74 results on '"Rhoda Ashley Morrow"'
Search Results
2. Tenofovir Gel for Prevention of Herpes Simplex Virus Type 2 Acquisition: Findings From the VOICE Trial
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Lorna K. Rabe, Jeanne M. Marrazzo, Barbra A. Richardson, Rhoda Ashley Morrow, Jill L. Schwartz, Sharon L. Hillier, Jeanna M. Piper, Mark A. Marzinke, Zvavahera M. Chirenje, Cliff Kelly, Craig W. Hendrix, and Carolyn D. Deal
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Adult ,0301 basic medicine ,medicine.medical_specialty ,Adolescent ,Herpesvirus 2, Human ,Sexual Behavior ,HIV Infections ,Antiviral Agents ,Major Articles and Brief Reports ,Young Adult ,03 medical and health sciences ,Pre-exposure prophylaxis ,0302 clinical medicine ,Double-Blind Method ,CAPRISA 004 ,Humans ,Immunology and Allergy ,Medicine ,Sex organ ,030212 general & internal medicine ,Seroconversion ,Tenofovir ,Herpes Genitalis ,business.industry ,Obstetrics ,Incidence ,Incidence (epidemiology) ,Hazard ratio ,Confidence interval ,030104 developmental biology ,Infectious Diseases ,Hormonal contraception ,HIV-1 ,Vaginal Creams, Foams, and Jellies ,Female ,Pre-Exposure Prophylaxis ,business - Abstract
Background Genital infection with herpes simplex virus type 2 (HSV-2) is common and increases risk of human immunodeficiency virus (HIV) transmission and acquisition. Pericoital use of tenofovir (TFV) gel provided protection from HSV-2 acquisition in the CAPRISA 004 study. Methods We measured estimate of effect of vaginal TFV 1% gel in preventing HSV-2 acquisition among women in VOICE, randomized, double-blinded, placebo-controlled trial assessing daily use of oral and vaginal TFV for HIV-1 preexposure prophylaxis. The TFV level in plasma at the first quarterly visit was used as a measure of gel use. Results Of 566 participants at risk for HSV-2 acquisition, 532 (94%) had first-quarter plasma TFV and end-of-study HSV-2 serologic data available. Over a follow-up period of 501 person-years, 92 incident cases of HSV-2 acquisition occurred: 77 were in women with no TFV detected in plasma, and 15 occurred in women with TFV detected in plasma (incidence, 20.6 cases/100 person-years [95% confidence interval [CI], 16.2-25.7] vs 11.9 cases/100 person-years [95% CI, 6.6-19.6], respectively). TFV detection in plasma was associated with a trend toward a reduced risk of HSV-2 seroconversion, with an unadjusted hazard ratio (HR) of 0.59 (95% CI, .34-1.02; P = .060) and a HR adjusted for site, age, having ≥2 male sex partners in the past 3 months, use of hormonal contraception, having anal sex in the past 3 months, and HIV status of 0.60 (95% CI, .33-1.08; P = .086). Conclusions Detection of TFV in plasma among TFV gel users was associated with a trend toward a reduced risk of HSV-2 acquisition, after controlling for sexual behavior and HIV-1 acquisition.
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- 2019
3. Peer Mentoring at the Uganda Cancer Institute: A Novel Model for Career Development of Clinician-Scientists in Resource-Limited Settings
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Jackson Orem, Philip Stevenson, Warren Phipps, Rachel Kansiime, Corey Casper, and Rhoda Ashley Morrow
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Cancer Research ,Biomedical Research ,020205 medical informatics ,MEDLINE ,02 engineering and technology ,Cancer Care Facilities ,lcsh:RC254-282 ,Peer Group ,03 medical and health sciences ,0302 clinical medicine ,Physicians ,Peer mentoring ,Role model ,ComputingMilieux_COMPUTERSANDEDUCATION ,0202 electrical engineering, electronic engineering, information engineering ,Humans ,Medicine ,Uganda ,030212 general & internal medicine ,Program Development ,Medical education ,Education, Medical ,business.industry ,4. Education ,Mentors ,Academies and Institutes ,Mentoring ,Peer group ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Research Personnel ,Oncology ,Facilitator ,Health Resources ,Special Articles ,business ,Limited resources ,Career development - Abstract
Cancer centers are beginning to emerge in low- and middle-income countries despite having relatively few oncologists and specialists in related fields. Uganda, like many countries in sub-Saharan Africa, has a cadre of highly motivated clinician-scientists-in-training who are committed to developing the capacity for cancer care and research. However, potential local mentors for these trainees are burdened with uniquely high demands on their time for clinical care, teaching, institutional development, advocacy, and research. Facilitated peer mentoring helps to fill skills and confidence gaps and teaches mentoring skills so that trainees can learn to support one another and regularly access a more senior facilitator/role model. With an added consultant component, programs can engage limited senior faculty time to address specific training needs and to introduce junior investigators to advisors and even potential dyadic mentors. Two years after its inception, our facilitated peer mentoring career development program at the Uganda Cancer Institute in Kampala is successfully developing a new generation of researchers who, in turn, are now providing role models and mentors from within their group. This program provides a practical model for building the next generation of clinical scientists in developing countries.
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- 2018
4. Herpes Simplex Virus Type 2 Acquisition Among HIV-1–Infected Adults Treated With Tenofovir Disoproxyl Fumarate as Part of Combination Antiretroviral Therapy: Results From the ACTG A5175 PEARLS Study
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Cynthia Firnhaber, Jared M. Baeten, Deborah Donnell, Mina C. Hosseinipour, Cynthia Riviere, Connie Celum, Mulinda Nyirenda, Jorge Sanchez, Thomas B. Campbell, N. Kumarasamy, James Hakim, Actg Pearls, Khuanchai Supparatpinyo, Aspire Study Team, Breno Santos, Anne Cent, Rhoda Ashley Morrow, Beatriz Grinsztejn, Umesh G. Lalloo, and Ting Hong
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Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,Adolescent ,Herpesvirus 2, Human ,International Cooperation ,viruses ,HIV Infections ,medicine.disease_cause ,Antiviral Agents ,Medication Adherence ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,Internal medicine ,medicine ,Humans ,Immunology and Allergy ,030212 general & internal medicine ,Seroconversion ,Tenofovir ,Proportional Hazards Models ,business.industry ,Brief Report ,Incidence (epidemiology) ,Hazard ratio ,Herpes Simplex ,Middle Aged ,medicine.disease ,Virology ,Clinical trial ,Regimen ,030104 developmental biology ,Infectious Diseases ,Herpes simplex virus ,HIV-1 ,Female ,Pre-Exposure Prophylaxis ,business ,Serostatus - Abstract
Objective Tenofovir disoproxyl fumarate (TDF) disoproxyl fumarate (TDF) has in vitro activity against herpes simplex virus type 2 (HSV-2) and reduced HSV-2 acquisition as preexposure prophylaxis. Whether TDF-containing antiretroviral therapy (ART) reduces HSV-2 acquisition is unknown. Design Secondary analysis of AIDS Clinical Trials Group A5175, a randomized, open-label study of 3 ART regimens among 1571 participants. Methods HSV-2 serostatus was assessed at baseline, at study exit, and before a change in ART regimen. Results Of 365 HSV-2-seronegative persons, 68 acquired HSV-2, with 24 receiving TDF-containing ART and 44 receiving ART without TDF (HSV-2 seroconversion incidence, 6.42 and 6.63 cases/100 person-years, respectively; hazard ratio, 0.89; 95% confidence interval, .55-1.44). Conclusions HSV-2 acquisition was not reduced in HIV-infected, HSV-2-uninfected persons during TDF-containing ART.
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- 2017
5. Comparative performance of the Uni-Gold™ HSV-2 Rapid: A point-of-care HSV-2 diagnostic test in unselected sera from a reference laboratory
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Rhoda Ashley Morrow and Enda Shevlin
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Adult ,Male ,Washington ,Herpesvirus 2, Human ,Point-of-Care Systems ,viruses ,HSL and HSV ,Reference laboratory ,Antibodies, Viral ,Sensitivity and Specificity ,Article ,Serology ,Virology ,Humans ,Medicine ,Subclinical infection ,Point of care ,Herpes Genitalis ,Diagnostic Tests, Routine ,Viral culture ,business.industry ,fungi ,food and beverages ,Diagnostic test ,Infectious Diseases ,Full service ,Female ,business - Abstract
HSV-2 diagnosis is typically by viral culture, viral DNA amplification of lesion material or by serology in cases of subclinical presentation. These methods can be time consuming and expensive. The Uni-Gold™ HSV-2 Rapid is a fast, point-of-care diagnostic test that can be performed outside a full service laboratory.To evaluate the ability of the Uni-Gold™ HSV-2 Rapid to correctly diagnose the presence or absence of anti-HSV-2 antibodies in patient serum samples in comparison to the University of Washington HSV Western blot (UWWB).Sera from 100 adult patients in the USA were tested for HSV-2 specific antibodies by Uni-Gold™ HSV-2 Rapid and results were compared to those of the UWWB to determine the test's sensitivity and specificity.Of 18 patients seropositive for HSV-2 by UWWB, 17 were correctly identified as such by the Uni-Gold™ HSV-2 Rapid. Of 76 patients who were seronegative for HSV-2 by UWWB, 75 were correctly identified by the rapid test. Six sera had indeterminate results by UWWB. Sensitivity for the Uni-Gold™ HSV-2 Rapid was 94% and specificity was 99%.The Uni-Gold™ HSV-2 Rapid had high sensitivity and specificity in a small sample of unselected, adults seeking care in the Seattle, USA area. An accurate, near-person test allows immediate counseling directed toward symptom recognition, treatment, and practices that can limit the risk of HSV-2 transmission.
