title: Herpes viruses, cytokines, and altered hemostasis in vital exhaustion.
abstract: OBJECTIVE
  Infections with herpes viruses have been implicated in the pathogenesis of atherosclerosis. We tested the hypothesis that vital exhaustion (VE) is associated with multiple herpesvirus infections, such as herpes simplex virus, varicella-zoster virus, Epstein-Barr virus, and cytomegalovirus, and with an increase in pathogen burden (ie, the aggregated seropositivity to immunoglobulin G antibodies for herpes simplex virus, varicella-zoster virus, Epstein-Barr virus, and cytomegalovirus). In addition, we examined the association of VE and pathogen burden with measures of hemostasis and inflammation.
  
  
  METHODS
  Blood samples were drawn from 29 men with VE and 30 male control subjects, all healthy and nonsmokers, to assess serological evidence of infection and measures of hemostasis and inflammation.
  
  
  RESULTS
  VE is associated with a relatively high pathogen burden, altered hemostasis, and higher levels of cytokines, such as interleukin-6. Across all subjects, a relatively high pathogen burden was also associated with altered hemostasis but not with increased cytokine levels. The interaction of VE with pathogen burden revealed significant linear increases in measures of hemostasis and inflammation. Finally, immunoglobulin G antibody titer levels of individual herpesvirus infections were not associated with hemostatic measures or with cytokines.
  
  
  CONCLUSIONS
  We conclude that stress-related alterations in hemostasis and inflammation are not necessarily linked to one particular herpesvirus infection but rather to an increase in aggregated seropositivity to herpesvirus infections.
authors.affiliation: Department of Medical Microbiology, Maastricht University, Maastricht, The Netherlands.
authors.forename: Andre
authors.initials: A
authors.lastname: van der Ven
authors.forename: Rob
authors.initials: R
authors.lastname: van Diest
authors.forename: Karly
authors.initials: K
authors.lastname: Hamulyák
authors.forename: Michael
authors.initials: M
authors.lastname: Maes
authors.forename: Cathrien
authors.initials: C
authors.lastname: Bruggeman
authors.forename: Ad
authors.initials: A
authors.lastname: Appels
mesh_terms: D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood / Q000276:immunology; D001777:Blood Coagulation; D016207:Cytokines / Q000097:blood*; D005221:Fatigue / Q000097:blood / Q000209:etiology* / Q000821:virology; D006487:Hemostasis; D006566:Herpesviridae Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007249:Inflammation / Q000209:etiology; D008297:Male; D008875:Middle Aged; D016036:Seroepidemiologic Studies
chemical_list: D000914:Antibodies, Viral; D016207:Cytokines; D007074:Immunoglobulin G