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American Journal of Respiratory and... Aug 2022Brain injury induces systemic immunosuppression, increasing the risk of viral reactivations and altering neurological recovery. To determine if systemic immune...
Brain injury induces systemic immunosuppression, increasing the risk of viral reactivations and altering neurological recovery. To determine if systemic immune alterations and lung replication of herpesviridae are associated and can help predict outcomes after brain injury. We collected peripheral blood mononuclear cells in patients with severe brain injury requiring invasive mechanical ventilation. We systematically searched for respiratory herpes simplex virus (HSV) replications in tracheal aspirates. We also performed chromatin immunoprecipitation sequencing, RNA-sequencing, and functional assays of monocytes and CD4 T cells collected on Day 1 to characterize the immune response to severe acute brain injury. The primary outcome was the Glasgow Outcome Scale Extended at 6 months. In 344 patients with severe brain injury, lung HSV reactivations were observed in 39% of the 232 patients seropositive for HSV and independently associated with poor neurological recovery at 6 months (hazard ratio, 1.90; 95% confidence interval, 1.08-3.57). Weighted gene coexpression network analyses of the transcriptomic response of monocytes to brain injury defined a module of 721 genes, including PD-L1 and CD80, enriched for the binding DNA motif of the transcriptional factor Zeb2 and whose ontogenic analyses revealed decreased IFN-γ-mediated and antiviral response signaling pathways. This monocyte signature was preserved in a validation cohort and predicted the neurological outcome at 6 months with good accuracy (area under the curve, 0.786; 95% confidence interval, 0.593-0.978). A specific monocyte signature is associated with HSV reactivation and predicts poor recovery after brain injury. The alterations of the immune control of herpesviridae replication are understudied and represent a novel therapeutic target.
Topics: Brain Injuries; Herpes Simplex; Herpesvirus 1, Human; Humans; Leukocytes, Mononuclear; Monocytes
PubMed: 35486851
DOI: 10.1164/rccm.202110-2324OC -
Oral Diseases Apr 2024The objective of this systematic review and meta-analysis of observational studies was to assess whether herpes simplex virus type 1 (HSV-1) can infect endodontic... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The objective of this systematic review and meta-analysis of observational studies was to assess whether herpes simplex virus type 1 (HSV-1) can infect endodontic periapical lesions.
MATERIALS AND METHODS
Studies with cross-sectional design investigating HSV-1 in periapical tissues of patients with symptomatic and asymptomatic acute and chronic apical periodontitis were searched through MEDLINE, Scopus, Embase, Web of Science, and Google Scholar. Pooled HSV-1 prevalence proportion with 95% confidence interval (95CI) in periapical lesions was assessed with both fixed-effect and random-effects models, with/without adjustment for study quality and publication bias. Result robustness was investigated through sensitivity and subgroup analyses.
RESULTS
Literature search, performed twice, provided 84 items, and eight remained for the meta-analysis; globally, there were 194 patients mostly adults. The pooled HSV-1 prevalence proportions, assessed with various methods, were 6.9% (95CI, 3.8-11.3%, fixed-effect); 6.8% (95CI, 3.6-11.0%, random-effects); 8.1% (95CI, 4.4-14.5%, quality-adjusted); and 4.8% (95CI, 2.0-11.4%; adjusted for small-study effect).
CONCLUSIONS
The results indicated that HSV-1 can colonize the periapical tissues of 3%-11% patients with periapical diseases. Such data do not imply a causative role of HSV-1 in disease development and advancement. Well-designed and large-sized prospective cohort studies should be added in the literature panorama.
Topics: Humans; Herpes Simplex; Herpesvirus 1, Human; Periapical Periodontitis; Prevalence
PubMed: 37338057
DOI: 10.1111/odi.14645 -
PLoS Medicine Dec 2022Economic losses due to herpes simplex infections in low- and middle-income countries (LMICs) are unknown. We estimated economic and quality-of-life losses due to genital...
