title: Longitudinal study on oral shedding of herpes simplex virus 1 and varicella-zoster virus in individuals infected with HIV.
abstract: Primary herpes simplex virus 1 (HSV-1) and varicella-zoster virus (VZV) infection leads to a life-long latent infection of ganglia innervating the oral mucosa. HSV-1 and VZV reactivation is more common in immunocompromised individuals and may result in viral shedding in saliva. We determined the kinetics and quantity of oral HSV-1 and VZV shedding in HSV-1 and VZV seropositive individuals infected with HIV and to assess whether HSV-1 shedding involves reactivation of the same strain intra-individually. HSV-1 and VZV shedding was determined by real-time PCR of sequential daily oral swabs (n = 715) collected for a median period of 31 days from 22 individuals infected with HIV. HSV-1 was genotyped by sequencing the viral thymidine kinase gene. Herpesvirus shedding was detected in 18 of 22 participants. Shedding of HSV-1 occurred frequently, on 14.3% of days, whereas solely VZV shedding was very rare. Two participants shed VZV. The median HSV-1 load was higher compared to VZV. HSV-1 DNA positive swabs clustered into 34 shedding episodes with a median duration of 2 days. The prevalence, duration and viral load of herpesvirus shedding did not correlate with CD4 counts and HIV load. The genotypes of the HSV-1 viruses shed were identical between and within shedding episodes of the same person, but were different between individuals. One-third of the individuals shed an HSV-1 strain potentially refractory to acyclovir therapy. Compared to HSV-1, oral VZV shedding is rare in individuals infected with HIV. Recurrent oral HSV-1 shedding is likely due to reactivation of the same latent HSV-1 strain.
authors.affiliation: Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Monique
authors.initials: M
authors.lastname: van Velzen
authors.forename: Werner J D
authors.initials: WJ
authors.lastname: Ouwendijk
authors.forename: Stacy
authors.initials: S
authors.lastname: Selke
authors.forename: Suzan D
authors.initials: SD
authors.lastname: Pas
authors.forename: Freek B
authors.initials: FB
authors.lastname: van Loenen
authors.forename: Albert D M E
authors.initials: AD
authors.lastname: Osterhaus
authors.forename: Anna
authors.initials: A
authors.lastname: Wald
authors.forename: Georges M G M
authors.initials: GM
authors.lastname: Verjans
mesh_terms: D000328:Adult; D004279:DNA, Viral / Q000737:chemistry / Q000235:genetics; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications*; D006561:Herpes Simplex / Q000821:virology*; D006562:Herpes Zoster / Q000821:virology*; D018259:Herpesvirus 1, Human / Q000302:isolation & purification*; D014645:Herpesvirus 3, Human / Q000302:isolation & purification*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D012463:Saliva / Q000821:virology*; D017422:Sequence Analysis, DNA; D019562:Viral Load; D014775:Virus Activation; D017201:Virus Shedding; D055815:Young Adult
chemical_list: D004279:DNA, Viral
keywords: genotyping; human herpesvirus-1; human herpesvirus-3; immunocompromised; reactivation; saliva