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- 2014
6. Erratum to: Precision of the Kalon Herpes Simplex Virus Type 2 IgG ELISA: an international inter-laboratory assessment
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Jairam R. Lingappa, Oliver Laeyendecker, Barry Kosloff, Maina M. Cheeba, Rhoda Ashley Morrow, Mubiana Inambao, Thomas C. Quinn, Jordyn Manucci, Estelle Piwowar-Manning, Kwitaka F. Maluzi, Anelet James, Bellington Vwalika, Eshan U. Patel, Erin M. Kahle, Sinead Delany-Moretlwe, and Glenda Gray
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0301 basic medicine ,Adult ,Male ,Herpesvirus 2, Human ,030106 microbiology ,Zambia ,Enzyme-Linked Immunosorbent Assay ,HIV Infections ,Biology ,medicine.disease_cause ,Antibodies, Viral ,Sensitivity and Specificity ,Microbiology ,lcsh:Infectious and parasitic diseases ,Kalon ,South Africa ,03 medical and health sciences ,Sensitivity ,0302 clinical medicine ,medicine ,Humans ,lcsh:RC109-216 ,030212 general & internal medicine ,Inter-laboratory ,Igg elisa ,Accuracy ,Herpes Genitalis ,Reproducibility of Results ,Herpes ,Precision ,HSV-2 ,Virology ,Reproducibility ,Infectious Diseases ,Herpes simplex virus ,ROC Curve ,Area Under Curve ,Immunoglobulin G ,Calibration ,Specificity ,Female ,Erratum ,Laboratories ,Research Article - Abstract
Background The commercial Kalon HSV-2 IgG ELISA is currently recommended for research use in sub-Saharan Africa because of its superior accuracy compared to other serologic assays. However, there are no data on key precision parameters of Kalon such as inter-operator variation, repeatability, and reproducibility, thus contributing to a barrier for its acceptance and use in clinical trials in sub-Saharan Africa. We evaluated the analytical and field precision of the Kalon HSV-2 IgG ELISA. Methods A total of 600 HIV-infected and uninfected serum samples from South Africa and Zambia, previously tested by the gold standard University of Washington HSV western blot (UW-WB), were tested using Kalon by two technologists in an United States reference laboratory. Aliquots of 183 samples were retested using Kalon by an on-site technologist in a South African laboratory and a Zambian laboratory. Results Intra-assay variation was below 10 %. Intra-assay, intra-laboratory, and inter-laboratory correlation and agreement were significantly high (p
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- 2017
7. Serologic Screening for Herpes Simplex Virus Type 2 in Persons With Human Immunodeficiency Virus
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Rhoda Ashley Morrow, Edward W. Hook, Nicholas Van Wagoner, Jeannette Y. Lee, and Paula Dixon
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Herpesvirus 2, Human ,Population ,HIV Infections ,medicine.disease_cause ,Negative Test Result ,Sensitivity and Specificity ,Article ,Serology ,Young Adult ,Internal medicine ,medicine ,Humans ,False Positive Reactions ,Serologic Tests ,Young adult ,education ,False Negative Reactions ,Herpes Genitalis ,Aged ,Subclinical infection ,education.field_of_study ,business.industry ,General Medicine ,Middle Aged ,Herpes simplex virus ,Immunology ,Female ,business - Abstract
Screening for subclinical herpes simplex virus type 2 (HSV-2) may be a useful adjunct in human immunodeficiency virus (HIV) care. However, HSV-2 serological tests have been suggested to perform less well in HIV-infected populations. In this study, HerpeSelect HSV-2 ELISA was compared with the Sure-Vue Rapid HSV-2 Test for HSV-2 screening of sera from 310 HIV-infected persons receiving care at an HIV-dedicated clinic in the Southeastern United States. In the study, assay agreement and whether the performance of both tests, rather than 1 test alone, would improve screening accuracy were determined. Overall percent test agreement was 96%. Negative percent agreement was best at a HerpeSelect index value
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- 2013
8. Prospective Characterization of the Risk Factors for Transmission and Symptoms of Primary Human Herpesvirus Infections Among Ugandan Infants
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Meei Li Huang, Elizabeth M Krantz, Corey Casper, Keith R. Jerome, Joshua T. Schiffer, Soren Gantt, Anna Wald, Annet Nakaganda, Rhoda Ashley Morrow, Stacy Selke, Lawrence Corey, and Jackson Orem
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0301 basic medicine ,Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Adolescent ,viruses ,Biology ,medicine.disease_cause ,Asymptomatic ,Virus ,Herpesviridae ,Cohort Studies ,03 medical and health sciences ,Major Articles and Brief Reports ,Risk Factors ,medicine ,Immunology and Allergy ,Humans ,Uganda ,Prospective Studies ,Child ,Subclinical infection ,Transmission (medicine) ,Incidence ,Infant, Newborn ,virus diseases ,Infant ,Cytomegalovirus ,Herpesviridae Infections ,Middle Aged ,030104 developmental biology ,Infectious Diseases ,Herpes simplex virus ,Child, Preschool ,Immunology ,Female ,medicine.symptom ,Breast feeding - Abstract
Background. Human herpesvirus (HHV) infections are common during infancy. Primary infections are frequently asymptomatic and best studied prospectively by using direct viral detection. Methods. Oropharyngeal swab specimens were collected weekly from Ugandan newborn infants, their mothers, and other children in the household. Blood specimens were collected every 4 months. Samples were tested for herpes simplex virus (HSV) types 1 and 2, Epstein-Barr virus (EBV), cytomegalovirus (CMV), HHV-6A, HHV-6B, and HHV-8, using quantitative polymerase chain reaction. Results. Thirty-two infants, 32 mothers, and 49 other household children were followed for a median of 57 weeks. Seventeen mothers had human immunodeficiency virus type 1 (HIV) infection; no infants acquired HIV-1. The 12-month incidence of postnatal infection was 76% for HHV-6B, 59% for CMV, 47% for EBV, 8% for HSV-1, and 0% for HHV-8. The quantity of oropharyngeal shedding by contacts was associated with HHV-6A or HHV-6B transmission. Maternal HIV-1 infection was associated with EBV transmission, while breastfeeding and younger child contacts were associated with CMV transmission. Except for HSV-1, primary HHV infections were subclinical. Conclusions. By capturing exposures and acquisition events, we found that the incidence and risk factors of infection vary by HHV type. HSV-1 infection, unlike other HHV infections, caused acute clinical illness in these infants.
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- 2015
9. Impact of Herpes Simplex Virus Type 2 on HIV-1 Acquisition and Progression in an HIV Vaccine Trial (the Step Study)
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Yunda Huang, Karen E Mark, Judith N. Wasserheit, Rhoda Ashley Morrow, Martin Casapia, Lawrence Corey, Susan Buchbinder, Devan V. Mehrotra, Holly Janes, Jonathan D. Fuchs, and Ruanne V. Barnabas
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Anti-HIV Agents ,Herpesvirus 2, Human ,viruses ,HIV Infections ,Biology ,Article ,Men who have sex with men ,Young Adult ,Risk Factors ,Internal medicine ,medicine ,Humans ,Pharmacology (medical) ,Homosexuality, Male ,Young adult ,Risk factor ,AIDS Vaccines ,Transmission (medicine) ,Hazard ratio ,Vaccine trial ,Herpes Simplex ,Middle Aged ,Viral Load ,biology.organism_classification ,Infectious Diseases ,Lentivirus ,Immunology ,HIV-1 ,Viral load - Abstract
Introduction: Extensive observational data suggest that herpes simplex virus type 2 (HSV-2) infection may facilitate HIV acquisition, increase HIV viral load, and accelerate HIV progression and onward transmission. To explore these relationships, we examined the impact of preexisting HSV-2 infection in an international HIV vaccine trial. Methods: We analyzed the associations between prevalent HSV-2 infection and HIV-1 acquisition and progression among 1836 men who have sex with men. We used Cox proportional hazards regression models to estimate the association between HSV-2 infection and both HIV acquisition and antiretroviral therapy (ART) initiation, and linear regression to explore the effect of HSV-2 on pre-ART viral load. Results: HSV-2 infection increased risk of HIV-1 acquisition among all volunteers [adjusted hazard ratio 2.2; 95% confidence interval (CI): 1.4 to 3.5]. Adjusting for demographic variables, circumcision, Ad5 titer, and significant risk behaviors, the risk of HIV acquisition among HSV-2-infected placebo recipients was 3-fold higher than HSV-2 seronegatives (adjusted hazard ratio 3.3; 95% CI: 1.6 to 6.9). Past HSV-2 infection was associated with a 0.2 log 10 copies per milliliter higher adjusted mean set point viral load (95% CI: 0.3 lower to 0.6 higher). HSV-2 infection was not associated with time to ART initiation. Conclusions: Among men who have sex with men in an HIV-1 vaccine trial, preexisting HSV-2 infection was a major risk factor for HIV acquisition. Past HSV-2 did not significantly increase HIV viral load or early disease progression. HSV-2-seropositive persons will likely prove more difficult than HSV-2-seronegative persons to protect against HIV infection using vaccines or other prevention strategies.