BACKGROUND
Economic losses due to herpes simplex infections in low- and middle-income countries (LMICs) are unknown. We estimated economic and quality-of-life losses due to genital herpes in 2019, in 90 LMICs, and from 2020 to 2030 in 45 countries in the World Health Organization (WHO) Africa. We additionally estimated economic losses due to human immunodeficiency virus (HIV) attributable to herpes simplex virus type 2 (HSV-2) infections.
METHODS AND FINDINGS
We estimated genital herpes-related spending on treatment, wage losses due to absenteeism, and reductions in quality of life, for individuals aged 15 to 49 years, living with genital herpes. Had HSV-2 had contributed to the transmission of HIV, we estimated the share of antiretroviral treatment costs and HIV-related wage losses in 2019 that can be attributed to incident and prevalent HSV-2 infections in 2018. For the former, we used estimates of HSV-2 incidence and prevalence from the global burden of disease (GBD) study. For the latter, we calculated population attributable fractions (PAFs), using the classic (Levin's) epidemiological formula for polytomous exposures, with relative risks (RRs) reported in literature. To extend estimates from 2020 to 2030, we modeled the transmission of HSV-2 in 45 African countries using a deterministic compartmental mathematical model, structured by age, sex, and sexual activity, which was fitted to seroprevalence gathered from a systematic review and meta-regression analysis. In the 90 LMICs, genital herpes contributed to US$813.5 million in treatment and productivity losses in 2019 (range: US$674.4 to US$952.2 million). Given observed care-seeking and absenteeism, losses are in the range of US$29.0 billion (US$25.6 billion to US$34.5 billion). Quality-of-life losses in the amount of 61.7 million quality-adjusted life years (QALYs) are also possible (50.4 million to 74.2 million). The mean annual cost of treatment and wage losses per infection is US$183.00 (95% CI: US$153.60 to US$212.55); the mean annual cost of quality-of-life losses is US$343.27 (95% CI: 272.41 to 414.14). If HSV-2 has fueled the transmission of HIV, then seroprevalent HSV-2 cases in 2018 can account for 33.2% of the incident HIV infections in 2019, with an associated antiretroviral therapy (ART) cost of US$186.3 million (range: US$163.6 to US$209.5 million) and 28.6% of HIV-related wage losses (US$21.9 million; range: US$19.2 to US$27.4 million). In the WHO Africa region, the 3.9 million seroprevalent genital herpes cases from 2020 to 2030 contributed to US$700.2 million in treatment and productivity losses. Additionally, quality-of-life losses in the range of 88 million to 871 million QALYs are also possible. If HSV-2 has contributed to the transmission of HIV, then in 2020, the PAF of HIV due to prevalent HSV-2 will be 32.8% (95% CI: 26.7% to 29.9%) and due to incident infections will be 4.2% (95% CI: 2.6% to 3.4%). The PAF due to prevalent infections will decline to 31.0% by 2030 and incident infections to 3.6%. Though we have accounted for the uncertainty in the epidemiological and economic parameter values via the sensitivity analysis, our estimates still undervalue losses due to limiting to the 15- to 49-year-old population.
CONCLUSIONS
Economic losses due to genital herpes in LMICs can be large, especially when considering the lifelong nature of the disease. Quality-of-life losses outweigh spending on treatment and reductions in productivity. If HSV-2 has contributed to the spread of HIV in LMICs, then nearly one third of antiretroviral costs and HIV-related wage losses can be attributed to HSV-2. Given the magnitude of the combined losses, a vaccine against HSV-2 must be a global priority.
Topics: Humans; Adolescent; Young Adult; Adult; Middle Aged; Herpes Genitalis; Herpesvirus 2, Human; Developing Countries; HIV; HIV Infections; Seroepidemiologic Studies; Financial Stress; Quality of Life; Anti-Retroviral Agents
PubMed: 36520853
DOI: 10.1371/journal.pmed.1003938 -
Multiple Sclerosis and Related Disorders Aug 2021Although there has long been a suspected association between varicella-zoster virus (VZV) and multiple sclerosis (MS), the connection has remained unclear. In this... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Although there has long been a suspected association between varicella-zoster virus (VZV) and multiple sclerosis (MS), the connection has remained unclear. In this study, we performed a meta-analysis in an attempt to assess the association between VZV IgG serostatus and MS.
