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Resumen Las cervicitis es una condición frecuente causada principalmente por agentes de transmisión sexual. Su presentación clínica varía desde cuadros asintomáticos hasta procesos inflamatorios extensos, que incluso asemejan un tumor maligno. Presentamos el caso de una adolescente que presentó úlceras genitales, síntomas generales y cérvix necrótico con aspecto tumoral. Los estudios de laboratorio confirmaron una co-infección por virus herpes simplex 2 (HSV-2) y Mycoplasma genitalium. El estudio histológico descartó una neo- plasia. Evolucionó favorablemente al tratamiento antimicrobiano, con recuperación progresiva del aspecto del cérvix. La cervicitis en raras ocasiones se presenta con compromiso necrótico. La co-infección por HSV-2 y M. genitalium, en este caso, pudo ser el determinante del daño cervical y la necrosis. Una evaluación acuciosa y estudio con exámenes diagnósticos de alta sensibilidad y especificidad permitieron hacer un diagnóstico y tratamiento adecuado.
Abstract Cervicitis is a frequent condition caused mainly by sexually trans- mitted agents. The clinical spectrum varies from absence of symptoms to extensive inflammatory processes that may simulate a malignant neoplasm. We present a clinical case of an adolescent with genital ulcers and systemic disease. Speculoscopy revealed a tumoral-looking cervix. Laboratory studies confirm infection with herpes simplex virus 2 (HSV-2) and Mycoplasma genitalium, together with a histological study that ruled out neoplasia. It progresses favorably to antimicrobial treatment, with recovery of the appearance of the cervix. Cervicitis rarely presents with necrotic involvement. Co-infection with HSV-2 and M. genitalium infection may have been the determinant of cervical damage and the necrotic appearance. A thorough evaluation and study with highly sensitive and specific diagnostic tests allowed an adequate diagnosis and treatment.
Subject(s)
Humans , Female , Adolescent , Uterine Cervicitis/complications , Uterine Cervicitis/diagnosis , Uterine Cervicitis/drug therapy , Mycoplasma genitalium , Coinfection , Mycoplasma Infections/complications , Mycoplasma Infections/diagnosis , Mycoplasma Infections/drug therapy , Herpesvirus 2, HumanABSTRACT
Objective:To construct a recombinant herpes simplex virus 2 (HSV-2) expressing enhanced green fluorescent protein (EGFP) using clustered, regularly interspaced, short palindromic repeat/CRISPR-associated nuclease 9 (CRISPR/Cas9) technology.Methods:Four strategies for inserting exogenous EGFP gene into HSV-2 genome using CRISPR/Cas9 technology were designed: (1) conventional homology-directed repair: circular two homology arm donor-mediated gene knock-in; (2) linearized single homology arm donor-mediated gene knock-in; (3) homology-independent targeted integration; (4) conventional homology-directed repair-mediated by cell lines stably expressing Cas9 and sgRNA.Results:The recombinant virus HSV-2-EGFP was successfully constructed based on the second, the third and the fourth strategies. The second strategy was the most efficient, followed by the third and the fourth strategies. The purified recombinant virus could stably express green fluorescent protein in seven passages and shared similar growth characteristics in Vero cells to the parental virus.Conclusions:Linearized single homology arm donor could increase the efficiency of gene knock-in, and cell lines stably expressing Cas9 and sgRNA could increase the efficiency of gene knock-in mediated by homology-directed repair.
