Impact of herpes simplex virus detection in respiratory specimens of patients with suspected viral pneumonia

Background Respiratory infection and failure is a commonly encountered problem in intensive care unit (ICU) patients. However, despite the accumulating body of evidence to suggest that herpes simplex virus type 1 (HSV-1) is associated with pneumonia, the exact role played by this virus in this proce...

Full description

Saved in:
Bibliographic Details
Published in:Infection 2010-10, Vol.38 (5), p.401-405
Main Authors: Scheithauer, S, Manemann, A. K, Krüger, S, Häusler, M, Krüttgen, A, Lemmen, S. W, Ritter, K, Kleines, M
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
ARDS
Brief Report
Case-Control Studies
Family Medicine
Female
General Practice
Herpes simplex virus
Herpes simplex virus 1
Herpesviridae
Humans
ICU
Infectious Diseases
Intensive Care Units
Internal Medicine
Male
Medicine
Medicine & Public Health
Middle Aged
pneumonia
Pneumonia, Viral - mortality
Pneumonia, Viral - virology
Respiration, Artificial - adverse effects
Respiratory System - virology
Simplexvirus - genetics
Simplexvirus - isolation & purification
Simplexvirus - physiology
Viral Load
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Respiratory infection and failure is a commonly encountered problem in intensive care unit (ICU) patients. However, despite the accumulating body of evidence to suggest that herpes simplex virus type 1 (HSV-1) is associated with pneumonia, the exact role played by this virus in this process is still not fully understood. Therefore, to identify patients at risk, we have conducted a case-control study to characterize patients with HSV-1-positive pneumonia. Patients and methods Between 2007 and 2009, all patients with suspected viral pneumonia were tested for the presence of herpes viruses using a PCR assay approach with respiratory specimens. To identify possible associations, risk factors, and impact of HSV, HSV-1-positive ICU patients (n = 51) were compared to age-, gender-, and department- and season-matched HSV-negative patients (n = 52). Results HSV-positive patients differed significantly from the HSV-negative ones only in terms of time of mechanical ventilation (13 vs. 6 days, respectively; p = 0.002). Subgroup analysis in the patients aged >60 years and in those without bacterial detection revealed a similar trend (p = 0.01 and p = 0.004, respectively). Mortality did not differ between the groups or between the HSV-1-positive patients treated with aciclovir and those who were not. A viral load >10E+05 geq/ml was associated with mechanical ventilation (20/21 vs. 17/29; p = 0.004), acute respiratory distress syndrome (ARDS; 19/21 vs. 18/29; p = 0.005), sepsis (18/21 vs. 14/29; p = 0.008), detection of a bacterial pathogen in the same specimen (10/21 vs. 4/29; p = 0.01) and longer ICU stay (25 vs. 30 days; p = 0.04). Conclusion Despite several associations with high viral load, the clinical outcome of HSV-1-positive ICU patients did not differ significantly from the clinical outcome of HSV-negative patients. This finding indicates that HSV-1 viral loads in respiratory specimens are a symptom of a clinically poor condition rather than a cause of it. Longitudinal and therapy studies are therefore needed to distinguish between HSV-1 as a causative pathogen and HSV-1 as a bystander of pneumonia/ARDS.
ISSN:0300-8126
1439-0973
DOI:10.1007/s15010-010-0036-x