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- 2011
10. HBV lamivudine resistance among hepatitis B and HIV coinfected patients starting lamivudine, stavudine and nevirapine in Kenya
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H. N. Kim, Linda S. Cook, Keith R. Jerome, Rhoda Ashley Morrow, Kenneth Tapia, Anne Cent, Godfrey Lule, Barbra A. Richardson, Michael H. Chung, Grace John-Stewart, and J. Scott
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Hepatitis B virus ,HBsAg ,Nevirapine ,Hepatology ,business.industry ,Stavudine ,virus diseases ,Lamivudine ,Hepatitis B ,medicine.disease_cause ,medicine.disease ,Lamivudine resistance ,Virology ,digestive system diseases ,Infectious Diseases ,Medicine ,business ,Viral load ,medicine.drug - Abstract
Widespread use of lamivudine in antiretroviral therapy may lead to hepatitis B virus resistance in HIV-HBV co-infected patients from endemic settings where tenofovir is not readily available. We evaluated 389 Kenyan HIV-infected adults before and for 18 months after starting highly-active antiretroviral therapy with stavudine, lamivudine and nevirapine. Twenty-seven (6.9%) were HBsAg(+) and anti-HBs negative: 24 were HBeAg-negative, 18 had HBV DNA ≤10,000 IU/ml. Sustained HBV suppression to
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- 2011
11. Performance of the Focus HerpeSelect-2 enzyme immunoassay for the detection of herpes simplex virus type 2 antibodies in seven African countries
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Connie Celum, Kenneth H. Fife, Nelly Mugo, Bellington Vwalika, Sinead Delany-Moretlwe, Etienne Karita, Jared M. Baeten, Rhoda Ashley Morrow, Jairam R. Lingappa, Brigitte Bekan Homawoo, Andrew Mujugira, Guy de Bruyn, and Renee Heffron
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Veterinary medicine ,Receiver operating characteristic ,medicine.diagnostic_test ,biology ,business.industry ,Area under the curve ,Dermatology ,Gold standard (test) ,medicine.disease_cause ,Virology ,Infectious Diseases ,Herpes simplex virus ,Western blot ,Immunoassay ,biology.protein ,Medicine ,Antibody ,business ,Serostatus - Abstract
Objective To compare the performance of the Focus HerpeSelect-2 enzyme immunoassay (EIA) with the gold standard herpes simplex virus (HSV) type 2 western blot, among HIV-1-uninfected men and women in east and southern Africa. Methods 3399 HIV-1-uninfected women and men from seven countries in east and southern Africa were tested for HSV-2 antibody using the Focus HerpeSelect-2 EIA. The performance of the HerpesSelect-2 EIA was compared with the gold standard HSV-2-specific western blot. Results Two-thirds (2294/3399) of participants were male and two-thirds (2242/3399) were from east Africa. By western blot testing, HSV-2 prevalence was 68%; 59% in men and 85% in women. At the manufacturer9s recommended cut-off value of greater than 1.1, the HerpeSelect-2 EIA had a sensitivity of 98.3% and specificity of 80.3%. Receiver operating characteristic plot analysis indicated that the optimum cut-off was 2.1 or greater, with sensitivity 93.9% and specificity 90.5%. Diagnostic accuracy was modestly higher for southern Africa (area under the curve (AUC) 0.979, 95% CI 0.970 to 0.988) compared with east Africa (AUC 0.954, 95% CI 0.942 to 0.965; p Conclusions The Focus HerpeSelect-2 EIA has acceptable diagnostic accuracy for the determination of HSV-2 serostatus in African HIV-1-uninfected adults. An assay cut-off value of 2.1 or greater results in approximately 90% sensitivity and specificity, against a gold standard HSV-2 western blot. Diagnostic accuracy differed slightly by geographical region.
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- 2011
12. Performance of HSV-2 type specific serological tests in men in Kenya
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Elizabeth A. Bukusi, King K. Holmes, David Friedrich, Rhoda Ashley Morrow, and Musa Otieno Ngayo
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Adult ,Male ,education.field_of_study ,Herpes Genitalis ,Adolescent ,Herpesvirus 2, Human ,Population ,Type specific ,Gold standard (test) ,Biology ,Antibodies, Viral ,Kenya ,Sensitivity and Specificity ,Virology ,Article ,Serology ,Western blot test ,Young Adult ,Rapid assay ,Humans ,Male population ,Serologic Tests ,Seroconversion ,education - Abstract
This study compared five serological tests with Western blot from University of Washington to determine the most accurate method for detecting antibodies to herpes simplex virus type 2 (HSV-2) in a male population in Kisumu, Kenya. A random sample of 250 fishermen from 18 beaches along Lake Victoria underwent serological testing by two generations of the HerpeSelect HSV-2 ELISA ("Focus Gen 1" and "Focus Gen 2"), Kalon HSV-2 ELISA ("Kalon"), Biokit HSV-2 Rapid Test ("Biokit"), and HerpeSelect Express Rapid HSV-2 ("Express") against the Western blot test ("WB") as the "gold standard". Sensitivity and specificity of tests in this population with a high prevalence of HSV-2 (58% by WB) were: Focus Gen 1: 98.6% and 63.5%; Focus Gen 2: 99.3% and 52.3%; Biokit: 66% and 90.9%; Express: 99.3% and 44.3% and Kalon: 98.6% and 85.7%. Increasing the positive cut-off value improved the specificity of the Focus Gen 2-84.9% and Kalon to 92.2%. Focus Gen 2 offered no improvement in specificity over that of Focus Gen 1. Neither rapid assay could be recommended as either a stand-alone assay or as a confirmatory test. The results of Kalon using a cut-off of 1.5 were the most concordant with those of WB for all the approaches tested. However, low positive Kalon test results should be interpreted with caution as they could reflect early seroconversion or false positive results.
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- 2010
13. Comparison of focus HerpesSelect and Kalon HSV-2 gG2 ELISA serological assays to detect herpes simplex virus type 2 antibodies in a South African population
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Philippe Mayaud, Wendy Stevens, Ute Jentsch, Sinead Delany-Moretlwe, Rhoda Ashley-Morrow, Jocelyn Moyes, and Helen A. Weiss
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Sexually transmitted disease ,biology ,business.industry ,Dermatology ,Seroepidemiologic Studies ,medicine.disease_cause ,Virology ,Virus ,Herpesviridae ,Serology ,Infectious Diseases ,Herpes simplex virus ,Immunology ,biology.protein ,Seroprevalence ,Medicine ,Antibody ,business - Abstract
Introduction Sero-epidemiological studies of herpes simplex virus (HSV) type 2 infection in Africa remain difficult to interpret as a result of the high rate of false-positive results observed when using the new recombinant gG2 HSV-2 ELISA tests. The performance of two widely used gG2 ELISA was compared to derive an appropriate testing algorithm for use in South Africa. Methods Sera from 210 women attending family planning clinics in Johannesburg were tested using HerpeSelect and Kalon HSV-2 gG2 assays. Sera from 20 discordant pairs, 44 concordant positive and 33 concordant negative samples were further tested by HSV Western blot. The sensitivity and specificity of each test and of combination algorithms compared with Western blot were calculated. Results HerpeSelect had a sensitivity of 98% (95% CI 95 to 100) and specificity of 61% (95% CI 48 to 74). Kalon was less sensitive (89%, 95% CI 83 to 94) but more specific (85%, 95% CI 61 to 100). Seroprevalence may have been overestimated by as much as 14% by HerpeSelect. Specificity was improved by raising the cut-off index for the determination of a positive result for HerpeSelect (to $3.5), but not for Kalon. HIV-1 infection reduced the specificity of HerpeSelect to 30%. Improved sensitivity and specificity were obtained by a two-test algorithm using HerpeSelect ($3.5) as the first test and Kalon to resolve equivocal results (sensitivity 92%, 95% CI 82 to 98; specificity 91%, 95% CI 79 to 98). Conclusion Newer HSV-2 serological tests have low specificity in this South African population with a high HIV-1 prevalence. Two-step testing strategies could provide rational testing alternatives to Western blot.
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- 2009
14. Herpes Simplex Virus Type-2 Seropositivity Among Ever Married Women in South and North Vietnam: A Population-Based Study
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Hieu Trong Nguyen, Hoa Van Le, Silvia Franceschi, Nubia Muñoz, Victor J. Schoenbach, Salvatore Vaccarella, Jennifer S. Smith, Thuy Thi Nguyen, Rhoda Ashley Morrow, Max Parkin, Peter J.F. Snijders, Anh Thi Hoang Pham, Rolando Herrero, Pathology, and CCA - Oncogenesis
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Adult ,Microbiology (medical) ,Sexually transmitted disease ,medicine.medical_specialty ,Adolescent ,Cross-sectional study ,viruses ,Herpesvirus 2, Human ,Population ,Prevalence ,Enzyme-Linked Immunosorbent Assay ,Dermatology ,Abortion ,Antibodies, Viral ,Article ,Risk Factors ,Seroepidemiologic Studies ,Epidemiology ,Humans ,Medicine ,Seroprevalence ,education ,Aged ,education.field_of_study ,Herpes Genitalis ,business.industry ,Public Health, Environmental and Occupational Health ,Middle Aged ,Cross-Sectional Studies ,Sexual Partners ,Infectious Diseases ,Vietnam ,Immunoglobulin G ,Immunology ,Regression Analysis ,Marital status ,Female ,business ,Demography - Abstract
Objective—To investigate herpes simplex virus type–2 (HSV-2) seropositivity and associated risk factors in Vietnamese women. Methods—Cross-sectional study with personal interviews and gynecological examinations among population-based samples of ever married women, aged 15–69 years, living in Ho Chi Minh City (HCMC) and Hanoi in 1997. Type-specific IgG antibodies against HSV-2 were detected using HerpeSelect ELISA (Focus Diagnostics). Adjusted prevalence ratios were estimated with logbinomial regression. Results—HSV-2 seroprevalence was higher in 1,106 women from HCMC (30.8%, 95% CI: 28.1– 33.4, age-standardized to 2000 world standard population) than in 1,170 women from Hanoi (8.8%, 95% CI: 7.1–10.5). In HCMC, HSV-2 seroprevalence was higher for women who were not married, HPV DNA positive, current hormonal contraceptive users, or had a history of multiple sexual partners or spontaneous abortion. HCMC seroprevalence was inversely associated with educational attainment, age at first intercourse, and age at first pregnancy. In the multivariable model for HCMC, a trend of increasing HSV-2 seroprevalence with age was observed, and prevalence ratios were nearly identical to age-adjusted prevalence ratios for marital status, age at first pregnancy, and HPV DNA positivity. Conclusion—HSV-2 was notably less prevalent in Hanoi than HCMC, where it was associated with traditional HSV-2 risk factors. These results are likely explained by socio-cultural, historical, economic, and demographic factors related to urban-rural and regional differences. Future population-based studies should include men and never-married women as a next step toward obtaining a more nearly complete picture of HSV-2 epidemiology in Vietnam.