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Introduction@#In Mongolia, diagnostic tests for the detection of the sexually transmitted congenital virus and human papilloma virus are currently not routinely used in clinical settings and the frequency of these STIs is enigmatic.@*Goal@#The prevalence of this virus were prospectively evaluated among 200 Mongolian pregnant women and their newborns and correlated with pregnancy outcome.@*Materials and Methods@#Taq Man PCRs were used to detect some virus in pre-birth vaginal swabs of the pregnant women and in oral swabs of their newborns. A standardized questionnaire concerning former and present pregnancies was developed and regression analysis was used to correlate virus detection with pregnancy outcome.@*Result@#Cytomegalovirus was the most prevalent of the tested pathogens (46.5% positive women and 10.5% newborns), human papilloma virus (31.5% and 4.5%) and herpes simplex virus-2 (1% and 0%). @*Statistical analysis@#The statistical analysis was conducted using the software program RStudio, version 0.99.896. Multiple regression analysis was used to assess the association between pathogen loads of mothers or newborns and the outcome variables (gestational age, neonatal length, weight, head circumferences and bacterial vaginosis).@*Conclusions@#Multiple regression analyses indicate that colonization of the mothers with cytomegalovirus is associated with transmission to newborns and that transmission is associated with reduced neonatal length and gestational age. Thus, diagnostic tests for their detection should be implemented in the clinical settings in Mongolia.
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Objective This study aimed to understand the herpes simplex virus-2 (HSV-2) infection and related factors among female drug abusers in the women's compulsory drug rehabilitation center of Shandong province and to provide reference for the prevention and control of HSV-2 in these settings.Methods We screened all of 451 female drug abusers in the women's compulsory drug rehabilitation centers in of Shandong province and conducted a study using both questionnaire investigation and serological tests for HSV-2,HIV and syphilis.We also used EpiData 3.1 software to establish a database and SPSS 20.0 software to conduct the x2 test and multivariate logistic regression analysis.Results A total of 451 female drug abusers were under study.We noticed that the rates for HSV-2 infection,HIV infection and syphilis infection appeared as 72.1％ (325/451),2.2％ (10/451) and 33.5 ％ (151/451) respectively.Results from univariate analysis showed that factors as:awareness on AIDS,having temporary sex partner after using the drug,having multiple sex partners after using the drug,providing commercial services or having temporary sex practice before being detained,with syphilis infection etc.,were associated with HSV-2 infection.Data from the multivariate analysis showed that the OR (95％CI) value of HSV-2 infection was 2.90 (1.19-7.06) for those who providing commercial service,when comparing to those who did not.Compared to those who did not suffer from syphilis infection,the OR (95％CI) value of HSV-2 infection for those with syphilis infection was 2.75 (1.63-4.63).Conclusions The rate of HSV-2 infection was high in the women's compulsory drug rehabilitation center of Shandong province.We should enhance measures and promote condom use to prevent from HSV-2 and other sexually transmitted diseases among them.
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Objective This study aimed to understand the herpes simplex virus-2 (HSV-2) infection and related factors among female drug abusers in the women's compulsory drug rehabilitation center of Shandong province and to provide reference for the prevention and control of HSV-2 in these settings.Methods We screened all of 451 female drug abusers in the women's compulsory drug rehabilitation centers in of Shandong province and conducted a study using both questionnaire investigation and serological tests for HSV-2,HIV and syphilis.We also used EpiData 3.1 software to establish a database and SPSS 20.0 software to conduct the x2 test and multivariate logistic regression analysis.Results A total of 451 female drug abusers were under study.We noticed that the rates for HSV-2 infection,HIV infection and syphilis infection appeared as 72.1％ (325/451),2.2％ (10/451) and 33.5 ％ (151/451) respectively.Results from univariate analysis showed that factors as:awareness on AIDS,having temporary sex partner after using the drug,having multiple sex partners after using the drug,providing commercial services or having temporary sex practice before being detained,with syphilis infection etc.,were associated with HSV-2 infection.Data from the multivariate analysis showed that the OR (95％CI) value of HSV-2 infection was 2.90 (1.19-7.06) for those who providing commercial service,when comparing to those who did not.Compared to those who did not suffer from syphilis infection,the OR (95％CI) value of HSV-2 infection for those with syphilis infection was 2.75 (1.63-4.63).Conclusions The rate of HSV-2 infection was high in the women's compulsory drug rehabilitation center of Shandong province.We should enhance measures and promote condom use to prevent from HSV-2 and other sexually transmitted diseases among them.
