Disseminated herpes simplex virus infection in an apparently immunocompetent woman

McMinn, Peter C.; Lim, Irene; McKenzie, Peter; Deth, A. G. Van; Simmons, Anthony

doi:10.5694/j.1326-5377.1989.tb101292.x

Cited by 20 publications

(7 citation statements)

References 16 publications

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“…Among the 27 pregnant patients, information is available in 21 women (Table 4). McMinn et al 49 reported an association of 55% in a series of 9 patients. Viral serology was positive in 1 of the 6 patients in whom no lesions were identified.…”

Section: Are M-c Lesions Present In Patients With Hs Hepatitis?mentioning

confidence: 94%

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Herpes Simplex Hepatitis in Adults

Sharma

Mosunjac²

2004

Journal of Clinical Gastroenterology

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Herpes simplex hepatitis is a treatable cause of acute hepatitis with a high mortality (41% to 79%). We present 4 adult patients who died of herpes simplex hepatitis and review another 70 patients (including pregnant women) from the literature to illustrate that herpes simplex hepatitis was only considered in the differential diagnosis in 26% to 33% of patients even though muco-cutaneous involvement was present in at least 70% of these patients. The presence of muco-cutaneous lesions in a patient with clinical symptoms and biochemical findings of acute hepatitis should raise the suspicion of herpes simplex hepatitis. Prompt treatment with acyclovir can be initiated within hours of admission in an attempt to prevent further hepatocellular damage in this potentially life-threatening infection.

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Section: Are M-c Lesions Present In Patients With Hs Hepatitis?mentioning

confidence: 94%

“…Case 1 was believed to have hepatitis A. 14,29,40,43,49,51,53,54,57 No correlation was made between the abnormal LFTs and herpes labialis in case 3.…”

Section: Was Hs Hepatitis Considered In the Work-up Of The Acute Hepamentioning

confidence: 97%

Herpes Simplex Hepatitis in Adults

Sharma

Mosunjac²

2004

Journal of Clinical Gastroenterology

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“…Functional analysis of oriL and oriS in PC12 cells. HSV-1 establishes latency in sympathetic neurons and reactivates with increased frequency in the presence of elevated levels of glucocorticoids (16,21,24,32,35,43,48). Based on these observations, we hypothesized that the GRE in oriL may function to enhance viral DNA replication in response to glucocorticoids specifically in cells of neural origin.…”

Section: Hsv-1 Oril Contains a Grementioning

confidence: 99%

“…Ten micrograms of DNA was digested with either EcoRI and DpnI to quantitate replicated DNAs (A) or EcoRI and MboI to quantitate input DNAs (data not shown). The digested DNAs were analyzed by Southern blot hybridization using a 32 a Undifferentiated PC12 cells were transfected with either an oriS or an oriLcontaining plasmid as described in the legend to Fig. 4.…”

Section: Hsv-1 Oril Contains a Grementioning

confidence: 99%

“…Indeed, glucocorticoids are primarily responsible for suppression of the immune response following stress. It is well documented in the clinical literature and in animal models of HSV latency and reactivation that stress and the clinical administration of glucocorticoids result in immunosuppression and the reactivation of HSV infections (6,21,24,32,35,43,48). The fact that reactivation routinely follows immunosuppression has led to the concept that immunosuppression is the cause of reactivation (i.e., reactivation is controlled in immunocompetent individuals, whereas it is not controlled in the immunocompromised host).…”

Section: Differential Effects Of Ngf and Dex On Oril-and Orisdependenmentioning

confidence: 99%

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Differential effects of nerve growth factor and dexamethasone on herpes simplex virus type 1 oriL- and oriS-dependent DNA replication in PC12 cells

