Herpes simplex virus reactivation in surgical patients

Area of Science:

• Immunology
• Virology
• Critical Care Medicine

Background:

• Herpes simplex virus (HSV) reactivation can indicate compromised host defense.
• Critically ill patients often experience impaired immune function.

Purpose of the Study:

• To investigate oral HSV shedding in critically ill surgical patients.
• To assess HSV reactivation as a marker of host defense in this population.
• To correlate HSV shedding and immune response with patient outcomes.

Main Methods:

• Studied 44 critically ill surgical patients for oral HSV shedding.
• Compared shedding rates with 50 healthy controls and 42 elective surgery patients.
• Monitored for specific HSV antibody response and correlated with mortality.

Main Results:

• 18 (41%) critically ill patients exhibited persistent oral HSV shedding.
• No controls shed HSV; 10% of elective surgery patients had transient shedding.
• Oral HSV shedding did not correlate with outcome in critically ill patients.
• Failure to mount an HSV antibody rise during shedding was linked to high mortality.

Conclusions:

• Critically ill surgical patients frequently show endogenous HSV reactivation.
• Impaired cell-mediated and humoral immunity are evident in this patient group.
• HSV antibody response, not shedding alone, may predict mortality in critically ill patients.