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- 2009
15. Prevalence and Correlates of Human Herpesvirus 8 Infection Among Peruvian Men Who Have Sex With Men
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Patricia Caballero, Luis Suarez, Javier R. Lama, Jorge Sanchez, Silvia M. Montano, William L. H. Whittington, Juan V. Guanira, Anna Wald, Rhoda Ashley Morrow, Corey Casper, and Connie Celum
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Adult ,Male ,Sexually transmitted disease ,medicine.medical_specialty ,Adolescent ,HIV Infections ,Article ,Men who have sex with men ,Serology ,Young Adult ,Risk Factors ,Peru ,Epidemiology ,Prevalence ,Humans ,Medicine ,Seroprevalence ,Pharmacology (medical) ,Homosexuality, Male ,business.industry ,Transmission (medicine) ,virus diseases ,Herpesviridae Infections ,Odds ratio ,Middle Aged ,medicine.disease ,Infectious Diseases ,Herpesvirus 8, Human ,Immunology ,Coinfection ,business ,Demography - Abstract
BACKGROUND: Infection with human herpesvirus 8 (HHV-8) is common among men who have sex with men (MSM) in North America and Europe and is also found to be endemic in some regions of South America. Little is known about HHV-8 prevalence and its correlates among MSM in the Andean region. METHODS: We assessed HHV-8 seroprevalence among 497 MSM recruited for the 2002 Peruvian HIV sentinel surveillance program using a combined HHV-8 enzyme immunoassay and immunofluorescence assay algorithm. Logistic regression analysis was used to estimate odds ratios (ORs) and their 95% confidence intervals (CIs) to determine the association between selected covariates and HHV-8 seropositivity. RESULTS: One hundred thirty-one (66.5% 95% CI 63.1% to 69.9%) of 197 HIV-infected and 80 (26.7% 95% CI 24.4% to 29.0%) of 300 HIV-uninfected MSM had serologic evidence of HHV-8 infection. Factors independently associated with HHV-8 infection were education
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- 2008
16. Maternal Herpes simplex virus type 2 infection, syphilis and risk of intra-partum transmission of HIV-1: results of a case control study
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Rhoda Ashley Morrow, Kuda Mutasa, Robert Ntozini, Peter J. Iliff, Frances M. Cowan, and Jean H. Humphrey
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Zimbabwe ,Sexually transmitted disease ,medicine.medical_specialty ,Sexual transmission ,Herpesvirus 2, Human ,Immunology ,Population ,HIV Infections ,Comorbidity ,Antibodies, Viral ,Acquired immunodeficiency syndrome (AIDS) ,Pregnancy ,Risk Factors ,Seroepidemiologic Studies ,Prevalence ,medicine ,Humans ,Immunology and Allergy ,Syphilis ,Treponema pallidum ,Pregnancy Complications, Infectious ,Risk factor ,education ,reproductive and urinary physiology ,Retrospective Studies ,education.field_of_study ,Obstetrics ,Transmission (medicine) ,business.industry ,Infant, Newborn ,Infant ,Herpes Simplex ,medicine.disease ,Antibodies, Bacterial ,Infectious Disease Transmission, Vertical ,female genital diseases and pregnancy complications ,Genital ulcer ,Infectious Diseases ,Case-Control Studies ,HIV-1 ,Female ,medicine.symptom ,business - Abstract
Genital ulcer disease including that caused by Herpes simplex virus type 2 (HSV-2) and syphilis facilitates sexual transmission of HIV-1. The effect of these infections on intra-partum mother-to-child-transmission (MTCT) of HIV-1 is unknown.A case-control study was conducted using archived sera from HIV-1 positive women enrolled in ZVITAMBO, an MTCT trial. Cases were 509 women who transmitted HIV-1 to their infants intra-partum; controls were 1018 women whose infants remained uninfected at 12 months. Maternal serum collected at delivery, were tested for HSV-2 antibody. The 6-week post-partum sample was also tested for syphilis by RPR and TPHA to identify women with incubating or active syphilis at delivery. Rates of prevalent and incident HSV-2 and recently acquired syphilis were compared between cases and controls.Overall prevalence of maternal HSV-2 and active syphilis at delivery were 82.5% [95% confidence interval (CI), 80.6-84.5] and 4.0% (95% CI, 3.0-5.1), respectively. Prevalent HSV-2 was associated with increased intra-partum MTCT [adjusted odds ratio (OR), 1.50; 95% CI, 1.09-2.08]. The proportion of intra-partum transmissions potentially attributable to prevalent HSV-2 infection was 28.4% (95% CI, 7.3-44.7). Maternal infection with active syphilis at delivery was not associated with intra-partum MTCT (unadjusted OR, 0.89; 95%CI, 0.49-1.59; adjusted OR, 0.64; 95% CI, 0.34-1.20).HSV-2 infection is common among HIV-1-positive women and is associated with an increased risk of intra-partum MTCT. More than 25% of intra-partum MTCT may be attributable to maternal HSV-2 co-infection. Active maternal syphilis at the time of delivery is not associated with intra-partum MTCT risk.
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- 2008
17. Effect of Sexually Transmitted Disease (STD) Coinfections on Performance of Three Commercially Available Immunosorbent Assays Used for Detection of Herpes Simplex Virus Type 2-Specific Antibody in Men Attending Baltimore, Maryland, STD Clinics
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Nancy E. Maldeis, Andrew Hardick, Thomas C. Quinn, Jean Summerton, Charlotte A. Gaydos, Rhoda Ashley Morrow, Melissa Riedesel, and Oliver Laeyendecker
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Adult ,Male ,Microbiology (medical) ,Sexually transmitted disease ,Herpesvirus 2, Human ,Blotting, Western ,Clinical Biochemistry ,Immunology ,Population ,Sexually Transmitted Diseases ,Enzyme-Linked Immunosorbent Assay ,Antibodies, Viral ,medicine.disease_cause ,Ambulatory Care Facilities ,Sensitivity and Specificity ,Viral Envelope Proteins ,Predictive Value of Tests ,Humans ,Immunology and Allergy ,Medicine ,Seroprevalence ,education ,education.field_of_study ,Chi-Square Distribution ,biology ,business.industry ,Clinical and Diagnostic Laboratory Immunology ,biology.organism_classification ,Virology ,Logistic Models ,Herpes simplex virus ,Baltimore ,Neisseria gonorrhoeae ,Regression Analysis ,Trichomonas vaginalis ,Reagent Kits, Diagnostic ,business ,Chlamydia trachomatis ,Mycoplasma genitalium - Abstract
Two hundred seventy-nine serum samples from men attending sexually transmitted disease (STD) clinics in Baltimore, Maryland, were tested for herpes simplex virus type 2 (HSV-2)-specific antibody by three immunosorbent glycoprotein G-2-based assays (the Kalon, Focus, and Biokit assays). The results for all samples with positive results were confirmed by Western blotting (91/279; 32.6% HSV-2 seroprevalence). All patients were also tested for Chlamydia trachomatis , Neisseria gonorrhoeae , Trichomonas vaginalis , Mycoplasma genitalium , human immunodeficiency virus type 1, and hepatitis C virus. The Kalon assay performed very well with samples from this population (90.8% sensitive, 99.4% specific), whereas the Focus assay had a sensitivity (82.6%) much lower than that shown previously. For 19.7% of the samples, the Biokit assay gave an indeterminate result. It was found that the odds of a sample having a Biokit assay indeterminate result compared to that of having a definitive positive or negative results were 3.88 times greater for subjects concurrently infected with N. gonorrhoeae , after the effects of other STDs were controlled for ( P = 0.001; 95% confidence interval, 1.78, 8.45). Unfortunately, we were unable to control for HSV-1 infection status in the regression model, which, on the basis of χ 2 analysis, might also affect the clarity of the Biokit test. The recommended index cutoff value of 1.1 for the Focus and Kalon assays was found to be optimal for this population.
