Herpes Genitalis

生殖器疱疹
  • 文章类型: Journal Article
    HSV-2再活化位点处的皮肤富含HSV-2特异性T细胞。为了评估免疫治疗疫苗是否可以引发基于皮肤的记忆T细胞,我们通过T细胞受体(TCR)β链(TRB)测序研究了在接种无复制能力的全病毒HSV-2候选疫苗(HSV529)之前和之后的皮肤活检和来自PBMC的HSV-2反应性CD4+T细胞.在第一疫苗剂量后,皮肤TRB库中来自PBMC的HSV-2反应性CD4+TRB序列的表示增加。我们发现疫苗接种后的持续扩张是独一无二的,在从PBMC分离的HSV-2反应性CD4+T细胞中未检测到的皮肤型T细胞克隆型。在一个参与者中,免疫优势的转换发生在疫苗接种后TCRαβ对的出现,但在血液中未检测到.通过在基于Jurkat的NR4A1报告系统中表达合成TCR,显示该TCRαβ具有HSV-2反应性。HSV-2再激活区域的皮肤具有与循环不同的寡克隆TRB库。定义治疗性疫苗接种对HSV-2特异性TRB库的影响需要基于组织的评估。
    The skin at the site of HSV-2 reactivation is enriched for HSV-2-specific T cells. To evaluate whether an immunotherapeutic vaccine could elicit skin-based memory T cells, we studied skin biopsies and HSV-2-reactive CD4+ T cells from PBMCs by T cell receptor (TCR) β chain (TRB) sequencing before and after vaccination with a replication-incompetent whole-virus HSV-2 vaccine candidate (HSV529). The representation of HSV-2-reactive CD4+ TRB sequences from PBMCs in the skin TRB repertoire increased after the first vaccine dose. We found sustained expansion after vaccination of unique, skin-based T cell clonotypes that were not detected in HSV-2-reactive CD4+ T cells isolated from PBMCs. In one participant, a switch in immunodominance occurred with the emergence of a TCR αβ pair after vaccination that was not detected in blood. This TCRαβ was shown to be HSV-2 reactive by expression of a synthetic TCR in a Jurkat-based NR4A1 reporter system. The skin in areas of HSV-2 reactivation possessed an oligoclonal TRB repertoire that was distinct from the circulation. Defining the influence of therapeutic vaccination on the HSV-2-specific TRB repertoire requires tissue-based evaluation.
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  • 文章类型: Journal Article
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  • 文章类型: Systematic Review
    2型单纯疱疹(HSV-2)感染的患病率上升对全球公共卫生提出了越来越大的挑战。全面了解中国的流行病学和负担差异对于将来制定有针对性和有效的干预策略至关重要。
    我们遵循Cochrane和PRISMA指南进行了系统的审查,并包括了在3月31日之前以中英文书目系统出版的出版物,2024.我们合成了不同人群类型的HSV-2血清阳性率数据。我们使用随机效应模型进行荟萃分析,并进行荟萃回归来评估人群特征与血清阳性率之间的关联。
    总的来说,确认了23999篇文章,纳入了报告总体血清阳性率(858项分层测量)的402份出版物(1,203,362名参与者).一般人群(风险较低)中合并HSV-2血清阳性率为7.7%(95%CI:6.8-8.7%)。与普通人群相比,在中等风险人群中,HSV-2患病率的风险较高(14.8%,95%CI:11.0-19.1%),和关键人群(31.7%,95%CI:27.4-36.1%)。女性性工作者(FSW)的HSV-2风险最高(ARR:1.69,95%CI:1.61-1.78)。我们发现东北地区的HSV-2血清阳性率高于其他地区(17.0%,95%CI:4.3-35.6%,ARR:1.38,95%CI:1.26-1.50,华北为参照组)。这突出了人口风险水平和地区的差异。我们还发现,在关键人群(如MSM和HIV不和谐人群)中,中国书目数据库出版物中的HSV-2患病率估计值低于英文数据库。
    HSV-2患病率风险分层存在梯度增加。我们还确定了区域,人口,以及HSV-2负担中出版物语言的年龄差异和异质性。这项研究为未来的HSV-2预防提供了指导,以消除HSV-2感染的差异并减少整体HSV-2负担。
    https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=408108,标识符CRD42023408108。
    UNASSIGNED: The rising prevalence of herpes simplex type 2 (HSV-2) infection poses a growing global public health challenge. A comprehensive understanding of its epidemiology and burden disparities in China is crucial for informing targeted and effective intervention strategies in the future.
