关键词: 疱疹，生殖器, 抗体, 药用制剂, 血清

Abstract: XIA Li *，MENG Jian, CHEN De-hua, CHENG Pei-hua, HUANG Xi, LUO Jing-ying, LIU Qun-ying, YANG Feng-yuan, YAN Wen-jie, TAO Zan-ying, SUN Wen-guo. *Department of Dermatology, Affiliated Hospital of Guilin Medical University, Guilin 541001, Guangxi, China Corresponding author: CHENG Pei-hua, Email: chenxi5797@sina.com 【Abstract】 Objective To estimate the relationship of herpes simplex virus （HSV） shedding with serum anti-herpes simplex virus （HSV） antibody levels and antiviral treatment in patients with asymptomatic genital herpes. Methods Totally, 650 patients with genital herpes were enrolled in this study. Swab samples were collected from urethral, genital, perianal mucosa and extragenital sites of previous HSV infection, and venous blood samples were also obtained from these patients. Fluorescence-based quantitative PCR was performed to detect HSV DNA and determine the copy number of HSV plasmid DNA, enzyme-linked immunosorbent assay （ELISA） to test the serum level of anti-HSV IgM and IgG antibodies. The patients positive for HSV DNA were classified into three groups to be treated with valaciclovir 0.3 g twice daily for 4 months （valaciclovir group, n = 152）, aciclovir 0.4 g thrice daily for 4 months （aciclovir group, n = 152）, or remain untreated （control group, n = 50）. Viral shedding was detected at 5 days, 10 days and 4 months after start of antiviral treatment, as well as at 1 and 4 months after termination of antiviral treatment. All the patients were followed for 1 year. Chi-square test was carried out to assess the differences in viral shedding rates among patients with different serum antibody levels, clinical course and recurrence frequency. Results Among the 650 patients, 354 （54.5％） shed HSV DNA, with the copy number of plasmid DNA ranging from 63 to 9.4 × 103 copies/ml and averaging 3.1 × 103 copies/ml. The viral shedding rate statistically differed between patients with a clinical course of > 3 years and those < 3 years （?字2 = 6.41, P < 0.05） as well as between patients with a high frequency of recurrence （> 6 times per year） and those with a low frequency （< or = 6 times per year, ?字2 = 9.46, P < 0.01）. Statistical differences were observed between patients who shed HSV DNA and those who did not in the percentage of patients positive for both anti-HSV-Ⅰ and anti-HSV-Ⅱ IgG and that positive for anti-HSV-Ⅰ IgG alone （both P < 0.01）, but not in that positive for anti-HSV-Ⅱ IgM （P > 0.05）. The viral shedding rate was significantly lower in the valaciclovir group and aciclovir group than in the control group during the course of antiviral therapy （all P < 0.01）, but no statistical difference was observed among the three groups at 1 and 4 months after termination of antiviral therapy （all P > 0.05）. The recurrence frequency of genital herpes was significantly reduced in the valaciclovir group and aciclovir group after antiviral treatment （both P < 0.01）, but remained unchanged in the control group （P > 0.05）. Conclusions The viral shedding rate reaches 54.5% in patients with asymptomatic genital herpes. Serum test shows a mixed infection with HSV-Ⅰ and HSV-Ⅱ in some patients with genital herpes. It seems that the longer the clinical course of genital herpes, the lower the viral shedding rate. Antiviral treatment can markedly reduce the recurrence of genital herpes, and suppress HSV viral shedding. 【Key words】 Herpes genitalis; Serum; Antibodies; Pharmaceutical preparations