METHODS
A literature search was performed using three databases: MEDLINE, EMBASE, and Cochrane. Eligible results included observational studies investigating the seroprevalence of VZV immunoglobulin G (IgG) in adults with MS versus non-MS controls. Two authors performed a screen of the search results, evaluating them for quality and relevant outcomes. Using a random-effect model, we estimated pooled odds ratios (ORs) and 95% confidence intervals (CIs).
RESULTS
The literature search yielded 1,268 articles, 8 of which (2,266 MS patients and 1,818 controls) were eligible for inclusion in the meta-analysis. Evaluation of all included studies together showed no significant association between VZV IgG seropositivity and MS (OR 1.439; 95%CI, 0.503-4.118; p 0.497). However, when analyzed in subgroups based on geographical area, studies performed in Asian countries showed VZV IgG seropositivity was more common in MS patients than in controls (OR 4.470; 95%CI 1.959-10.203; p < 0.001). No significant association was found in European countries.
CONCLUSIONS
This study found evidence of an association between VZV IgG seropositivity and MS in Asian countries. Additional studies are warranted to ascertain factors impacting this association.
Topics: Adult; Antibodies, Viral; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunoglobulin G; Multiple Sclerosis; Seroepidemiologic Studies
PubMed: 34148006
DOI: 10.1016/j.msard.2021.103024 -
Neurology India 2023Indian data regarding serious neurological and psychiatric adverse events, following coronavirus disease 2019 (COVID-19) vaccination, are lacking. We, therefore,...
Indian data regarding serious neurological and psychiatric adverse events, following coronavirus disease 2019 (COVID-19) vaccination, are lacking. We, therefore, systematically evaluated cases of post-vaccinal serious neurological and psychiatric adverse reactions published from India. A systematic review of cases published from India, which were archived in PubMed, Scopus, and Google Scholar databases, was performed; pre-print databases along with ahead-of-print contents were searched in addition. Retrieved articles, as on June 27, 2022, were evaluated following PRISMA guidelines. EndNote 20 web tool was used to make a PRISMA flow chart. Individual patients' data were compiled in a tabular form. The protocol of the systematic review was registered with PROSPERO (CRD42022324183). A total of 64 records describing 136 instances of serious neurological and psychiatric adverse events were identified. More than 50% (36/64) reports were from the following four states, namely, Kerala, Uttar Pradesh, New Delhi, and West Bengal. The mean age of persons developing these complications was 44.89 ± 15.77 years. In the majority, adverse events occurred within 2 weeks of administration of the first dose of COVISHIELD vaccine. Immune-mediated central nervous system (CNS) disorders were identified in 54 instances. Guillain-Barre syndrome and other immune-mediated peripheral neuropathies were reported in 21 cases. Post-vaccinal herpes zoster was recorded in 31 vaccine recipients. Psychiatric adverse events were recorded in six patients. In Indian recipients of COVID-19 vaccine, a variety of serious neurological complications were reported. The overall risk appears minuscule. Immune-mediated central and peripheral neuronal demyelinations were the most frequently reported post-vaccinal adverse events. A large number of cases of herpes zoster have also been reported. Immune-mediated disorders responded well to immunotherapy.
Topics: Adult; Humans; Middle Aged; ChAdOx1 nCoV-19; COVID-19; COVID-19 Vaccines; Guillain-Barre Syndrome; Herpes Zoster; Herpesvirus 3, Human; Peripheral Nervous System Diseases; Vaccines
PubMed: 37148041
DOI: 10.4103/0028-3886.375420 -
The Journal of Craniofacial SurgeryTo investigate the anatomical, pathogenetic, and pharmacological characteristics of herpes zoster ophthalmicus (HZO)- related ophthalmoplegia.
