title: Changes in the soluble mucosal immune environment during genital herpes outbreaks.
abstract: BACKGROUND
  Genital tract secretions provide variable inhibitory activity against herpes simplex virus (HSV) ex vivo. We hypothesize that the anti-HSV activity may prevent the spread of virus from the more commonly affected sites, such as the external genitalia, to the upper genital tract.
  
  
  METHODS
  The antimicrobial activity of cervicovaginal lavage (CVL) and concentrations of mucosal immune mediators were measured in 10 HIV-seronegative women with an active external herpetic lesion and compared with 10 HIV-seronegative women who were HSV-1 and HSV-2 seronegative. Samples were obtained at the time of a symptomatic external lesion (day 0), after 1 week of oral acyclovir (day 7), and 1 week after completing treatment (day 14). Controls were evaluated at parallel intervals.
  
  
  RESULTS
  The anti-HSV activity was higher in CVL obtained from cases compared to controls at presentation (day 0) (54.3% vs. 28%), fell to similar levels on day 7, and then rebounded on day 14 (69% vs. 25%). The anti-HSV activity correlated positively and significantly with the concentrations of several inflammatory proteins; the concentrations of these proteins tended to be higher in cases compared with controls and followed a similar temporal pattern.
  
  
  CONCLUSIONS
  Increases in inflammatory immune mediators and anti-HSV activity were detected in CVL at the time of clinical outbreaks and after completion of a short course of acyclovir. These mucosal responses may protect against HSV spread but could facilitate HIV infection and contribute to the clinical observation that, independent of clinical lesions, HSV-2 is a risk factor for HIV acquisition.
authors: Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.
authors: Marla J
authors: MJ
authors: Keller
authors: Rebecca P
authors: RP
authors: Madan
authors: Gail
authors: G
authors: Shust
authors: Colleen A
authors: CA
authors: Carpenter
authors: N Merna
authors: NM
authors: Torres
authors: Sylvia
authors: S
authors: Cho
authors: Hnin
authors: H
authors: Khine
authors: Meei-Li
authors: ML
authors: Huang
authors: Lawrence
authors: L
authors: Corey
authors: Mimi
authors: M
authors: Kim
authors: Betsy C
authors: BC
authors: Herold
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage; D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage; D002582:Cervix Mucus / Q000276:immunology*; D004196:Disease Outbreaks; D005260:Female; D006558:Herpes Genitalis / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology*; D018259:Herpesvirus 1, Human / Q000276:immunology*; D018258:Herpesvirus 2, Human / Q000276:immunology*; D006801:Humans; D008875:Middle Aged; D044364:Vaginal Douching; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir