142例亚临床型生殖器疱疹患者病毒脱排特点分析

The characteristics of herpes simplex virus shedding in 142 cases of subclinical genital herpes

目的分析亚临床型生殖器疱疹(GH)患者的病毒脱排特点,为临床治疗提供依据。方法选取2014年6月—2016年6月间我院收治的亚临床型GH患者142例,荧光定量PCR法检测患者单纯疱疹病毒(HSV)-DNA脱排情况,酶联免疫吸附试验(ELISA)检测患者血清Ig G抗体类型。分析年龄、性别、抗体类型及病程长短、发病频率对病毒脱排阳性率的影响。结果 142例患者中HSV-DNA阳性率为49.3%,女性的病毒脱排阳性率高于男性(P<0.05)。血清HSV-ⅠIg G++HSV-ⅡIg G+与单纯HSV-ⅡIg G+患者病毒脱排阳性率差异无统计学意义,但二者均高于单纯HSV-ⅠIg G+患者。病程≤6年的患者病毒脱排阳性率高于>6年者,频发患者(复发≥6次/年)高于少发患者(复发<6次/年,均P<0.05)。病程≤6年的患者中,频发患者高于少发患者,而病程>6年的患者中,频发与少发患者病毒脱排阳性率差异无统计学意义(P>0.05)。同时女性患者HSV-Ⅱ感染率高于男性(P<0.05)。结论亚临床型GH患者的病毒脱排阳性率与性别、血清抗体类型、病程及发病频率等因素密切相关。

Objective To study the characteristics of shedding herpes simplex virus(HSV) in patients with subclinicalgenital herpes, and provide basis for clinical therapy. Methods A total of 142 patients with subclinical genital herpes wereobtained in our hospital from June 2014 to June 2016. The fluorescent quantitation polymerase chain reaction was used todetect the HSV-DNA, and enzyme linked immunosorbent assay(ELISA) was applied to check the type of serum Ig G. Theeffects of age, gender, antibody types, disease courses and occurrence frequency on the positive rate of HSV DNA sheddingwere analyzed. Results The positive rate of HSV-DNA in 142 patients was 49.3%, and females showed significantly higherHSV shedding rate than males(P < 0.05). There was no significant difference in HSV shedding rate between patients withserum HSV-Ⅰ Ig G++HSV-Ⅱ Ig G+and patients with HSV-Ⅱ Ig G+alone, while both of which showed higher HSV sheddingrate than those of patients with HSV- Ⅰ Ig G+alone. Patients with short infection period(≤6 years) showed significantlyhigher HSV shedding rate than patients with longer infection period(>6 years). HSV shedding rate in patients with highfrequent occurrence was found to be significantly higher than that in patients with low frequent occurrence(P < 0.05). Inpatients who showed short infection period(≤6 years), the HSV shedding rate was found significantly higher in frequentpatients(recurrence ≥ 6 times/year) than that in few occurrence patients(recurrence < 6 times/year). There was nosignificant difference in HSV shedding rate in patients with recurrent occurrence when they went through more than 6 years' HSV infection(P > 0.05). More patients with positive HSV- Ⅱ Ig G were found in female than that in male(P < 0.05).Conclusion In patients with subclinical genital herpes, HSV shedding rate is closely related to gender, serum antibodytype, disease course and recurrent occurrence.