title: Clinical correlates of herpes simplex virus viremia among hospitalized adults.
abstract: BACKGROUND
  Quantification of herpes simplex virus (HSV) DNA in the peripheral blood is often used to evaluate patients suspected of having disseminated HSV infection. Few studies have examined the clinical correlates of HSV viremia among adults.
  
  
  METHODS
  We conducted a retrospective analysis of blood samples sent to a molecular virology reference laboratory at a university hospital for quantification of HSV DNA from October 2001 through June 2006. Medical records of patients with detectable HSV DNA were reviewed to abstract relevant clinical characteristics.
  
  
  RESULTS
  HSV DNA was detected in 38 (4%) of 951 samples from 29 patients, 19 of whom (66%) were >16 years old. Detailed medical records were available for review from 13 (68%) of 19 adult patients. Of the 10 patients whose HSV infection was typed, 6 (60%) had HSV-2, 3 (30%) had HSV-1, and 1 (10%) had evidence of HSV-1 and HSV-2 coinfection. All patients with viremia were treated with antiviral medications. The most common clinical findings were hepatitis (62%), fever (54%), central nervous system alterations (46%), skin lesions (38%), abdominal pain (31%), and sepsis (31%). Respiratory failure (23%) was uncommon. Patients with HSV viremia were observed to have a high mortality rate (6 of 10 immunocompromised and 1 of 3 immunocompetent individuals).
  
  
  CONCLUSIONS
  HSV viremia may be associated with a variety of signs and symptoms of morbidity in immunocompetent and immunocompromised hospitalized adults and is associated with high rates of mortality, although causality can be determined only by additional studies.
authors.affiliation: Department of Medicine, University of Washington, Seattle, Washington, USA.
authors.forename: William R
authors.initials: WR
authors.lastname: Berrington
authors.forename: Keith R
authors.initials: KR
authors.lastname: Jerome
authors.forename: Linda
authors.initials: L
authors.lastname: Cook
authors.forename: Anna
authors.initials: A
authors.lastname: Wald
authors.forename: Lawrence
authors.initials: L
authors.lastname: Corey
authors.forename: Corey
authors.initials: C
authors.lastname: Casper
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D002493:Central Nervous System Diseases / Q000821:virology; D004279:DNA, Viral / Q000097:blood; D005260:Female; D005334:Fever / Q000821:virology; D005838:Genotype; D006505:Hepatitis / Q000821:virology; D006801:Humans; D007121:Immunocompetence; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D018805:Sepsis / Q000821:virology; D018139:Simplexvirus / Q000145:classification / Q000235:genetics / Q000472:pathogenicity* / Q000502:physiology*; D014766:Viremia / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality / Q000821:virology*
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral