 |
|
Asymptomatic Perianal Shedding of Herpes Simplex Virus in Patients With Acquired Immunodeficiency Syndrome
Cláudio S. Pannuti, MD, PhD;
Maria Cristina D. S. Finck;
Renato S. Grimbaun, MD;
Laura M. Sumita;
Andréia L. S. Almeida, MD;
Nancy F. Rezende, MD;
Maria P. S. Gomes, MD;
João R. R. Pinho, MD;
Louis V. Kirchhoff, MD, MPH
Arch Dermatol. 1997;133(2):180-183.
Abstract
| |
Objective
To determine the frequency of asymptomatic perianal shedding of herpes simplex virus (HSV) in adult patients with acquired immunodeficiency syndrome (AIDS).
Design
Cross-sectional study.
Setting
A 1000-bed, state-supported hospital in Brazil that provides comprehensive health care.
Patients
Eighty-two consecutively hospitalized patients with AIDS (Centers for Disease Control and Prevention class C).
Main Outcome Measurement
Specimens for HSV culture were obtained with premoistened swabs of the perianal region at approximately 7-day intervals during the hospitalization of each patient. After the specimens were inoculated into cultures of human foreskin and Vero cells, supernatants of cultures showing the cytopathic effect characteristic of HSV infection were tested for virus in a confirmatory immunoenzymatic assay. Typing of HSV was performed by polymerase chain reaction amplification of HSV-1- and HSV-2-specific DNA polymerase sequences.
Results
On entry into the study, 12 (15%) of 82 patients had perianal ulceration and 70 did not. None of the patients in the latter group developed perianal ulcers during the study period, but HSV was isolated at least once from 17 (24%) of them. Nine of the 17 asymptomatic perianal shedders had a mean of 3 perianal swabs collected before the first HSV isolation, and 11 (65%) of 17 had a total of 18 perianal swabs collected 8 to 62 days after the HSV isolation. All postpositive samples were negative for HSV except 1 obtained from a patient 13 days after the first positive sample. Twelve of the 17 asymptomatic perianal shedders of HSV were followed up clinically for 8 to 62 days after the first episode of shedding, and none developed perianal ulceration.
Conclusions
We conclude that asymptomatic perianal shedding of HSV is common in patients with AIDS, even among those without a history of perianal HSV lesions. This shedding appears to be short-lived, intermittent, and not associated with early subsequent development of perianal ulcers. These findings present a new perspective on the natural course of perianal HSV infection in patients with AIDS.
Arch Dermatol. 1997;133:180-183
Author Affiliations
From the Infectious Diseases Service, State Employees Hospital of São Paulo (Drs Pannuti, Grimbaun, Almeida, Rezende, and Gomes), the Department of Infectious and Parasitic Diseases, Faculty of Medicine, University of São Paulo (Drs Pannuti and Pinho and Mss Finch and Sumita), São Paulo, Brazil; and the Department of Internal Medicine, University of Iowa, and the Department of Veterans Affairs Medical Center, Iowa City, Iowa (Dr Kirchhoff).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Cutting Edge: Myeloid Complement C3 Enhances the Humoral Response To Peripheral Viral Infection
Verschoor et al.
J. Immunol. 2001;167:2446-2451.
ABSTRACT
| FULL TEXT
Relation Between Herpes Simplex Viruses and Human Immunodeficiency Virus Infections
Severson and Tyring
Arch Dermatol 1999;135:1393-1397.
ABSTRACT
| FULL TEXT
Detection and Direct Typing of Herpes Simplex Virus in Perianal Ulcers of Patients with AIDS by PCR
do Nascimento et al.
J. Clin. Microbiol. 1998;36:848-849.
ABSTRACT
| FULL TEXT
Asymptomatic Shedding of HSVin AIDS
Journal Watch Dermatology 1997;1997:4-4.
FULL TEXT
|