OBJECTIVE
To investigate the anatomical, pathogenetic, and pharmacological characteristics of herpes zoster ophthalmicus (HZO)- related ophthalmoplegia.
METHODS
Case report-based systematic review was performed.
RESULTS
This study included 96 patients (54 [56.25%] women and 42 [43.75%] men [P = 0.221]). The mean age at presentation was 64.32 ± 17.48 years. All the patients included in the study had HZO- related ophthalmoplegia, with rash presenting as initial symptom in 87 (90.62%) cases, and diplopia in 9 (9.38%) cases. Thirty-seven (38.54%) patients achieved complete recovery, whereas 59 (61.46%) patients had permanent ophthalmoplegia. Females recovered in 26/54 cases and males in 11/42 cases (P = 0.028). Recovery rates after peroral versus intravenous antivirals (15/38 versus 19/46) and > 10 days versus ≤10 days antiviral treatment (22/54 versus 12/30) did not significantly differ ( P = 0.865 and P = 0.947, respectively). immunocompetent patients treated with corticosteroids had significantly better recovery rates compared to immunodeficient counterparts (17/34 [50.00%] and 5/22 [22.73%], respectively [ P = 0.041]).
CONCLUSIONS
The outcome of HZO-related ophthalmoplegia is associated with gender, immune status, corticosteroid use, and time of antiviral treatment initiation.
Topics: Male; Humans; Female; Middle Aged; Aged; Aged, 80 and over; Herpes Zoster Ophthalmicus; Herpesvirus 3, Human; Ophthalmoplegia; Antiviral Agents; Diplopia
PubMed: 35275867
DOI: 10.1097/SCS.0000000000008631 -
Journal of Veterinary Internal Medicine 2024Equine herpes virus type 1 (EHV-1) infection in horses is associated with upper respiratory disease, neurological disease, abortions, and neonatal death. (Review)
Review
BACKGROUND
Equine herpes virus type 1 (EHV-1) infection in horses is associated with upper respiratory disease, neurological disease, abortions, and neonatal death.
OBJECTIVE
To determine if there is an association between the level and duration of EHV-1 viremia and either abortion or equine herpesvirus myeloencephalopathy (EHM) in domesticated horses?
METHODS
A systematic review was performed searching numerous databases to identify peer reviewed reports that evaluated viremia and EHM, or viremia and abortion published before January 19, 2021. Randomized controlled trials and observational studies were assessed for risk of bias or publication quality.
RESULTS
A total of 189 unique studies were identified, of which 34 met the inclusion criteria. Thirty studies evaluated viremia and neurologic outcomes including 4 observational studies. Eight experimental studies examined viremia and abortion, which used the Ab4 and OH03 virus strains or recombinant Ab4 derivatives. Incidence rates for both EHM and abortion in experimental studies varied among the studies as did the level of evidence. Viremia was generally detectable before the onset of either EHM or abortion. Risk of bias was generally low to moderate, sample sizes were small, and multiple studies reported negative outcome data.
CONCLUSIONS AND CLINICAL IMPORTANCE
The results of this study support that viremia is regularly present before EHM or abortion occurs. However, no inferences could be made about the relationship between the occurrence of either neurological signs or abortion and the magnitude or duration of viremia.
Topics: Horses; Animals; Herpesvirus 1, Equid; Horse Diseases; Viremia; Herpesviridae Infections; Abortion, Veterinary; Female; Pregnancy
PubMed: 38069576
DOI: 10.1111/jvim.16948 -
BMJ Global Health Jul 2020To describe the epidemiology of herpes simplex virus type 1 (HSV-1) in Europe. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To describe the epidemiology of herpes simplex virus type 1 (HSV-1) in Europe.
