RECURRENCES AFTER ORAL AND GENITAL HERPES-SIMPLEX VIRUS-INFECTION - INFLUENCE OF SITE OF INFECTION AND VIRAL TYPE
RECURRENCES AFTER ORAL AND GENITAL HERPES-SIMPLEX VIRUS-INFECTION - INFLUENCE OF SITE OF INFECTION AND VIRAL TYPE
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DOI：
10.1056/nejm198706043162304
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发表时间：
1987-06-04
影响因子：
158.5
通讯作者：
COREY, L
中科院分区：
文献类型：
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作者：
LAFFERTY, WE;COOMBS, RW;COREY, L
我们前瞻性地随访了39例由同一病毒引起的口咽部和生殖器原发性单纯疱疹病毒（HSV）感染（12例HSV 1型和27例HSV 2型）成人，以评估病毒类型（HSV-1与HSV-2）和感染部位（口咽部与生殖器）对复发频率的影响。HSV感染的后续复发模式根据病毒类型和解剖部位显著不同。12例HSV-1型患者中5例发生口唇复发，27例HSV-2型患者中1例发生口唇复发（P < 0.001）。HSV-2型27例中有24例生殖器复发，HSV-1型12例中有3例生殖器复发（P < 0.01）。生殖道复发率（HSV-1和HSV-2）平均为0.23/月，口唇复发率仅为0.04/月（P < 0.001）。平均每月复发频率依次为生殖器HSV-2感染，每月0.33;口唇HSV-1感染，每月0.12;生殖器HSV-1感染，每月0.020;和口腔HSV-2感染，每月0.001（每次比较P < 0.01）。我们得出结论，HSV-1和HSV-2感染之间以及骶骨和三叉神经解剖部位之间HSV感染再激活的可能性不同。生殖器HSV感染的临床复发率是口唇HSV感染的6倍，这可能是近年来临床公认的生殖器疱疹患病率相对快速增加的原因。
We prospectively followed 39 adults with concurrent primary herpes simplex virus (HSV) infection (12 with HSV type 1 and 27 with HSV type 2) of the oropharynx and genitalia, caused by the same virus in each person, to evaluate the influence of viral type (HSV-1 vs. HSV-2) and site of infection (oropharyngeal vs. genital) on the frequency of recurrence. The subsequent recurrence patterns of HSV infection differed markedly according to viral type and anatomical site. Oral-labial recurrences developed in 5 of 12 patients with HSV-1 and 1 of 27 patients with HSV-2 (P < 0.001). Conversely, genital recurrences developed in 24 of 27 patients with HSV-2 and 3 of 12 patients with HSV-1 (P < 0.01). The mean rate of subsequent genital recurrences (due to HSV-1 and HSV-2) was 0.23 per month, wheres the mean rate of oral-labial recurrences was only 0.04 per month (P < 0.001). The mean monthly frequencies of recurrence were, in order, genital HSV-2 infections, 0.33 per month; oral-labial HSV-1 infections, 0.12 per month; genital HSV-1 infections, 0.020 per month; and oral HSV-2 infections, 0.001 per month (P < 0.01 for each comparison). We conclude that the likelihood of reactivation of HSV infection differs between HSV-1 and HSV-2 infections and between the sacral and trigeminal anatomical sites. The sixfold more frequent clinical recurrence rate of genital HSV infections as compared with oral-labial HSV infections may account for the relatively rapid increase in the prevalence of clinically recognized genital herpes in recent years.