Cone R W, Hobson A C, Brown Z, Ashley R, Berry S, Winter C, Corey L
Department of Laboratory Medicine, University of Washington, Seattle.
JAMA. 1994 Sep 14;272(10):792-6.
To investigate the prevalence and level of genital herpes simplex virus (HSV) among women at delivery.
DESIGN, PATIENTS, AND SETTING: A prospective analysis of HSV by culture and by polymerase chain reaction (PCR) of genital specimens and by HSV serologic studies in 100 asymptomatic women in labor; prospective analysis of HSV by PCR among 50 seronegative nonpregnant women at a student health center; and retrospective analysis of genital specimens for HSV by PCR from 17 HSV culture-positive women with uninfected neonates and from two HSV culture-negative women with HSV-infected neonates. All pregnant women were at a university hospital.
Presence of HSV by culture and levels of HSV by quantitative, type-specific PCR in cervical and vulvar specimens; HSV serologic testing by Western blot.
All of the 100 asymptomatic women in labor who were studied prospectively were HSV culture negative. In nine HSV was recovered by PCR. Herpes simplex virus was recovered by PCR in one of the 50 seronegative nonpregnant women; she soon became seropositive. All 17 culture-positive women had HSV recovered by PCR. High levels of HSV DNA were obtained by PCR from the two culture-negative women with infected neonates. Among those from whom HSV was recovered by PCR, HSV DNA levels were 250 times higher from culture-positive samples than from culture-negative samples (11,571 genome equivalents vs 46 genome equivalents; P < .001).
The frequency of infant exposure to HSV DNA-containing secretions from HSV-seropositive mothers is about eight times higher than previously reported using HSV culture methods. High maternal levels of HSV DNA may be associated with an increased frequency of transmission of HSV to the infant.
调查分娩时女性单纯疱疹病毒（HSV）的感染率及感染水平。
设计、研究对象与研究地点：对100名无症状待产女性的生殖器标本进行单纯疱疹病毒培养、聚合酶链反应（PCR）检测以及单纯疱疹病毒血清学研究，进行前瞻性分析；对学生健康中心的50名血清学阴性的非孕妇进行单纯疱疹病毒PCR检测，进行前瞻性分析；对17例单纯疱疹病毒培养阳性但新生儿未感染的女性以及2例单纯疱疹病毒培养阴性但新生儿感染的女性的生殖器标本进行单纯疱疹病毒PCR检测，进行回顾性分析。所有孕妇均来自大学医院。
通过培养检测单纯疱疹病毒的存在情况，通过定量、型特异性PCR检测宫颈和外阴标本中单纯疱疹病毒的水平；通过免疫印迹法进行单纯疱疹病毒血清学检测。
前瞻性研究的100名无症状待产女性单纯疱疹病毒培养均为阴性。9例通过PCR检测出单纯疱疹病毒。50名血清学阴性的非孕妇中有1例通过PCR检测出单纯疱疹病毒；她很快血清学转为阳性。17例培养阳性的女性均通过PCR检测出单纯疱疹病毒。2例培养阴性但新生儿感染的女性通过PCR检测出高水平的单纯疱疹病毒DNA。在通过PCR检测出单纯疱疹病毒的样本中，培养阳性样本的单纯疱疹病毒DNA水平比培养阴性样本高250倍（11,571个基因组当量对46个基因组当量；P <.001）。
婴儿接触单纯疱疹病毒血清学阳性母亲含单纯疱疹病毒DNA分泌物的频率比之前使用单纯疱疹病毒培养方法报告的高约8倍。母亲体内高水平的单纯疱疹病毒DNA可能与单纯疱疹病毒传播给婴儿的频率增加有关。
