the women studied, 140 (27%) had type-indeterminate neutralizing antibodies; 55 of these sera (39%) had antibody only to HSV-1 by Western blot. CONCLUSION: The seroprevalence of HSV-2 in an STD clinic population was seriously underestimated by CINA.
Antibodies, Viral↗
Effect of various infection-control methods for light-cure units on the cure of composite resins.
This study (1) compared the curing-light intensity with various barrier infection-control methods used to prevent cross contamination, (2) compared the Knoop hardness value of cured composite resin when various barrier control methods were used, and (3) correlated the hardness of the composite resin with the light-intensity output when different infection-control methods were used. The light-cure unit tips were covered with barriers, such as cellophane wrap, plastic gloves, Steri-shields, and finger cots. The control group had no barrier. Composite resins were then cured for each of the five groups, and their Knoop hardness values recorded. The results showed that there was significant statistical difference in the light-intensity output among the five groups. However, there was no significant statistical difference in the Knoop hardness values among any of the groups. There was also no correlation between the Knoop hardness value of the composite resin with the light-intensity output and the different infection-control methods. Therefore, any of the five infection-control methods could be used as barriers for preventing cross-contamination of the light-cure unit tip, for the light-intensity output for all five groups exceeded the recommended value of 300 W/m2. However, to allow a greater margin of error in clinical situations, the authors recommend that the plastic glove or the cellophane wrap be used to wrap the light-cure tip, since these barriers allowed the highest light-intensity output.
Composite Resins↗