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- 2007
18. Seroprevalence of Herpes Simplex Virus Type 1 in Children in the United States
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Fujie Xu, Lauri E. Markowitz, Gary Dubin, Rhoda Ashley Morrow, Francis K. Lee, Maya R. Sternberg, and Kristina E. Luther
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medicine.medical_specialty ,Adolescent ,National Health and Nutrition Examination Survey ,Cross-sectional study ,Ethnic group ,Herpesvirus 1, Human ,White People ,Serology ,Age Distribution ,Seroepidemiologic Studies ,Mexican Americans ,Epidemiology ,Humans ,Seroprevalence ,Medicine ,Sex Distribution ,Child ,Poverty ,business.industry ,Herpes Simplex ,United States ,Confidence interval ,Black or African American ,Cross-Sectional Studies ,El Niño ,Pediatrics, Perinatology and Child Health ,Immunology ,business ,Demography - Abstract
Objectives To describe HSV-1 seroprevalence in children in the United States and to examine factors associated with herpes simplex virus type 1 (HSV-1) infection in children. Study design Sera samples available from 2989 children age 6 to 13 years who participated in the National Health and Nutrition Examination Surveys (NHANES) 1999-2002 were tested for HSV-1 antibodies using a type-specific immunodot assay. HSV-1 seroprevalence in children age 12 to 13 years was compared with that reported in an earlier survey (NHANES 1988-1994). Results Overall, HSV-1 seroprevalence in children age 6 to 13 years was 31.1% (95% confidence interval [CI], 28.6% to 33.9%). Seroprevalence increased with age, from 26.3% in 6- to 7-year-olds to 36.1% in 12-to 13-year-olds, and varied by race/ethnicity, birthplace, and poverty level. Among US-born children age 12 to 13 years, the point estimate of HSV-1 seroprevalence was lower in NHANES 1999-2002 than in NHANES 1988-1994 (34.3% vs 38.1%), but the differences were not statistically significant. Conclusions HSV-1 is a common infection in US children, with more than 25% infected by age 7. Race/ethnicity, birthplace, and poverty level are predictors for HSV-1 infection in children.
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- 2007
19. Herpes Simplex Virus Type 2 and Risk of Intrapartum Human Immunodeficiency Virus Transmission
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Dorothy Mbori-Ngacha, Rhoda Ashley-Morrow, Lawrence Corey, Grace John-Stewart, Barbara Lohman-Payne, Alison L. Drake, Carey Farquhar, Anna Wald, Rose Bosire, and Dalton Wamalwa
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Adult ,medicine.medical_specialty ,Herpesvirus 2, Human ,HIV Infections ,medicine.disease_cause ,Herpesviridae ,Virus ,Cohort Studies ,Acquired immunodeficiency syndrome (AIDS) ,Pregnancy ,Humans ,Medicine ,Serologic Tests ,Pregnancy Complications, Infectious ,Risk factor ,Sida ,Herpes Genitalis ,biology ,business.industry ,Obstetrics ,Transmission (medicine) ,Obstetrics and Gynecology ,biology.organism_classification ,medicine.disease ,Kenya ,Infectious Disease Transmission, Vertical ,Herpes simplex virus ,Case-Control Studies ,DNA, Viral ,Immunology ,Nested case-control study ,Female ,business - Abstract
Objective To determine whether herpes simplex virus type 2 (HSV-2) infection was associated with risk of intrapartum human immunodeficiency virus type 1 (HIV-1) transmission and to define correlates of HSV-2 infection among HIV-1-seropositive pregnant women. Methods We performed a nested case control study within a perinatal cohort in Nairobi, Kenya. Herpes simplex virus type 2 serostatus and the presence of genital ulcers were ascertained at 32 weeks of gestation. Maternal cervical and plasma HIV-1 RNA and cervical HSV DNA were measured at delivery. Results One hundred fifty-two (87%) of 175 HIV-1-infected mothers were HSV-2-seropositive. Among the 152 HSV-2-seropositive women, nine (6%) had genital ulcers at 32 weeks of gestation, and 13 (9%) were shedding HSV in cervical secretions. Genital ulcers were associated with increased plasma HIV-1 RNA levels (P=.02) and an increased risk of intrapartum HIV-1 transmission (16% of transmitters versus 3% of nontransmitters had ulcers; P = .003), an association which was maintained in multivariable analysis adjusting for plasma HIV-1 RNA levels (P=.04). We found a borderline association for higher plasma HIV-1 RNA among women shedding HSV (P=.07) and no association between cervical HSV shedding and either cervical HIV-1 RNA levels or intrapartum HIV-1 transmission (P=.4 and P=.5, [corrected] respectively). Conclusion Herpes simplex virus type 2 is the leading cause of genital ulcers among women in sub-Saharan Africa and was highly prevalent in this cohort of pregnant women receiving prophylactic zidovudine. After adjusting for plasma HIV-1 RNA levels, genital ulcers were associated with increased risk of intrapartum HIV-1 transmission. These data suggest that management of HSV-2 during pregnancy may enhance mother-to-child HIV-1 prevention efforts. Level of evidence II.
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- 2007
20. Clinical Disease in Children Associated With Newly Described Coronavirus Subtypes
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Rhoda Ashley Morrow, Nancy Wright, Judson Heugel, Emily T. Martin, Janet A. Englund, and Jane Kuypers
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,viruses ,Disease ,medicine.disease_cause ,law.invention ,Immunocompromised Host ,stomatognathic system ,law ,Epidemiology ,Humans ,Medicine ,Respiratory system ,Child ,Respiratory Tract Infections ,Polymerase chain reaction ,Coronavirus ,Reverse Transcriptase Polymerase Chain Reaction ,business.industry ,Infant, Newborn ,Infant ,virus diseases ,Clinical disease ,Virology ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Cohort ,Immunology ,Respiratory virus ,Female ,Coronavirus Infections ,business - Abstract
OBJECTIVES. Coronaviruses cause upper respiratory illness and occasionally lower tract disease in susceptible populations. In this study we examined the prevalence of 4 human coronaviruses, including subtypes OC43, 229E, and the recently described NL63 and HKU1 in a pediatric population presenting to a children's hospital. PATIENTS AND METHODS. Specimens collected over a 1-year period from pediatric patients presenting with acute respiratory illness were analyzed for the presence of 4 coronavirus subtypes using consensus and subtype-specific real-time reverse-transcription polymerase chain reaction assays. The demographic and clinical characteristics associated with coronavirus infection were examined retrospectively. RESULTS. Coronaviruses were detected in 66 of 1043 children. Eight, 11, 19, and 28 specimens were positive for subtypes 229E, NL63, OC43, and HKU1, respectively. Coronaviruses were detected throughout the study period; all 4 of the subtypes were present simultaneously in December. The acute clinical features were similar across subtypes. Of 32 children infected with a coronavirus as the sole respiratory pathogen, 13 had lower respiratory tract disease. Children whose only detectable respiratory virus was a coronavirus were more likely to have underlying chronic disease than were children coinfected with another respiratory virus. CONCLUSIONS. Although 4 subtypes of coronavirus were detected, the recently discovered coronavirus subtypes NL63 and HKU1 accounted for the majority of coronaviruses detected in our cohort of mostly hospitalized children with respiratory symptoms. New subtypes likely represent a substantial portion of previously unexplained respiratory illnesses.
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- 2007
21. Precision of the Kalon Herpes Simplex Virus Type 2 IgG ELISA: an international inter-laboratory assessment
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Jordyn Manucci, Anelet James, Mubiana Inambao, Oliver Laeyendecker, Bellington Vwalika, Kwitaka F. Maluzi, Erin M. Kahle, Glenda Gray, Eshan U. Patel, Sinead Delany-Moretlwe, Jairam R. Lingappa, Rhoda Ashley Morrow, Thomas C. Quinn, Estelle Piwowar-Manning, and Maina M. Cheeba
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Research use ,business.industry ,Repeatability ,Gold standard (test) ,Reference laboratory ,Serum samples ,Virology ,3. Good health ,Infectious Diseases ,Medicine ,Inter-laboratory ,business ,Igg elisa ,Antibody detection - Abstract
The commercial Kalon HSV-2 IgG ELISA is currently recommended for research use in sub-Saharan Africa because of its superior accuracy compared to other serologic assays. However, there are no data on key precision parameters of Kalon such as inter-operator variation, repeatability, and reproducibility, thus contributing to a barrier for its acceptance and use in clinical trials in sub-Saharan Africa. We evaluated the analytical and field precision of the Kalon HSV-2 IgG ELISA. A total of 600 HIV-infected and uninfected serum samples from South Africa and Zambia, previously tested by the gold standard University of Washington HSV western blot (UW-WB), were tested using Kalon by two technologists in an United States reference laboratory. Aliquots of 183 samples were retested using Kalon by an on-site technologist in a South African laboratory and a Zambian laboratory. Intra-assay variation was below 10 %. Intra-assay, intra-laboratory, and inter-laboratory correlation and agreement were significantly high (p
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- 2015
22. Herpes Simplex Viruses and Herpes B Virus
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Keith R. Jerome and Rhoda Ashley Morrow
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Herpes B virus ,biology ,viruses ,Varicella zoster virus ,biology.organism_classification ,medicine.disease_cause ,Virology ,Herpesviridae ,Serology ,Herpes simplex virus ,Antigen ,biology.protein ,medicine ,Antibody ,Cytopathic effect - Abstract
This chapter focuses on the herpes simplex viruses (HSV) and herpes B virus, describing their transmission, clinical significance, and detection mechanisms. Herpes simplex virus types 1 and 2 (HSV-1 and HSV-2), formally designated human herpesvirus 1 and human herpesvirus 2, respectively, are members of the family Herpesviridae. Primary infection with HSV-1 or HSV-2 is followed by the establishment of latency in the dorsal root ganglia, typically the trigeminal ganglia for orolabial disease and the lumbosacral ganglia for genital disease. Immunostaining methods to detect antigen require less expertise than cytopathic effect (CPE)-based culture methods and are usually less expensive than culture. Polymerase chain reaction (PCR) provides the best sensitivity of the direct detection approaches. Tests based on crude antigen mixtures are still marketed, but they have unacceptably low sensitivity and specificity, especially for detecting new HSV-2 infections in those with prior HSV-1 infection. The HSV Western blot assay used by the University of Washington laboratory uses nitrocellulose blots prepared with human diploid fibroblast-infected cell proteins. Western blotting detects antibodies to multiple viral proteins, including those to the type-specific glycoproteins gG-1 and gG-2. Simple gG-based lateral-flow assays are available that are designed for point-of-care testing. Type-specific serology is critical for identifying pregnant women with new HSV infections. Serodiagnosis of herpes B virus infections has been complicated by extensive cross-reactivity with HSV-1 and HSV-2. Serologic testing can be useful for evaluation of potentially infected animals involved in human exposures and for screening of research animals.