Hardwicke

Schaffer

1997

J Virol

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The herpes simplex virus type 1 (HSV-1) genome contains three origins of DNA replication, one copy of oriL and two copies of oriS. Although oriL and oriS are structurally different, they have extensive nucleotide sequence similarity and can substitute for each other to initiate viral DNA replication. A fundamental question that remains to be answered is why the HSV-1 genome contains two types of origin. We have recently identified a novel glucocorticoid response element (GRE) within oriL that is not present in oriS and have shown by gel mobility shift assays that purified glucocorticoid receptor (GR), as well as GR present in cellular extracts, can bind to the GRE in oriL. To determine whether glucocorticoids and the GRE affect the efficiency of oriL-dependent DNA replication, we performed transient DNA replication assays in the presence and absence of dexamethasone (DEX). Because HSV-1 is a neurotropic virus and establishes latency in cells of neural origin, these tests were conducted in PC12 cells, which assume the properties of sympathetic neurons when differentiated with nerve growth factor (NGF). In NGF-differentiated PC12 cells, oriL-dependent DNA replication was enhanced 5-fold by DEX, whereas in undifferentiated cells, DEX enhanced replication ϳ2-fold. Notably, the enhancement of oriL function by DEX was abolished when the GRE was mutated. NGF-induced differentiation alone had no effect. In contrast to oriL, oriS-dependent DNA replication was reduced ϳ5-fold in NGF-differentiated PC12 cells and an additional 4-fold in differentiated cells treated with DEX. In undifferentiated PC12 cells, DEX had only a minor inhibitory effect (ϳ2-fold) on oriS function. Although the cis-acting elements that mediate the NGF-and DEX-specific repression of oriS-dependent DNA replication are unknown, a functional GRE is critical for the DEX-induced enhancement of oriL function in NGF-differentiated PC12 cells. The enhancement of oriL-dependent DNA replication by DEX in differentiated PC12 cells suggests the possibility that glucocorticoids, agents long recognized to enhance reactivation of latent herpesvirus infections, act through the GRE in oriL to stimulate viral DNA replication and reactivation in terminally differentiated neurons in vivo.

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Herpes simplex virus hepatitis: An analysis of the published literature and institutional cases

Norvell¹,

Blei²,

Jovanovic³

et al. 2007

Liver Transpl

240

318

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Hepatitis is a rare complication of herpes simplex virus (HSV), often leading to acute liver failure (ALF), liver transplantation (LT), and/or death. Our aim was to identify variables associated with either survival or progression (death/LT), based on an analysis of cases in the literature and our institution. A total of 137 cases (132 literature, 5 institutional) of HSV hepatitis were identified. The main features at clinical presentation were fever (98%), coagulopathy (84%), and encephalopathy (80%). Rash was seen in less than half of patients. Most cases (58%) were first diagnosed at autopsy and the diagnosis was suspected clinically prior to tissue confirmation in only 23%. Overall, 74% of cases progressed to death or LT, with 51% in acyclovirtreated patients as compared to 88% in the untreated subjects (P ϭ 0.03). Variables on presentation associated with death or need for LT compared to spontaneous survival: male gender, age Ͼ40 yr, immunocompromised state, ALT Ͼ5,000 U/L, platelet count Ͻ75 ϫ 10 3 /L, coagulopathy, encephalopathy, and absence of antiviral therapy. In conclusion, HSV hepatitis has a high mortality and is often clinically unsuspected. Patients who are male, older, immunocompromised, and/or presenting with significant liver dysfunction are more likely to progress to death and should thus be evaluated for LT early. Based on the frequent delay in HSV diagnosis, low risk-benefit ratio, and significantly improved outcomes, empiric acyclovir therapy for patients presenting with ALF of unknown etiology is recommended until HSV hepatitis is excluded.

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Disseminated herpes simplex virus infection in an apparently immunocompetent woman

Cited by 20 publications

References 16 publications

Herpes Simplex Hepatitis in Adults

Herpes Simplex Hepatitis in Adults

Differential effects of nerve growth factor and dexamethasone on herpes simplex virus type 1 oriL- and oriS-dependent DNA replication in PC12 cells

Herpes simplex virus hepatitis: An analysis of the published literature and institutional cases

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