口腔領域の単純ヘルペスウイルス感染症におけるウイルス分離率, 感染価および局所病変の経時的変化について

抄録

To elucidate the relationship between lesion titer of herpes simplex virus (HSV) and clinical states, virus isolation and infectivity titration were carried out in 200 samples collected from clinically suspected lesions of 178 patients in the Department of Oral Surgery, Yokohama City University Hospital.
The virus isolation rate in patients diagnosed to have a primary HSV infection were 68%, 52% in those with a recurrent infection, and 56% in total.
In patients with a primary infection, the isolation rate exceeded 90% up to five days after onset, then decreased markedly. Average virus titer remained unchanged until seven days of disease (3.3-3.8 log₁₀ TCID₅₀/2ml/sample). In patients with a recurrent infection, the isolation rate was relatively high in the early phase (77% on day 0 and 1), then showed a tendency to decrease. Average virus titer was highest in the samples obtained in the early phase (5.8 log₁₀ TClD₅₀/2ml/sample).
Virus isolation rate was higher in primary cases than in those of recurrence. Average virus titer in lesions, however, was significantly lower in the primary infection, which was a finding of interest.
Regarding the change of virus infectivity, titer in the early phase of the recurrent cases was remarkably high at first, then tended to decrease more quickly as time elapsed compared with those of primary infection.
Morbid states were roughly classified into three categories: 1) “redness”, 2) “vesicle etc.” (vesicle and pustule), and 3) “ulcer etc.” (erosion, ulcer and crust). Their involvements were examined according to the number of days after the onset of the disease. In the primary infection, “ulcer etc.” occupied more than half of the lesions throughout the period. In the recurrent infections, “vesicle etc.” was the majority in an early phase but after 4 days this decreased markedly and, instead “ulcer etc.” occupied more than 2/3 of the lesions.
Changes in morbid states, virus titers, and isolation rates in the course of HSV infection and their relationship were discussed.