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- 2015
23. A novel peer mentoring consultant program for career development of clinician-scientists in Uganda
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Jackson Orem, Rhoda Ashley Morrow, R. Kansiime, J.L. Barrett, Warren Phipps, and Corey Casper
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Nursing ,business.industry ,Peer mentoring ,Medicine ,Library science ,Center (algebra and category theory) ,General Medicine ,Infectious and parasitic diseases ,RC109-216 ,Public aspects of medicine ,RA1-1270 ,business ,Career development - Abstract
R.A. Morrow, W. Phipps, J. Orem, R. Kansiime, J.L. Barrett, C. Casper; University of Washington/Fred Hutch Cancer Research Center, Seattle, WA/US, University of Washington/Fred Hutchinson Cancer Research Center, Seattle, WA/US, Uganda Cancer Institute, Kampala, UG, Hutchinson Center Research Institute Uganda, Kampala, UG, Fred Hutchinson Cancer Reserach Center, Seattle, WA/US, University of Washington, Seattle, WA/US
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- 2015
24. Serologic Assays for the Diagnosis of Herpes Virus 1 (HSV-1) Herpes Virus 2 (HSV-2): Test Characteristics of FDA Approved Type-Specific Assays in an Ethnically, Racially, and Economically Diverse Patient Population
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Eric S. Rosenberg, Fujie Xu, Gregory K. Robbins, Hang Lee, Heather Bradley, Sara Lammert, Demetre Daskalakis, Danielle M. Crochiere, Anne Rompalo, Barbara Detrick, Donna Felsenstein, Laura E. Riley, Amy Shui, Lauri E. Markowitz, Rhoda Ashley Morrow, Kate Cunningham, and Charlotte A. Gaydos
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business.industry ,Type specific ,HSL and HSV ,medicine.disease_cause ,Virology ,Herpesviridae ,Serology ,Patient population ,Infectious Diseases ,Oncology ,Herpes virus ,Drug approval ,Medicine ,business - Published
- 2015
25. High Risk of Human Immunodeficiency Virus in Men Who Have Sex with Men with Herpes Simplex Virus Type 2 in the EXPLORE Study
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Susan Buchbinder, James P. Hughes, Rhoda Ashley Morrow, Anna Wald, Connie Celum, Elizabeth L. Brown, Beryl A. Koblin, Kenneth H. Mayer, and Elizabeth M Krantz
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Epidemiology ,Herpesvirus 2, Human ,Sexual Behavior ,Blotting, Western ,HIV Infections ,Men who have sex with men ,Interviews as Topic ,Acquired immunodeficiency syndrome (AIDS) ,Risk Factors ,Internal medicine ,Prevalence ,medicine ,Humans ,Prospective Studies ,Homosexuality, Male ,Sida ,Herpes Genitalis ,Proportional Hazards Models ,Randomized Controlled Trials as Topic ,biology ,business.industry ,Incidence ,Incidence (epidemiology) ,Hazard ratio ,biology.organism_classification ,medicine.disease ,United States ,Confidence interval ,Immunology ,Bisexuality ,business - Abstract
The relation between herpes simplex virus type 2 (HSV-2) and human immunodeficiency virus (HIV) acquisition was evaluated among 4,295 high-risk, HIV-negative men who have sex with men in an intensive behavioral intervention (colloquially referred to as ‘‘EXPLORE’’) study in the United States from 1999 to 2003. Sexual behavior data were obtained by computer-assisted self-interview, and sera were collected semiannually for HIV and HSV-2 serology. HSV-2 infection was classified as ‘‘recent incident’’ (at the first HSV-2 seropositive visit), ‘‘remote incident’’ (within 24 months of the first positive visit), and ‘‘prevalent’’ (for visits >24 months after the first HSV-2 positive visit). Baseline HSV-2 prevalence was 20.3%. HSV-2 incidence was 1.9 (95% confidence interval (CI): 1.6, 2.2) per 100 person-years; significant risk factors were African-American race, unprotected receptive anal intercourse, an HIV-positive male sex partner, and six or more male partners in the prior 6 months. The behavioral intervention did not reduce HSV-2 acquisition (adjusted hazard ratio (HR) ¼ 1.2, 95% CI: 0.9, 1.6). Overall HIV incidence was 1.9 (95% CI: 1.7, 2.2) per 100 person-years. HIV risk was elevated among men who have sex with men with recent incident HSV-2 (adjusted HR ¼ 3.6, 95% CI: 1.7, 7.8), remote incident HSV-2 (adjusted HR ¼ 1.7, 95% CI: 0.8, 3.3), and prevalent HSV-2 (adjusted HR ¼ 1.5, 95% CI: 1.1, 2.1) infection compared with HSV-2 seronegative participants. HIV intervention strategies targeting HSV-2 prevention and suppression among men who have sex with men should be evaluated. behavior therapy; herpes genitalis; herpesvirus 2, human; HIV; homosexuality, male
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- 2006
26. Maternal herpes simplex virus antibody avidity and risk of neonatal herpes
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Charles G. Prober, Ann M. Arvin, Anna Wald, Lawrence Corey, Elizabeth M Krantz, Rhoda Ashley Morrow, Elizabeth L. Brown, and Linda L. Yasukawa
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Adult ,Time Factors ,Herpesvirus 2, Human ,viruses ,Antibody Affinity ,chemical and pharmacologic phenomena ,Herpesvirus 1, Human ,medicine.disease_cause ,Sensitivity and Specificity ,Herpesviridae ,Virus ,Pregnancy ,Alphaherpesvirinae ,medicine ,Humans ,Avidity ,Pregnancy Complications, Infectious ,Seroconversion ,biology ,business.industry ,Transmission (medicine) ,Infant, Newborn ,Obstetrics and Gynecology ,Herpes Simplex ,biology.organism_classification ,Virology ,Infectious Disease Transmission, Vertical ,Herpes simplex virus ,ROC Curve ,Immunology ,Female ,Viral disease ,business - Abstract
The objective of the study was to assess whether herpes simplex virus antibody avidity is associated with risk of transmission of herpes simplex virus to the neonate.We developed a novel herpes simplex virus type 1 avidity test based on the commercially available Focus HerpeSelect-1 enzyme-linked immunosorbent assay kit using sera from nonpregnant subjects with genital herpes simplex virus-1 infection. We used this test, and the previously developed herpes simplex virus type 2 avidity test, to compare maternal herpes simplex virus-1 and herpes simplex virus-2 antibody avidity in women who transmitted herpes simplex virus to the neonate and women who had herpes simplex virus isolated from genital secretions at delivery but who did not transmit herpes simplex virus to their infants.Among nonpregnant subjects with genital herpes simplex virus-1 infection whose sera were used to develop the herpes simplex virus-1 avidity test, a significant relationship between herpes simplex virus-1 antibody avidity and time since herpes simplex virus-1 acquisition was observed (P.001, mixed-effects model), with median avidity values increasing over time after primary infection. Among pregnant, herpes simplex virus-1, or herpes simplex virus-2 seropositive women, 4 of 8 women (50%) with avidity 40 or greater transmitted herpes simplex virus to the neonate, compared with only 12 of 97 (12%) of women with avidity greater than 40 (P = .02).Herpes simplex virus-1 antibody avidity increased over time after genital herpes simplex virus-1 acquisition, as has been previously observed for herpes simplex virus-2. Among women with herpes simplex virus antibody at delivery, low antibody avidity was associated with herpes simplex virus transmission to the neonate and may be a useful marker for recent seroconversion.
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- 2006
27. Comparison of Real-Time PCR Assays with Fluorescent-Antibody Assays for Diagnosis of Respiratory Virus Infections in Children
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Rhoda Ashley Morrow, Meei Li Huang, Nancy Wright, James Ferrenberg, Jane Kuypers, Anne Cent, and Lawrence Corey
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Microbiology (medical) ,Male ,Adolescent ,viruses ,Fluorescent Antibody Technique ,medicine.disease_cause ,Polymerase Chain Reaction ,Sensitivity and Specificity ,Virus ,law.invention ,Adenoviridae ,Human metapneumovirus ,law ,Virology ,Influenza A virus ,medicine ,Humans ,Child ,Respiratory Tract Infections ,Polymerase chain reaction ,biology ,Respiratory tract infections ,Infant, Newborn ,Infant ,biology.organism_classification ,Parainfluenza Virus 1, Human ,Parainfluenza Virus 2, Human ,Parainfluenza Virus 3, Human ,Respiratory Syncytial Viruses ,Real-time polymerase chain reaction ,Virus Diseases ,Child, Preschool ,biology.protein ,Respiratory virus ,Female ,Metapneumovirus ,Antibody - Abstract
Conventional fluorescent-antibody (FA) methods were compared to real-time PCR assays for detection of respiratory syncytial virus (RSV), influenza virus type A (FluA), parainfluenza virus types 1, 2, and 3 (PIV1, PIV2, and PIV3), human metapneumovirus (MPV), and adenovirus (AdV) in 1,138 specimens from children with respiratory illnesses collected over a 1-year period. At least one virus was detected in 436 (38.3%) specimens by FA and in 608 (53.4%) specimens by PCR ( P < 0.001). Specimen quality was inadequate for FA in 52 (4.6%) specimens; 13 of these (25%) were positive by PCR. In contrast, 18 (1.6%) specimens could not be analyzed by PCR; 1 of these was positive by FA. The number of specimens positive only by PCR among specimens positive by PCR and/or FA was 18 (7.0%) of 257 for RSV, 18 (13.4%) of 134 for FluA, 25 (64.1%) of 39 for PIV1, 8 (88.9%) of 9 for PIV2, 17 (30.1%) of 55 for PIV3, and 101 (76.5%) of 132 for AdV. MPV was detected in 6.6% of all specimens and in 9.5% of the 702 specimens negative by FA. The mean number of virus copies per milliliter in specimens positive by both PCR and FA was significantly higher, at 6.7 × 10 7 , than that in specimens positive only by PCR, at 4.1 × 10 4 ( P < 0.001). The PCR assays were significantly more sensitive than FA assays for detecting respiratory viruses, especially parainfluenza virus and adenovirus. Use of real-time PCR to identify viral respiratory pathogens in children will lead to improved diagnosis of respiratory illness.
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- 2006
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28. Knowledge of Partners’ Genital Herpes Protects against Herpes Simplex Virus Type 2 Acquisition
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Ellen Lairson, Stacy Selke, Judy Zeh, Rhoda Ashley Morrow, Elizabeth M Krantz, and Anna Wald
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Adult ,Male ,medicine.medical_specialty ,Time Factors ,Multivariate analysis ,Adolescent ,Herpesvirus 2, Human ,Sexual Behavior ,Protective factor ,Disclosure ,Herpesvirus 1, Human ,medicine.disease_cause ,Serology ,Risk Factors ,Internal medicine ,Humans ,Immunology and Allergy ,Medicine ,Sex organ ,Prospective cohort study ,Herpes Genitalis ,business.industry ,Transmission (medicine) ,Hazard ratio ,Middle Aged ,Sexual Partners ,Infectious Diseases ,Herpes simplex virus ,Multivariate Analysis ,Immunology ,Female ,business - Abstract
Background Prospective studies of herpes simplex virus type 2 (HSV-2) infection in discordant couples have shown a low rate of transmission. However, unlike partners with genital herpes in prospectively monitored couples, most persons who transmit genital herpes are not aware of having the infection. Methods Because HSV has a short incubation period and most persons who acquire genital herpes can identify the transmitting partner, a time-to-event design was used to assess risks of HSV acquisition among patients with newly acquired genital herpes. Results Among 199 persons with laboratory-documented newly acquired genital herpes, the median duration of the sexual relationship with the transmitting partner was 3.5 months, and the median number of sex acts before transmission was 40. The median time to HSV-2 acquisition was greater among participants whose partners disclosed that they had genital herpes, compared with participants whose partners did not disclose their status (270 vs. 60 days; P = .03). In multivariate models, having a partner who disclosed that he or she had genital herpes remained a strong protective factor against genital HSV-2 acquisition (hazard ratio, 0.48 [95% confidence interval, 0.25-0.91]). Conclusion These findings suggest that testing persons with HSV type-specific serologic assays and encouraging disclosure may result in a decreased risk of HSV-2 transmission to sex partners.
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- 2006
29. Performance of a novel test for IgM and IgG antibodies in subjects with culture-documented genital herpes simplex virus-1 or -2 -infection
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David Friedrich and Rhoda Ashley Morrow
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Microbiology (medical) ,Sexually transmitted disease ,Herpesvirus 2, Human ,viruses ,Blotting, Western ,Enzyme-Linked Immunosorbent Assay ,Herpesvirus 1, Human ,Antibodies, Viral ,medicine.disease_cause ,Sensitivity and Specificity ,Virus ,Herpesviridae ,Serology ,03 medical and health sciences ,0302 clinical medicine ,Diagnosis ,medicine ,Humans ,IgM tests ,030212 general & internal medicine ,Seroconversion ,seroconversion ,Immunoassay ,0303 health sciences ,Herpes Genitalis ,biology ,030306 microbiology ,General Medicine ,herpes simplex virus ,Virology ,3. Good health ,IgG type-specific serology ,Infectious Diseases ,Herpes simplex virus ,Immunoglobulin M ,Immunoglobulin G ,genital herpes ,Immunology ,biology.protein ,Viral disease ,Antibody - Abstract
Novel tests (BioPlex) for herpes simplex virus-1 (HSV-1) and HSV-2 IgG were compared with HerpeSelect HSV-1 and HSV-2 ELISAs for type-specific IgG. The sensitivity and specificity of BioPlex HSV-1 IgG were 94%(84/89) and 96%(119/124), respectively, with unselected sera, while the sensitivity and specificity of BioPlex HSV-2 IgG were 92% (109/118) and 98% (95/97), respectively. BioPlex IgM was compared with Diamedix IgM against sera from patients with culture-documented genital herpes. The test results were concordant in 81% of sera from HSV-1 patients and in 90% of sera from HSV-2 patients. Use of BioPlex IgM in addition to BioPlex IgG tests increased HSV-2 seroconversion detection from 47% of subjects to 70%. Use of Diamedix IgM in addition to Focus IgG ELISA increased HSV-2 detection from 40% of subjects to 70%. IgM was detected by BioPlex in 63% of sera from patients with early HSV-2 infection (< 30 days) and in 59% of sera by Diamedix. IgM was also detected in a large proportion of sera from subjects with established HSV-2 infection (33% by BioPlex and 29% by Diamedix). Addition of IgM testing substantially increased the ability to detect seroconversion early in infection. IgM is an indicator of recent infection only in subjects who lack detectable IgG.
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- 2006
30. Herpes simplex virus infection in women in the WIHS: Epidemiology and effect of antiretroviral therapy on clinical manifestations
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Nancy A. Hessol, Peter Bacchetti, Ruth M. Greenblatt, Mardge H. Cohen, Timothy J. Wilkin, Niloufar Ameli, Howard Minkoff, Mary Young, Rhoda Ashley Morrow, and Stephen J. Gange
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Herpesvirus 2, Human ,Sexual Behavior ,viruses ,Immunology ,HIV Infections ,Herpesvirus 1, Human ,Antibodies, Viral ,Acquired immunodeficiency syndrome (AIDS) ,Antiretroviral Therapy, Highly Active ,Internal medicine ,Epidemiology ,Prevalence ,medicine ,Humans ,Immunology and Allergy ,Sex organ ,Prospective Studies ,Prospective cohort study ,Herpes Genitalis ,Ulcer ,business.industry ,virus diseases ,Odds ratio ,Middle Aged ,medicine.disease ,United States ,CD4 Lymphocyte Count ,Genital ulcer ,Sexual Partners ,Infectious Diseases ,Socioeconomic Factors ,HIV-1 ,Female ,medicine.symptom ,business ,Cohort study - Abstract
Objective: To determine the prevalence of infection with herpes simplex virus types 1 (HSV-1) and 2 (HSV-2) among women with and at high risk for HIV infection, and to evaluate the effect of HAART on the recurrence of genital lesions. Methods: We evaluated the epidemiology and clinical manifestations associated with HSV-1 and HSV-2 among 1796 HIV-infected and 476 HIV-uninfected women enrolled in a multisite cohort study. Serum antibodies to HSV-1 and HSV-2 at baseline and self-reported history of genital herpes, reports of recent genital sores and presence of genital ulcers on examination, and use of HAART regimen at each study visit were analyzed. Results: Reactivity to HSV-1 only and HSV-2 only was detected in 18% and 20% of HIV-infected, and in 28% and 18% of HIV-uninfected participants respectively; 58% of HIV-infected women and 45% of HIV-uninfected women were seropositive for both HSV types. Reactivity to HSV-2 was associated with increasing age, more male sexual partners, earlier sexual debut, African-American race, Latina ethnicity, less education and lower income. HIV-uninfected women reported significantly fewer genital sores than HIV-infected women who had used HAART for at least 1 year and had optimal CD4 cell gain and viral suppression (adjusted odds ratio (OR), 0.19; 95% confidence interval (Cl), 0.13-0.28). Conclusion: Use of HAART and subsequent immune recovery does not completely eliminate the effect of HIV infection on genital lesions among women with concurrent HSV-2 infection.
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- 2006
31. Herpes Simplex Virus Type 2 (HSV-2) Western Blot Confirmatory Testing Among Men Testing Positive for HSV-2 Using the Focus Enzyme-Linked Immunosorbent Assay in a Sexually Transmitted Disease Clinic
- Author
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Rhoda Ashley-Morrow, Wayne R Hogrefe, Anna Wald, Paul D. Swenson, Matthew R. Golden, and H. Hunter Handsfield
- Subjects
Adult ,Male ,Microbiology (medical) ,Sexually transmitted disease ,Adolescent ,genetic structures ,Herpesvirus 2, Human ,viruses ,Blotting, Western ,Population ,Sexually Transmitted Diseases ,Enzyme-Linked Immunosorbent Assay ,Dermatology ,Antibodies, Viral ,medicine.disease_cause ,Ambulatory Care Facilities ,Sensitivity and Specificity ,Herpesviridae ,Virus ,Predictive Value of Tests ,Alphaherpesvirinae ,Prevalence ,medicine ,Humans ,education ,Aged ,education.field_of_study ,Herpes Genitalis ,biology ,business.industry ,Public Health, Environmental and Occupational Health ,Middle Aged ,biology.organism_classification ,Virology ,Infectious Diseases ,Herpes simplex virus ,Immunology ,biology.protein ,Viral disease ,Antibody ,business ,Algorithms - Abstract
The objective of this study was to define the positive predictive value (PPV) of the Focus herpes simplex virus type 2 (HSV-2) enzyme-linked immunosorbent assay (ELISA) in a low HSV-2 prevalence population and to develop a new test interpretation algorithm.HSV-2 Western blots were performed on sera from male sexually transmitted disease clinic patients testing HSV-2 ELISA-positive and used to define a new class of indeterminate HSV-2 ELISA result. HSV-2 Western blots were then prospectively performed on sequential sera with indeterminate HSV-2 ELISAs.Ninety-one (84%) of 108 HSV-2 ELISA-positive sera tested HSV-2 Western blot-positive. Western blot positivity was more common in men without herpes simplex virus type 1 (HSV-1) antibody than in those with HSV-1 antibody (93% vs 76%, P = 0.02) and in men with a history or clinical evidence of genital lesions (88% vs 80%, P = 0.30). Selectively raising the ELISA index value defining HSV-2 positivity from1.1 toor=3.0 either among HSV-1-positive men or among those without a history or clinical evidence of genital lesions increased the PPV toor=93%. Prospective evaluation of an algorithm incorporating HSV-1 serostatus found that 11 of 70 persons with indeterminate HSV-2 ELISAs were Western blot-positive.Clinicians should consider selectively using a higher index value to define Focus ELISA HSV-2 positivity based on either HSV-1 serostatus or clinical circumstances.