METHODS
We systematically reviewed HSV-1 related publications, conducted various meta-analyses and meta-regressions, assessed pooled mean seroprevalence, and estimated pooled mean proportions of HSV-1 viral detection in clinically diagnosed genital ulcer disease (GUD) and in genital herpes.
RESULTS
We extracted, from 142 relevant records, 179 overall (622 stratified) seroprevalence measures, 4 overall proportions of HSV-1 in GUD and 64 overall (162 stratified) proportions of HSV-1 in genital herpes. Pooled mean seroprevalence was 67.4% (95% CI 65.5% to 69.3%) with 32.5% (95% CI 29.4% to 35.7%) of children and 74.4% (95% CI 72.8% to 76.0%) of adults infected. Pooled seroprevalence increased steadily with age, being lowest in those aged <20 years (39.3%, 95% CI 35.9% to 42.7%) and highest in those aged >50 years (82.9%, 95% CI 78.8% to 86.6%). Pooled seroprevalence decreased yearly by 0.99-fold (95% CI 0.99 to 1.00). Pooled mean proportion of HSV-1 detection was 13.6% (95% CI 4.1% to 27.1%) in GUD, 34.1% (95% CI 31.7% to 36.5%) in genital herpes and 49.3% (95% CI 42.2% to 56.4%) in first episode genital herpes. Pooled proportion of HSV-1 detection in genital herpes increased yearly by 1.01-fold (95% CI 1.00 to 1.02), with higher detection in women (42.0%, 95% CI 37.4% to 46.7%) than men (24.1%, 95% CI 19.8% to 28.6%).
CONCLUSIONS
HSV-1 epidemiology is transitioning away from its historical pattern of oral acquisition in childhood. Every year, seroprevalence is declining by 1% and the proportion of HSV-1 in genital herpes is increasing by 1%. As many as two-thirds of children are reaching sexual debut unexposed, and at risk of HSV-1 genital acquisition in adulthood.
Topics: Adult; Child; Europe; Female; Herpes Simplex; Herpesvirus 1, Human; Homosexuality, Male; Humans; Male; Middle Aged; Seroepidemiologic Studies; Sex Workers; Sexual and Gender Minorities; Young Adult
PubMed: 32675066
DOI: 10.1136/bmjgh-2020-002388 -
AIDS Research and Therapy Oct 2022As one of the most prolific sexually transmitted infections (STIs) in the world, Herpes Simplex Virus Type 2 (HSV-2) is one of the primary causes of genital ulcers. In... (Meta-Analysis)
Meta-Analysis
BACKGROUND
As one of the most prolific sexually transmitted infections (STIs) in the world, Herpes Simplex Virus Type 2 (HSV-2) is one of the primary causes of genital ulcers. In addition, HSV-2 infection multiplies the risk of acquiring HIV. Men who have sex with men (MSM) are at particularly high risk of contracting both diseases. Unfortunately, little information is available with regarding to the comprehensive prevalence of HSV-2 among MSM in mainland China. The objective of this manuscript was to determine the composite prevalence of HSV-2 among MSM in mainland China via systematic review and meta-synthesis.
METHODS
We systematically searched PubMed, Embase, Chinese National Knowledge Infrastructure, WanFang Database for Chinese Periodicals, and the VIP Database for Chinese Technical Periodicals for relevant articles published from the database's inception to 28 April 2022 that reported data on the prevalence of HSV-2 within the MSM population in mainland China. We considered publications to be eligible for inclusion if they satisfied these conditions: (1) publication participants were MSM in China mainland. Studies were excluded if participants were exclusively all HIV-positive MSM, all HIV-negative MSM, injection-drug users, or MSM sex workers. These studies would have introduced selection bias and skewed pooled prevalence estimates higher or lower; (2) proportion of HSV-2 virus among MSM in China mainland were reported; (3) HSV-2 diagnosis was conducted in a laboratory based on a strict type-specific glycoprotein-G based assays diagnostic method or PCR method; and (4) had a sample size over 20. Exclusion criteria included: (1) not being an original manuscript, such as a review article; (2) being a guideline, correspondence, and/or conference abstract; (3) the publication population did not reside in China mainland when the study was carried out; and (4) if the same epidemiological data were printed in both English and Chinese journals, English articles were preferred. We assessed the risk of bias in each individual publication using the modified quality assessment tool for systematic reviews of observational publications (QATSO). This meta-analysis was conducted by using R software. Due to extensive heterogeneity between various publications, we employed a random effect model to calculate the composite prevalence and corresponding 95% confidence intervals. We then conducted meta-regression to investigate the potential causes of observed heterogeneity. Lastly, we employed subgroup analysis based on characteristics of studies to compare the prevalence estimates across the groups. Publication bias was evaluated by funnel plot, Begg's test and Egger's test. Sensitivity analysis was also performed by removing each single study separately.
