Sun Yongjiang, Chan Roy Kum Wah, Tan Suat Hoon, Ng Patricia Pei Lin
Infectious Disease Laboratory, Infectious Disease Research Centre, Level 2, TTSH Medical Centre, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Republic of Singapore.
J Med Virol. 2003 Nov;71(3):423-8. doi: 10.1002/jmv.10502.
A subset of erythema multiforme (erythema multiforme) is associated with herpes simplex virus (HSV) infection; viral cultures of erythema multiforme lesions are, however, usually negative and viral antigens difficult to identify. Polymerase chain reaction (PCR) has been used to demonstrate the association, hence, is currently the only available sensitive diagnostic means for HSV-associated erythema multiforme. A nested PCR, which could simultaneously detect and genotype HSV in erythema multiforme lesions and in clinical swab specimen was developed using the DNA polymerase gene of HSV as target gene because it is the only detectable HSV gene in a high proportion of erythema multiforme lesions. The PCR has demonstrated its robust sensitivity on swab samples by being able to detect further 45.3% HSV cases in comparison with virus isolation with 100% specificity in both detection and genotyping confirmed by virus isolation and DNA sequencing. This study represents the first investigation of typing HSV virus in HSV-associated erythema multiforme patients, and the finding that 66.7% of the patients was attributed to HSV1, 27.8% to HSV2, and 5.6% to HSV1 and 2 co-infection may reflect the distribution of HSV1 and 2 in local general population.
多形红斑的一个亚组与单纯疱疹病毒（HSV）感染相关；然而，多形红斑皮损的病毒培养通常为阴性，且病毒抗原难以识别。聚合酶链反应（PCR）已被用于证实这种关联，因此，它是目前唯一可用于诊断HSV相关性多形红斑的敏感方法。利用HSV的DNA聚合酶基因作为靶基因，开发了一种巢式PCR，该方法可同时检测多形红斑皮损和临床拭子样本中的HSV并进行基因分型，因为它是在大部分多形红斑皮损中唯一可检测到的HSV基因。与病毒分离相比，该PCR在拭子样本上显示出强大的敏感性，能够检测出另外45.3%的HSV病例，在病毒分离和DNA测序证实的检测和基因分型中均具有100%的特异性。本研究首次对HSV相关性多形红斑患者的HSV病毒进行分型调查，发现66.7%的患者归因于HSV1，27.8%归因于HSV2，5.6%归因于HSV1和HSV2共同感染，这可能反映了HSV1和HSV2在当地普通人群中的分布情况。