    UNASSIGNED: We followed Cochrane and PRISMA guidelines for a systematic review and included publications published in Chinese and English bibliographic systems until March 31st, 2024. We synthesized HSV-2 seroprevalence data across different population types. We used random-effects models for meta-analyses and conducted meta-regression to assess the association between population characteristics and seroprevalence.
    UNASSIGNED: Overall, 23,999 articles were identified, and 402 publications (1,203,362 participants) that reported the overall seroprevalence rates (858 stratified measures) were included. Pooled HSV-2 seroprevalence among the general population (lower risk) was 7.7% (95% CI: 6.8-8.7%). Compared to the general population, there is a higher risk of HSV-2 prevalence among intermediate-risk populations (14.8%, 95% CI: 11.0-19.1%), and key populations (31.7%, 95% CI: 27.4-36.1%). Female sexual workers (FSWs) have the highest HSV-2 risk (ARR:1.69, 95% CI: 1.61-1.78). We found northeastern regions had a higher HSV-2 seroprevalence than other regions (17.0%, 95% CI: 4.3-35.6%, ARR: 1.38, 95% CI: 1.26-1.50, Northern China as the reference group). This highlighted the disparity by population risk levels and regions. We also found lower HSV-2 prevalence estimates in publications in Chinese bibliographic databases than those in English databases among key populations (such as MSM and HIV-discordant populations).
    UNASSIGNED: There is a gradient increase in HSV-2 prevalence risk stratification. We also identified region, population, and age disparities and heterogeneities by publication language in the HSV-2 burden. This study provides guidance for future HSV-2 prevention to eliminate disparities of HSV-2 infection and reduce overall HSV-2 burden.
    UNASSIGNED: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=408108, identifier CRD42023408108.
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  • 文章类型: Journal Article
    从既定的延迟,人类疱疹病毒2型(HSV-2)经常重新激活到生殖道,导致有症状的溃疡或亚临床脱落。组织驻留记忆(TRM)CD8+T细胞在生殖器皮肤上积聚并持续在复发的局部部位是病毒再激活的“第一反应者”,进行免疫监视和遏制,并中止病毒诱导临床病变的能力。这篇综述描述了独特的时空特征,转录签名,在人HSV-2感染的组织背景下,TRMCD8+T细胞的非催化效应功能。我们强调了对内在阻力之间复杂重叠的最新见解,天生的防御,以及组织微环境中的适应性免疫,并讨论皮肤和粘膜水平的快速病毒宿主动力学如何影响生殖器疱疹疾病的临床结果。
    From established latency, human herpes virus type 2 (HSV-2) frequently reactivates into the genital tract, resulting in symptomatic ulcers or subclinical shedding. Tissue-resident memory (TRM) CD8+ T cells that accumulate and persist in the genital skin at the local site of recrudescence are the \"first responders\" to viral reactivation, performing immunosurveillance and containment and aborting the ability of the virus to induce clinical lesions. This review describes the unique spatiotemporal characteristics, transcriptional signatures, and noncatalytic effector functions of TRM CD8+ T cells in the tissue context of human HSV-2 infection. We highlight recent insights into the intricate overlaps between intrinsic resistance, innate defense, and adaptive immunity in the tissue microenvironment and discuss how rapid virus-host dynamics at the skin and mucosal level influence clinical outcomes of genital herpes diseases.
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  • 文章类型: Journal Article
    背景:目前2型单纯疱疹病毒(HSV-2)感染的患病率非常高,患有HSV-2的个体面临反复爆发,实现缓解的挑战,和艾滋病毒感染的风险增加。本研究旨在探讨饮酒与HSV-2感染之间的关系。
    方法:本研究的数据来自2009年至2016年参加国家健康和营养调查(NHANES)的7257名参与者。目标人群包括具有可靠HSV-2血浆结果的成年人,使用自我报告方法评估饮酒量.我们评估了饮酒与HSV-2感染之间的关联的比值比(OR)和95%置信区间(CI)。这些估计来自针对关键混杂因素进行调整的逻辑回归模型。亚组分析特别关注饮酒,和HSV-2感染之间的相互作用,酒精消费,其他变量通过分层分析进行评估.
    结果:在包括的7,257名参与者中,89.8%(6,518/7,257)报告了不同水平的饮酒史。与从不喝酒的人相比,前饮酒者的调整后赔率比(OR),轻度饮酒者,适度饮酒者,重度饮酒者为1.79(95%CI:1.34-2.4,p<0.001),1.38(95%CI:1.07-1.77,p=0.012),1.49(95%CI:1.15-1.94,p=0.003),和1.47(95%CI:1.14-1.9,p=0.003),分别。亚组分析和敏感性分析结果保持稳定。
    结论:目前的研究表明,与从未饮酒的人相比,有饮酒史的人感染HSV-2的风险更高。
    BACKGROUND: The current prevalence of Herpes simplex virus type 2 (HSV-2) infection is notably high, with individuals afflicted by HSV-2 facing recurrent outbreaks, challenges in achieving remission, and an elevated risk of HIV infection. This study aims to investigate the relationship between alcohol consumption and HSV-2 infection.
    METHODS: The data for this study were sourced from 7257 participants who took part in the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2016. The target population consisted of adults with reliable HSV-2 plasma results, and alcohol consumption was assessed using self-report methods. We evaluated the odds ratio (OR) and 95% confidence interval (CI) for the association between alcohol consumption and HSV-2 infection. These estimations were derived from a logistic regression model that was adjusted for key confounding factors. Subgroup analysis specifically focused on alcohol consumption, and the interaction between HSV-2 infection, alcohol consumption, and other variables was assessed through stratified analysis.
    RESULTS: Among the 7,257 participants included, 89.8% (6,518/7,257) reported varying levels of alcohol consumption history. Compared to individuals who never drinkers, the adjusted odds ratios (ORs) for former drinkers, light drinkers, moderate drinkers, and heavy drinkers were 1.79 (95% CI: 1.34-2.4, p < 0.001), 1.38 (95% CI: 1.07-1.77, p = 0.012), 1.49 (95% CI: 1.15-1.94, p = 0.003), and 1.47 (95% CI: 1.14-1.9, p = 0.003), respectively. The results remained stable in subgroup analyses and sensitivity analyses.
    CONCLUSIONS: Current research indicates that individuals with a history of alcohol consumption exhibit a higher risk of HSV-2 infection compared to those who have never drinkers.
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  • 文章类型: Journal Article
    单纯疱疹病毒1型(HSV-1)和2型(HSV-2)是慢性,高度流行的病毒感染在世界各地引起显著的发病率。HSV-2是性传播的,是生殖器溃疡(GUD)的主要原因。它还增加了感染艾滋病毒的风险,助长了艾滋病毒的流行。HSV-1通常在儿童期通过非性接触获得,并有助于口腔和眼部疾病。但它也可以通过性传播导致GUD。HSV-1和HSV-2均可引起新生儿疱疹和神经系统疾病。鉴于HSV-1和HSV-2感染的普遍性以及现有的预防和控制措施有限,疫苗接种将是降低与HSV感染相关的全球发病率负担的最有效策略.疫苗策略包括预防性疫苗接种,这将防止易感人群感染,并可能给予青少年,和治疗性疫苗接种,将给予有症状的生殖器HSV-2感染的人。本文讨论了这两种疫苗的疫苗价值概况。本“HSV疫苗价值概况”(VVP)旨在提供高水平的、全面评估目前可用于潜在公共卫生的信息和数据,管道疫苗和疫苗类产品的经济和社会价值。这个VVP是由学术界的主题专家开发的,非营利组织,政府机构和多边组织。所有贡献者都对HSVVVP的各个要素具有广泛的专业知识,并共同致力于确定当前的研究和知识差距。VVP是仅使用现有的和公开的信息开发的。
    Herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) are chronic, highly prevalent viral infections that cause significant morbidity around the world. HSV-2 is sexually transmitted and is the leading cause of genital ulcer disease (GUD). It also increases the risk of HIV acquisition, fueling the HIV epidemic. HSV-1 is typically acquired in childhood through nonsexual contact and contributes to oral and ocular disease, but it can also be sexually transmitted to cause GUD. Both HSV-1 and HSV-2 cause neonatal herpes and neurologic disease. Given the ubiquitous nature of HSV-1 and HSV-2 infections and the limited existing prevention and control measures, vaccination would be the most efficient strategy to reduce the global burden of morbidity related to HSV infection. Vaccine strategies include prophylactic vaccination, which would prevent infection among susceptible persons and would likely be given to adolescents, and therapeutic vaccinations, which would be given to people with symptomatic genital HSV-2 infection. This document discusses the vaccine value profile of both types of vaccines. This \'Vaccine Value Profile\' (VVP) for HSV is intended to provide a high-level, holistic assessment of the information and data that are currently available to inform the potential public health, economic and societal value of pipeline vaccines and vaccine-like products. This VVP was developed by subject matter experts from academia, non-profit organizations, government agencies and multi-lateral organizations. All contributors have extensive expertise on various elements of the HSV VVP and collectively aimed to identify current research and knowledge gaps. The VVP was developed using only existing and publicly available information.
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    文章类型: Journal Article
    本报告总结了2015年至2023年美国武装部队现役军人性传播感染(STIs)的发病率和趋势。本报告汇编的数据来自衣原体的医学监测,淋病,梅毒是国家法定报告的疾病。2个额外性传播感染的病例数据,人乳头瘤病毒(HPV)和生殖器单纯疱疹病毒(HSV),也提出了。衣原体和淋病的粗总发病率最初平均每年上升6.7%和9.8%,分别,直到2019年。从2020年起,利率稳步下降。到2023年,衣原体感染率下降了约39%,虽然女性淋病率下降了40%以上,男性占19%,服务会员。最初梅毒增加,平均而言,从2015年到2019年,每年10%,然后在2020年下降,但到2023年恢复了上升趋势,在2023年几乎是2015年的两倍。在监测期间,生殖器HPV和HSV的年总发病率总体呈下降趋势,分别下降30.7%和24.7%,分别。经年龄和性别调整的衣原体发病率,淋病,与普通美国人口相比,美国武装部队中的梅毒仍然升高,这可能是由于包括强制性性传播感染筛查在内的因素,更完整的报告,年龄分布的不完全调整,以及军事现役军人和普通美国人口之间的不公平比较。在COVID-19大流行期间制定的社会限制可能导致真实病例率和筛查覆盖率的下降。
    This report summarizes incidence rates and trends of sexually transmitted infections (STIs) from 2015 through 2023 among active component service members of the U.S. Armed Forces. The data compiled for this report are derived from the medical surveillance of chlamydia, gonorrhea, and syphilis as nationally notifiable diseases. Case data for 2 additional STIs, human papilloma virus (HPV) and genital herpes simplex virus (HSV), are also presented. The crude total case rates of chlamydia and gonorrhea initially rose by an average of 6.7% and 9.8% per year, respectively, until 2019. From 2020 onwards, rates steadily declined. By 2023, chlamydia rates had dropped by approximately 39%, while gonorrhea rates had fallen by more than 40% for female, and 19% for male, service members. Initially syphilis increased, on average, 10% annually from 2015 to 2019, then declined in 2020, but resumed its upward trend through 2023, nearly doubling the 2015 rate in 2023. The total crude annual incidence rates of genital HPV and HSV exhibited downward trends in general over the surveillance period, decreasing by 30.7% and 24.7%, respectively. Age- and gender-adjusted case rates for chlamydia, gonorrhea, and syphilis remain elevated within the U.S. Armed Forces compared to the general U.S. population, which may be due to factors that include mandatory STI screening, more complete reporting, incomplete adjustment for age distribution, and inequitable comparisons between the military active duty and general U.S. populations. Social restrictions enacted during the COVID-19 pandemic may have contributed to declines in true case rates and screening coverage.