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Objective To analyze the prevalence rates and associated risk factors on HIV, syphilis,herpes simplex virus-2(HSV-2)among female sex workers(FSWs)in Jiaozhou,Shandong province. Methods Through convenient sampling,an anonymous questionnaire survey was conducted on female sex workers to collect related information. Blood specimens were drawn for serological tests on HIV,syphilis and HSV-2 antibodies,respectively. Patients with positive results from both treponema pallidum and HSV-2 tested by ELISA method,were defined as being superinfected. Results A total of 460 FSWs were recruited in this study. The prevalence rates of HIV,syphilis,HSV-2,and syphilis/HSV-2 superinfection were 0.22%,5.9%,43.0%,and 11.7%, respectively. Among the methamphetamine users,the prevalence rates of syphilis,HSV-2,and syphilis/HSV-2 superinfection were 12.4%,55.2%,and 22.9%,respectively. Results from multivariate analysis showed that factors that significantly associated with syphilis infection would include:methamphetamine use(OR=3.61,95%CI:1.62-8.06),having first commercial sex intercourse at under 20 years of age(OR=2.80,95% CI:1.15-6.85),more than 2 establishments that the FSWs worked in the last month(OR=4.37,95%CI:0.83-22.83). Factors associated with HSV-2 infection were methamphetamine use(OR=2.30,95%CI:1.43-3.70),having first commercial sex intercourse at under 20 years of age (OR=1.77,95%CI:1.16-2.69),working at low-end establishments (OR=2.61,95%CI:1.66-4.10),working at the local sex-work venues for more than one year(OR=2.01,95%CI:1.28-3.14),with low education backgrounds(OR=2.27,95%CI:1.18-4.36),using methamphetamine(OR=3.95,95%CI:2.09-7.44),low education background(OR=2.43,95%CI:1.10-5.36),21-30 year-olds(OR=2.95,95%CI:1.08-8.03),older than 31 years of age(OR=7.05, 95%CI:2.48-20.01) etc.,were independent risk factors associated with the superinfection of syphilis and HSV-2. Conclusion The prevalence rates of syphilis,HSV-2 and syphilis/HSV-2 superinfection were relatively high among FSWs in Jiaozhou,especially among the FSWs who were methamphetamine users.
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Objective To analyze the prevalence rates and associated risk factors on HIV, syphilis,herpes simplex virus-2(HSV-2)among female sex workers(FSWs)in Jiaozhou,Shandong province. Methods Through convenient sampling,an anonymous questionnaire survey was conducted on female sex workers to collect related information. Blood specimens were drawn for serological tests on HIV,syphilis and HSV-2 antibodies,respectively. Patients with positive results from both treponema pallidum and HSV-2 tested by ELISA method,were defined as being superinfected. Results A total of 460 FSWs were recruited in this study. The prevalence rates of HIV,syphilis,HSV-2,and syphilis/HSV-2 superinfection were 0.22%,5.9%,43.0%,and 11.7%, respectively. Among the methamphetamine users,the prevalence rates of syphilis,HSV-2,and syphilis/HSV-2 superinfection were 12.4%,55.2%,and 22.9%,respectively. Results from multivariate analysis showed that factors that significantly associated with syphilis infection would include:methamphetamine use(OR=3.61,95%CI:1.62-8.06),having first commercial sex intercourse at under 20 years of age(OR=2.80,95% CI:1.15-6.85),more than 2 establishments that the FSWs worked in the last month(OR=4.37,95%CI:0.83-22.83). Factors associated with HSV-2 infection were methamphetamine use(OR=2.30,95%CI:1.43-3.70),having first commercial sex intercourse at under 20 years of age (OR=1.77,95%CI:1.16-2.69),working at low-end establishments (OR=2.61,95%CI:1.66-4.10),working at the local sex-work venues for more than one year(OR=2.01,95%CI:1.28-3.14),with low education backgrounds(OR=2.27,95%CI:1.18-4.36),using methamphetamine(OR=3.95,95%CI:2.09-7.44),low education background(OR=2.43,95%CI:1.10-5.36),21-30 year-olds(OR=2.95,95%CI:1.08-8.03),older than 31 years of age(OR=7.05, 95%CI:2.48-20.01) etc.,were independent risk factors associated with the superinfection of syphilis and HSV-2. Conclusion The prevalence rates of syphilis,HSV-2 and syphilis/HSV-2 superinfection were relatively high among FSWs in Jiaozhou,especially among the FSWs who were methamphetamine users.
