title: Herpes simplex virus specific T cell response in a cohort with primary genital infection correlates inversely with frequency of subsequent recurrences.
abstract: During the last decades, a changing epidemiological pattern of genital herpes simplex virus (HSV) infection has emerged. Primary infection is now caused as often by HSV-1 as by HSV-2. Once established, HSV can be reactivated leading to recurrent mucocutaneous lesions as well as meningitis. Why some otherwise immune-competent individuals experience severe and frequent recurrences is not known, and the immunological mechanism underlying recurrent symptomatic HSV infection is not fully understood. In this study, we investigate and characterise the immune response of patients with first episode of HSV genital infection and its relation to the frequency of symptomatic recurrences.
  
  
  
  In this cohort study, clinical and immunological data were collected from 29 patients who were followed 1 year after presenting with a first episode of genital or meningeal HSV infection. They were classified by PCR and serology as those with primary HSV-1, primary HSV-2 and non-primary HSV-2 infection.
  
  
  
  HSV-specific interleukin(Il)-4 and Il-10 responses at first visit were higher in primary infected HSV-2 infected patients experiencing lower numbers of recurrences during subsequent year.
  
  
  
  The median number of recurrences following primary HSV-2 genital infection may partly be predicted by the strength of an early HSV-specific IL-4 and IL-10 response.
authors.affiliation: Unit of Infectious Diseases, Department of Medicine, Solna (MedS), Karolinska Institutet and the Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Franzen-Röhl
authors.affiliation: Department of Microbiology, Tumour and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Danika
authors.initials: D
authors.lastname: Schepis
authors.affiliation: Department of Preparedness, Swedish Institute for Communicable Disease Control, Stockholm, Sweden.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Atterfelt
authors.affiliation: Department of Preparedness, Swedish Institute for Communicable Disease Control, Stockholm, Sweden.
authors.forename: Kristina
authors.initials: K
authors.lastname: Franck
authors.affiliation: Department of Medicine, Solna, Unit of Dermatology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Arne
authors.initials: A
authors.lastname: Wikström
authors.affiliation: Department of Infectious Diseases, Section of Virology, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Jan-Åke
authors.initials: JÅ
authors.lastname: Liljeqvist
authors.affiliation: Department of Infectious Diseases, Section of Virology, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Tomas
authors.initials: T
authors.lastname: Bergström
authors.affiliation: Unit of Infectious Diseases, Department of Medicine, Solna (MedS), Karolinska Institutet and the Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Aurelius
authors.affiliation: Department of Microbiology, Tumour and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Klas
authors.initials: K
authors.lastname: Kärre
authors.affiliation: Department of Microbiology, Tumour and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Louise
authors.initials: L
authors.lastname: Berg
authors.affiliation: Unit of Infectious Diseases, Department of Medicine, Solna (MedS), Karolinska Institutet and the Karolinska University Hospital, Stockholm, Sweden.|Department of Preparedness, Swedish Institute for Communicable Disease Control, Stockholm, Sweden.
authors.forename: Hans
authors.initials: H
authors.lastname: Gaines
mesh_terms: D015331:Cohort Studies; D006558:Herpes Genitalis / Q000453:epidemiology / Q000276:immunology*; D018259:Herpesvirus 1, Human / Q000276:immunology*; D018258:Herpesvirus 2, Human / Q000276:immunology*; D006801:Humans; D012008:Recurrence; D013601:T-Lymphocytes / Q000276:immunology*
keywords: GENITAL HERPES; HERPES SIMPLEX (CLINICAL); HSV VIROLOGY; IMMUNOLOGY; INFECTION CONTROL