Clinical relevance of herpes simplex virus viremia in Intensive Care Unit patients. Issue 1 (July 2015)

• Record Type: Journal Article
• Authors: Lepiller, Q.; Sueur, C.; Solis, M.; Barth, H.; Glady, L.; Lefebvre, F.; Fafi-Kremer, S.; Schneider, F.; Stoll-Keller, F.
• Is Part Of: Journal of infection. Volume 71:Issue 1(2015)
• Page Start: 93
• Page End: 100
• Publication Date: 2015-07
• Subjects: Infection -- Periodicals; Bacterial Infections -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.905
• DOI: 10.1016/j.jinf.2015.02.013
• Languages: English
• ISSNs: 0163-4453

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Summary</title> <sec> <title id="sectitle0015">Objectives</title> <p id="abspara0010">To determine the clinical relevance of herpes simplex virus (HSV) viremia episodes in critically ill adult patients.</p> </sec> <sec> <title id="sectitle0020">Methods</title> <p id="abspara0015">1556 blood samples obtained for HSV PCR analysis in Intensive Care Unit (ICU) patients over 4 years were retrospectively analyzed, focusing on the comprehensive analysis of 88 HSV-viremic patients.</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">HSV DNA was detected in 11.8% of samples from the ICU. HSV viral loads remained below 5 × 10<sup>2</sup> copies/ml in 68.2% of patients and exceeded 10<sup>4</sup> copies/ml in 7.9%. Episodes of HSV-viremia correlated with immunosuppressed status and mechanical ventilation in 79.5% and 65.9% of patients, respectively. Only a subset of patients exhibited HSV-related organ damage, including pneumonia and hepatitis (10.2% and 2.3%, respectively). The mortality rate in HSV-viremic patients was not significantly increased compared to the overall mortality rate in the ICU (27.3% <italic>vs.</italic> 22.9%, <italic>p</italic> = 0.33). Only patients with high HSV viral loads tended to have a higher, though non-significant, death rate (57.1%, <italic>p</italic> = 0.14).</p> </sec> <sec> <title id="sectitle0030">Conclusions</title> <p id="abspara0025">Our results suggest HSV viremia is common in ICU patients, potentially favored by immunocompromised status and mechanical ventilation. The global impact of HSV-viremia on mortality in the ICU was low. Quantifying HSV DNA may help identifying patients at-risk of severe HSV-induced symptoms.</p> </sec> </abstract>