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  • 文章类型: Letter
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  • 文章类型: Historical Article
    背景:审查和更新研究重点对于评估进展并确保在研究中最佳分配财务和人力资源至关重要。2001年,世卫组织为低收入和中等收入国家(LMICs)的2型单纯疱疹病毒(HSV-2)研究举办了一个研究重点确定讲习班。这项研究旨在描述2000年至2020年间研讨会概述的五个关键研究优先领域中的三个领域的进展:HSV-2/HIV相互作用,HSV-2控制措施和HSV-2数学建模。其余的优先事项在一份配套文件中得到解决。
    方法:MEDLINE系统文献检索,CINAHL,建立了全球卫生和Cochrane数据库。基于LMIC的相关主要研究研究,包括以英文撰写并于2000-2020年出版的。论文由两名独立审稿人筛选,并选择合适的变量从研究文本中手动提取。将数据组织到Excel电子表格中,并使用IBMSPSS进行分析。
    结果:总计,确定了3214篇离散论文,其中180人符合纳入条件(HSV-2/HIV相互作用,98;控制措施,58;数学建模,24).大多数研究是在东非进行的。世卫组织2001年的大多数HSV-2研究优先事项至少部分得到了解决。总的来说,尽管有几项研究描述了HSV-2与HIV的获取和传播之间的密切关系,HSV-2控制反复显示对HIV脱落或传播的影响很小。Further,虽然数学模型预测疫苗会显著影响HSV-2指标,HSV-2疫苗研究很少。抗病毒抗性的研究也很少。
    结论:自2000年以来,LMICHSV-2研究解决了其控制问题,艾滋病毒相互作用和数学建模在很大程度上解决了2001年世卫组织HSV-2讲习班确定的优先事项。然而,疫苗研究仍然存在关键知识差距,抗病毒成本效益,抗病毒抗性和特定地理区域。
    BACKGROUND: Reviewing and updating research priorities is essential to assess progress and to ensure optimal allocation of financial and human resources in research. In 2001, WHO held a research priority setting workshop for herpes simplex virus type 2 (HSV-2) research in low-income and middle-income countries (LMICs). This study aimed to describe progress between 2000 and 2020 in three of the five key research priority areas outlined in the workshop: HSV-2/HIV interactions, HSV-2 control measures and HSV-2 mathematical modelling. The remaining priorities are addressed in a companion paper.
    METHODS: A systematic literature search of MEDLINE, CINAHL, Global Health and Cochrane databases was carried out. Relevant primary research studies based in LMICs, written in English and published on 2000-2020 were included. Papers were screened by two independent reviewers, and suitable variables were selected for manual extraction from study texts. Data were organised into an Excel spreadsheet and analysed using IBM SPSS.
    RESULTS: In total, 3214 discrete papers were identified, of which 180 were eligible for inclusion (HSV-2/HIV interactions, 98; control measures, 58; mathematical modelling, 24). Most studies were conducted in East Africa. The majority of the 2001 WHO HSV-2 research priorities were addressed at least in part. Overall, despite several studies describing a strong relationship between HSV-2 and the acquisition and transmission of HIV, HSV-2 control repeatedly demonstrated little effect on HIV shedding or transmission. Further, although mathematical modelling predicted that vaccines could significantly impact HSV-2 indicators, HSV-2 vaccine studies were few. Studies of antiviral resistance were also few.
