Neuropsychiatric symptoms and immune activation in patients with genital herpes.
OBJECTIVE
Neuropsychiatric disturbances are common among patients with genital herpes simplex virus (HSV) infection. To date, no studies have examined the possible role of immune activation in the aetiology of these disturbances. The aim of this study was to examine the relationship between markers of immune activation and measures of emotional and somatic dysfunction among patients with symptomatic genital herpes.


METHODS
Twenty-two patients with documented genital herpes were assessed when herpetic lesions were present and when they were not. Each assessment included a clinical examination, self-reported symptom measures as well as a blood and urine collection. Markers of immune activation [neopterin and interleukin (IL)-6] in serum and urine were quantified by enzyme-linked immunoassay. These measures were also obtained from a group of healthy control subjects.


RESULTS
Urine, but not serum, levels of neopterin and IL-6 correlated significantly with measures of reported psychological distress and fatigue. These associations were not confined to periods of overt clinical lesions.


CONCLUSIONS
HSV-related neuropsychiatric morbidity correlates selectively with regional, but not systemic, measures of immune activation. We hypothesise that communication between the local inflammatory site in the pelvis and the brain occurs through autonomic afferent pathways.
1School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.
Uté
U
Vollmer-Conna
2 Sydney Sexual Health Centre at the Sydney Hospital, Sydney, New South Wales, Australia.
Marcus
M
Chen
3Inflammatory Diseases Research Unit, School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia.
Andrew
A
Lloyd
2 Sydney Sexual Health Centre at the Sydney Hospital, Sydney, New South Wales, Australia.
Basil
B
Donovan