Human cytomegalovirus and Herpes simplex viruses 1 and 2 are double stranded DNA viruses that establish lifetime latency in a host upon initial infection(1–3). Primary infection or reactivation of the latent virus in a pregnant woman can transmit the virus in utero or during birth to the fetus causing high neonatal morbidity(4,5). Majority of these infections are asymptomatic at birth, but may present later with potential lethal infection and disseminated disease (HSV) or long term neurodevelopmental sequelae including sensorineural hearing loss (HCMV)(1,4,5). The infection can, however, be symptomatic where it may present as non-specific neurologic conditions for HCMV or sepsis-like condition for HSV or severe HCMV cases(4,6), which may not result in the physician ordering immediate testing for these viruses(4).
An early detection of HCMV/HSV is thus necessary to decrease morbidity for asymptomatic infections. Their specific detection against other disease-causing agents is also required to inform correct patient treatment for non-specific symptoms or polymicrobial infections. An ideal test should be rapid to aid in clinical decision-making and broad based to include these viruses with other common neonatal infectious agents with similar symptoms and for which tests are commonly ordered. This work discusses the development of a rapid quantitative PCR based viral assay for HSV and HCMV that can be multiplexed with sepsis or other infectious disease panels with its probe-free chemistry, in order to allow early and specific detection of these viruses in neonates.
Herpes simplex viruses type 1 and type 2 (HSV-1 and HSV-2) are amongst the most common human infectious viral pathogens capable of causing serious clinical diseases at every stage of life, from fatal disseminated disease in newborns to cold sores genital ulcerations and blinding eye disease. Primary mucocutaneous infection with HSV-1 & HSV-2 is followed by a lifelong viral latency in the sensory ganglia. In the majority of cases, herpes infections are clinically asymptomatic. However, in symptomatic individuals, the latent HSV can spontaneously and frequently reactivate, reinfecting the muco-cutaneous surfaces and causing painful recurrent diseases. The innate and adaptive mucosal immunities to herpes infections and disease remain to be fully characterized. The understanding of innate and adaptive immune mechanisms operating at muco-cutaneous surfaces is fundamental to the design of next-generation herpes vaccines. In this paper, the phenotypic and functional properties of innate and adaptive mucosal immune cells, their role in antiherpes immunity, and immunopathology are reviewed. The progress and limitations in developing a safe and efficient mucosal herpes vaccine are discussed.
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