    CONCLUSIONS: Since 2000, LMIC HSV-2 research addressing its control, HIV interactions and mathematical modelling has largely addressed the priorities set in the 2001 WHO HSV-2 workshop. However, key knowledge gaps remain in vaccine research, antiviral cost-effectiveness, antiviral resistance and specific geographical areas.
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  • 文章类型: Historical Article
    背景:低收入和中等收入国家(LMICs)的2型单纯疱疹病毒(HSV-2)感染负担很高,与艾滋病毒密切相关。2001年,世卫组织主办了一次研讨会,为LMICs中的HSV-2确定研究重点。定期重新评估研究重点对于确保有效分配资源至关重要。这项研究描述了2000年至2020年间在解决研讨会重点五个主题领域中的两个领域中确定的优先事项方面取得的进展:HSV-2流行病学和诊断。其余领域在配套文件中得到解决。
    方法:对MEDLINE的系统搜索,CINAHL,建立了全球卫生和Cochrane数据库。在低收入国家进行的相关初级和次级研究,包括2000-2020年出版的英文著作。两名独立研究人员筛选,识别论文,并从研究文本中提取预先识别的变量。将数据组织到Excel电子表格中,并使用IBMSPSSV.26进行分析。
    结果:总体而言,确定了4445篇离散论文,其中165份出版物有资格列入。据报道,一般人群中HSV-2患病率最高的是南非和西非。女性患病率高于男性,并随年龄增长而增加。重点人群中的HSV-2患病率研究很少,大多数在东亚和南亚。关于年轻人群(平均年龄=25岁)中HSV-2发病率和北非和中东HSV-2感染率的队列研究很少。HSV-2诊断中研究最多的主题涉及血清学技术和直接分子生物学。即时测试的研究也很少。
    结论:在低收入国家中确定的HSV-2研究主要针对2001年世卫组织研讨会确定的流行病学和诊断优先事项。未解决的优先事项包括即时测试,被忽视的地理环境和人群亚组中的抗病毒抗性和HSV-2流行病学探索。
    BACKGROUND: Low-income and middle-income countries (LMICs) have a high burden of herpes simplex virus type 2 (HSV-2) infection, which has been strongly associated with HIV. In 2001, the WHO hosted a workshop to set research priorities for HSV-2 in LMICs. Periodic re-evaluation of research priorities is essential to ensure effective allocation of resources. This study describes the progress made between 2000 and 2020 in addressing the priorities identified in two of the five thematic areas that were the workshop\'s focus: HSV-2 epidemiology and diagnostics. The remaining areas are addressed in a companion paper.
    METHODS: A systematic search of MEDLINE, CINAHL, Global Health and Cochrane databases was carried out. Relevant primary and secondary research studies conducted in LMICs, written in English and published from 2000-2020 were included. Two independent researchers screened, identified papers and extracted preidentified variables from study texts. Data were organised into an Excel spreadsheet and analysed using IBM SPSS V.26.
    RESULTS: Overall, 4445 discrete papers were identified, of which 165 publications were eligible for inclusion. The highest general population HSV-2 prevalence was reported in South and West Africa. Prevalence was higher among women than men and increased with age. HSV-2 prevalence studies among key populations were few, and the majority were in East and South Asia. Cohort studies of HSV-2 incidence among younger populations (mean age=25 years) and HSV-2 infection prevalence in North Africa and the Middle East were few. The most researched topic in HSV-2 diagnostics addressed serological techniques and direct molecular biology. Studies of point-of-care testing were also few.
    CONCLUSIONS: HSV-2 research identified in LMICs has mainly addressed the epidemiology and diagnostics priorities identified by the 2001 WHO workshop. Unaddressed priorities include point-of-care testing, antiviral resistance and exploration of HSV-2 epidemiology in neglected geographical settings and population subgroups.
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