RESULTS
This study included 31 articles (9 published in English and 22 in Chinese) in our meta-synthesis. The pooled prevalence of HSV-2 among MSM in China mainland was 0.094 (95%CI:0.074 to 0.116). Prevalence of HSV-2 among MSM in Southwest China was higher than other regions, prevalence of HSV-2 among MSM that recruited from VCT (Voluntary Counseling and Testing) was lower than other ways, respectively. Compared to 2000-2010, the prevalence of HSV-2 among MSM in mainland China showed a downward trend during 2011-2020, however, the difference was not statistically significant .
CONCLUSION
Prevalence of HSV-2 among MSM in China mainland is high, around 0.094. It indicated HSV-2 needed to be screening for MSM population among China mainland and proper actions should be taken to curve the trend of HSV-2 among MSM in China. Trial registration CRD42020180361.
Topics: Humans; Male; China; Glycoproteins; Herpesvirus 2, Human; HIV Infections; Homosexuality, Male; Prevalence; Sexual and Gender Minorities
PubMed: 36182910
DOI: 10.1186/s12981-022-00469-w -
Journal of Veterinary Internal Medicine 2024Equine herpes virus type 1 (EHV-1) infection in horses is associated with upper respiratory disease, neurological disease, abortions, and neonatal death. (Review)
Review
BACKGROUND
Equine herpes virus type 1 (EHV-1) infection in horses is associated with upper respiratory disease, neurological disease, abortions, and neonatal death.
REVIEW QUESTION
Does pharmacological therapy decrease either the incidence or severity of disease or infection caused by EHV-1 in domesticated horses?
METHODS
A systematic review was preformed searching AGRICOLA, CAB Abstracts, Cochrane, PubMed, Web of Science, and WHO Global Health Index Medicus Regional Databases to identify articles published before February 15, 2021. Selection criteria were original research reports published in peer reviewed journals, and studies investigating in vivo use of therapeutic agents for prevention or treatment of EHV-1 in horses. Outcomes assessed included measures related to clinical outcomes that reflect symptomatic EHV-1 infection or virus infection. We evaluated risk of bias and performed a GRADE evaluation of the quality of evidence for interventions.
RESULTS
A total of 7009 unique studies were identified, of which 9 met the inclusion criteria. Two studies evaluated valacyclovir or small interfering RNAs, and single studies evaluated the use of a Parapoxvirus ovis-based immunomodulator, human alpha interferon, an herbal supplement, a cytosine analog, and heparin. The level of evidence ranged between randomized controlled studies and observational trials. The risk of bias was moderate to high and sample sizes were small. Most studies reported either no benefit or minimal efficacy of the intervention tested.
CONCLUSIONS AND CLINICAL IMPORTANCE
Our review indicates minimal or limited benefit either as a prophylactic or post-exposure treatment for any of the studied interventions in the mitigation of EHV-1-associated disease outcome.
Topics: Animals; Horses; Herpesvirus 1, Equid; Horse Diseases; Herpesviridae Infections; Antiviral Agents; Valacyclovir
PubMed: 38380685
DOI: 10.1111/jvim.17016