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Abstract
Background Recurrent herpes simplex infection markedly reduces patients' quality of life. How closely viral replicative activity tracks the severity of the course has not been sufficiently measured. We set out to compare viral DNA load in patients with differing recurrence frequency and to describe it alongside clinical, immunological, and epidemiological indicators.
Materials and Methods 240 participants aged 18 to 68 years were allocated to three groups: a main group (n = 140, frequently recurring course), a comparison group (n = 60, infrequently recurring course), and a control group (n = 40, apparently healthy individuals). Viral DNA load was measured by real-time PCR, serum IFN-γ, IL-4, and total IgE by enzyme-linked immunosorbent assay, and the CD4/CD8 ratio by flow cytometry. Epidemiological data were collected by questionnaire and review of medical records.
Results Viral DNA load rose stepwise across the groups: undetectable in the control group, 2.4 ± 0.2 in the comparison group, and 4.1 ± 0.3 log₁₀ copies/mL in the main group (p < 0.001). In parallel, the annual number of recurrences in the main group was 2.7-fold higher than in the comparison group (5.8 ± 0.3 vs 2.1 ± 0.2) and remission was 2.9-fold shorter (2.3 ± 0.2 vs 6.7 ± 0.5 months; p < 0.001). Immunological indicators in the main group differed from control: IFN-γ and the CD4/CD8 ratio were lower, IL-4 and total IgE higher (p < 0.001). Hypothermia (62.1%) and stress (55.7%) were the triggers most often reported, and 65.7% of recurrences occurred in autumn and winter.
Conclusion A recurring course was associated with disturbed immunological balance, higher viral DNA load, and a set of epidemiological factors. A stepwise relationship was found between viral DNA load and recurrence frequency. Establishing the prognostic value of this indicator will require a prospective study with baseline measurement followed by observation.
Keywords:
Herpes simplex, interferon-gamma, polymerase chain reaction
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