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Cellular Immune Response in Genital Herpes Simplex Virus Infection

List of authors.
  • Lawrence Corey, M.D.,
  • William C. Reeves, M.D.,
  • and King K. Holmes, M.D., Ph.D.

Abstract

We studied the relations between the cellular immune response, pre-existing complement-fixing antibody and virus type with duration of virus excretion in genital herpes simplex virus (HSV) infection.

Thirty-six patients (seven with HSV-1 and 29 with HSV-2) with genital herpes underwent serologic testing, sequential viral cultures and weekly determination of lymphocyte-transformation stimulation index with inactivated HSV antigen. The duration of virus excretion was shortest in those with pre-existing complement-fixing antibody, was unrelated to virus type, and was inversely correlated with the magnitude of the mean peak stimulation index (r = -0.69, P<0.001). Prolonged virus excretion occurred in patients with a delayed and diminished peak index. Recurrent episodes had a higher peak index (29.4 compared to 14.5) (P<0.02), an earlier development of the peak during recurrences (9.1 vs. 25.8 days) (P<0.01) and a briefer duration of viral shedding than initial episodes. Thus, the temporal course and magnitude of the stimulation index correlate with and may determine the duration of genital HSV infection. (N Engl J Med 299:986–991, 1978)

Funding and Disclosures

Supported in part by a Program Project Grant (AI-12192), a Venereal Disease Training Grant (1–T32-AI-07140) and a Young Investigators Grant (AI-14415) from the National Institutes of Health and by a grant (SEA-76–06–72) from the Division of Hospitals and Clinics, Bureau of Medical Services, U.S. Public Health Service.

We are indebted to Lois Brewer, who performed the lymphocyte-transformation assays, to Ernest Tolentino and Kimberly Brockhouse, who performed HSV isolation, typing and serologic tests, to Carolyn Lipinski, W.H.C.S., Michael Remington, P.A., and Carol Winter, R.N., who assisted in patient evaluations, and to Michael Banks, Sharon Oliver Clifner and Pam Ryan, who assisted in data collection.

Author Affiliations

From the departments of Laboratory Medicine, Microbiology and Immunology and Medicine and the School of Public Health, University of Washington, and the U.S. Public Health Service Hospital, Seattle (address reprint requests to Dr. Corey at Virology Laboratory, L-512, Children's Orthopedic Hospital and Medical Center, 4800 Sand Point Way N.E., Seattle, WA 98105).

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