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Objective To explore the sero-prevalence and risk factors for herpes simplex virus 2 (HSV-2) infection and unprotected sexual behavior in an ethnically diverse population of HIVinfected subjects in a county of Yunnan province. Methods HIV-infected individuals attending for routine follow-up by local Center for Disease Control and Prevention (CDC) were recruited to participate in the study under 'informed consent'. A face-to-face questionnaire interview was administered to each participant. Blood was drawn for HSV-2 testing by HerpeSelect HSV-2 ELISA (Focus Diagnostics) and CD4+ T counting. Results A total of 300 HIV-infected individuals participated in the study. The mean age of the subjects was 37.6 years with 76.7% as males. Ethnically, Han, Dai and Jingpo accounted for 44.3%, 37.3% and 16.0% of the sample, respectively. Half of the subjects reported HIV acquisition through injection drug use. The sero-prevalence of HSV-2 was 35.0%. Results from multiple logistic regression analysis indicated that individuals who acquired HIV through heterosexual contact were more likely to be HSV-2 positive than those who acquired HIV through injection drug use (OR=4.244,95%CI: 1.924-9.364),whereas Dai (OR=0.300,95% CI: 0.152-0.593) and Jingpo (OR=0.376, 95% CI: 0.167-0.850) were less likely to be HSV-2 positive than the Hans. Among 105 people who were co-infected with HIV/HSV-2, 60 had sexual intercourses in the past 3 months and 41.7% of them reported no or inconsistent use of condoms. Most unprotected sexual contacts occurred within married couples. Conclusion HSV-2 infection was highly prevalent among HIV-infected individuals in this county, and a significant proportion of HIV/HSV-2 co-infected subjects engaged in unprotected sex. HSV-2 testing, behavioral and biomedical interventions among HIV-infected individuals and their sexual partners should be involved in the local HIV prevention and control programs.
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Objective: To construct the recombinant expressive vector of HSV-2-EGFP for the primary application in rapid,direct and sensitive diagnosis of herpes simplex virus infection. Methods: The gene fragment coding for HSV-2 ICP10 promoter was amplified by PCR,and the PCR product was cloned into pEGFP-1 to construct the recombinant plasmid pICP10-EGFP,which would be identified by DNA sequencing.The recombinant plasmid pICP10-EGFP were transfected into Vero cells by cation lipoid Lipofectamine 2000,then G418 was added to screen the positive cells to obtain stable cell line Vero-ICP10-EGFP.Vero-ICP10-EGFP was infected by various titers of HSV-2,and the EGFP fluorescence was detected under inverted microscope at 6,8 and 10 h post-infection.The specificity of the cell line was detected by infection with human cytomegalovirus(HCMV) and coxsackievirus. Results: The recombinant plasmid pICP10-EGFP was proved to be correct by the double restriction enzyme digestion and DNA sequencing.The Vero-ICP10-EGFP fluorescent emitting cells can be observed as early as 6 h after infection with HSV,with pronounced increase in the intensities at later hours.No induction of detectable fluorescence was detected by infection with HCMV and coxsackievirus 6,10 and 24 h post-infection. Conclusion: This novel GFP reporter system expressing the HSV-inducible EGFP reporter gene might provide a fast,easy and sensitive model for monitoring HSV in clinical specimens.
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Objective To study the relation between the clinical feature and glycoprotein D gene sequence analysis of a wild strain of HSV 2 isolated from one relapsed patient with genital herpes. Methods The partial glycoprotein D gene sequence of the above mentioned strain was amplified and cloned with PCR. Results The comparison of the amino acid sequence of gD gene between the wild strain and HSV 2G strain published showed that there was a mutation at site80 and site159. Conclusion In order to develop effective vaccine which is suitable for China, it is necessary to investigate the differences of the gene structure and function of gD among HSV isolated from China and other countries.