- Published
- 2005
32. Longitudinal Risk of Herpes Simplex Virus (HSV) Type 1, HSV Type 2, and Cytomegalovirus Infections among Young Adolescent Girls
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Susan L. Rosenthal, Paul A. Succop, Rhoda Ashley Morrow, David I. Bernstein, Frank M. Biro, Lawrence R. Stanberry, and Lisa Mills
- Subjects
Microbiology (medical) ,Sexually transmitted disease ,Human cytomegalovirus ,Pediatrics ,medicine.medical_specialty ,Longitudinal study ,Adolescent ,Urban Population ,Cross-sectional study ,Herpesvirus 2, Human ,viruses ,Attack rate ,Herpesvirus 1, Human ,Risk Factors ,Seroepidemiologic Studies ,medicine ,Humans ,Seroprevalence ,Longitudinal Studies ,Risk factor ,Child ,Herpes Genitalis ,business.industry ,Herpes Simplex ,medicine.disease ,Infectious Diseases ,Cytomegalovirus Infections ,Cohort ,Immunology ,Female ,business - Abstract
Background Cross-sectional seroprevalence studies indicate that infections with herpes simplex virus (HSV) types 1 (HSV-1) and 2 (HSV-2) and cytomegalovirus (CMV) are common. However, data on the rates of acquisition of these infections are limited. Methods A 3-year longitudinal study of HSV-1, HSV-2, and CMV seroprevalence was conducted in a cohort of 174 adolescent girls (age at enrollment, 12-15 years). Results At study entry, 41% of the girls reported a history of sexual activity, and by the end of the study, 73% reported a history of sexual activity. At enrollment, 71% of all participants were seropositive for CMV, 44% were seropositive for HSV-1, and 7% were seropositive for HSV-2. By the end of the study, 81% of the girls were seropositive for CMV, 49% were seropositive for HSV-1, and 14% were seropositive for HSV-2. Among girls with a history of sexual activity, 15.5% were HSV-2 seropositive at the beginning of the study, and 18.9% were HSV-2 seropositive at the end of the study. The attack rates, based on the number of cases per 100 person-years, were 13.8 for CMV infection and 3.2 for HSV-1 infection (among all girls) and 4.4 for HSV-2 infection (among girls with a history of sexual activity). Participants with preexisting HSV-1 antibodies were associated with a significantly lower attack rate for HSV-2 infection. A generalized estimating equation model indicated that participants with a longer history of sexual activity and those who had more sexually transmitted diseases during the 6-month periods before the study visits were more likely to be HSV-2 seropositive. Conclusions This longitudinal study of adolescent girls found high baseline CMV and HSV-1 seroprevalence rates and substantial attack rates for all 3 pathogens.
- Published
- 2004
33. Evaluation of quantitative and type-specific real-time RT-PCR assays for detection of respiratory syncytial virus in respiratory specimens from children
- Author
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Jane Kuypers, Rhoda Ashley Morrow, and Nancy Wright
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Male ,Respiratory syncytial virus ,law.invention ,min, minutes ,DNA, deoxyribonucleic acid ,law ,Child ,Fluorescent Antibody Technique, Indirect ,Mononegavirales ,Antigens, Viral ,Polymerase chain reaction ,biology ,Reverse Transcriptase Polymerase Chain Reaction ,Age Factors ,μg, microgram ,Reverse transcription polymerase chain reaction ,Infectious Diseases ,medicine.anatomical_structure ,Real-time polymerase chain reaction ,Child, Preschool ,RNA, Viral ,Female ,medicine.symptom ,Type-specific ,Quantitative ,Adult ,Adolescent ,Paramyxoviridae ,RT-PCR, reverse transcription-polymerase chain reaction ,bp, basepair ,Respiratory Syncytial Virus Infections ,Sensitivity and Specificity ,Article ,Virus ,Virology ,medicine ,Humans ,mL, milliliter ,μL, microliter ,DNA Primers ,Base Sequence ,Infant, Newborn ,Infant ,mM, millimolar ,biology.organism_classification ,Respiratory Syncytial Virus, Human ,RNA, ribonucleic acid ,Sputum ,Respiratory tract - Abstract
Background: Respiratory syncytial virus (RSV) is a major cause of lower respiratory tract morbidity in young children and immunosuppressed patients. Objectives: To rapidly and accurately quantify and subtype RSV in respiratory samples, we developed and evaluated two real-time RT-PCR assays. Study design: A quantitative assay was designed using primers for a consensus region of the matrix protein gene and a subtype-specific assay for RSV-A and RSV-B detection was designed using primers for the polymerase gene. Quantitative RSV RT-PCR results of pediatric nasal wash samples submitted to the University of Washington Virology Laboratory from December 2002, through May 2003, were compared to those of an indirect fluorescent antibody RSV antigen detection assay (FA). Results: Specificity of the RT-PCR assay was high, with no amplification of eleven common respiratory viruses and eight herpes viruses. Among 751 samples, RSV was detected in 267 (35.6%) by FA and in 286 (38.1%) by RT-PCR. Median RSV copy number in nasal wash samples that were positive by both FA and RT-PCR was 2.5×107 copies/mL versus a median of 3.0×104 copies/mL for samples positive by RT-PCR only (P
- Published
- 2004
34. Development and Use of a Type-Specific Antibody Avidity Test Based on Herpes Simplex Virus Type 2 Glycoprotein G
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David Friedrich, Elizabeth M Krantz, Rhoda Ashley Morrow, and Anna Wald
- Subjects
Adult ,Male ,Washington ,Microbiology (medical) ,Sexually transmitted disease ,Adolescent ,Herpesvirus 2, Human ,Antibody Affinity ,Enzyme-Linked Immunosorbent Assay ,Dermatology ,Antibodies, Viral ,medicine.disease_cause ,Sensitivity and Specificity ,Herpesviridae ,Virus ,Viral Envelope Proteins ,Predictive Value of Tests ,Recurrence ,Alphaherpesvirinae ,medicine ,Humans ,Avidity ,Herpes Genitalis ,biology ,business.industry ,Public Health, Environmental and Occupational Health ,Middle Aged ,biology.organism_classification ,Specific antibody ,Infectious Diseases ,Herpes simplex virus ,Immunology ,biology.protein ,Female ,Antibody ,business - Abstract
Objectives: It is difficult to discriminate between lesions resulting from recently acquired versus established genital herpes simplex virus type 2 (HSV-2) infection. Methods not based on history or serum IgM status are needed. Goal: Our goal was to use type-specific gG-2 antibody avidity determinations based on HerpeSelect HSV-2 enzyme-linked immunosorbent assay (ELISA) to identify new infections. Study: Sera (N = 168) from 71 patients with first-episode genital herpes and 45 sera from 21 patients with recurrent episodes were tested. Results: Median avidity increased from 30.2 in sera drawn ≤6 weeks to 54.9 >6 weeks after infection (P
- Published
- 2004
35. Reduced Levels of Neutralizing Antibodies to Kaposi Sarcoma–Associated Herpesvirus in Persons with a History of Kaposi Sarcoma
- Author
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David M. Koelle, Corey Casper, Lawrence Corey, Rhoda Ashley Morrow, Jeffrey Vieira, and Louise E. Kimball
- Subjects
Adult ,Male ,viruses ,HIV Infections ,Antibodies, Viral ,medicine.disease_cause ,Statistics, Nonparametric ,Virus ,Herpesviridae ,Immune system ,Neutralization Tests ,medicine ,Humans ,Immunology and Allergy ,Gammaherpesvirinae ,Neutralizing antibody ,Sarcoma, Kaposi ,biology ,HIV ,virus diseases ,Middle Aged ,biochemical phenomena, metabolism, and nutrition ,biology.organism_classification ,Virology ,CD4 Lymphocyte Count ,Transplantation ,Titer ,Infectious Diseases ,Microscopy, Fluorescence ,Immunoglobulin G ,Herpesvirus 8, Human ,Immunology ,biology.protein ,Female ,Antibody - Abstract
Kaposi sarcoma-associated herpesvirus (KSHV) has been identified as the etiologic agent of Kaposi sarcoma (KS). Although KSHV is required for the development of KS, immune dysfunction is a common and important cofactor in the development of KS, as illustrated by the presence of KS in association with HIV infection or immunosuppressive-drug treatment after transplantation. Because neutralizing antibodies (NAb) constitute an important component of an antiviral immune response, we examined the functionality of the humoral immune response associated with KS, by measuring KSHV NAb titers in 3 groups of subjects. Group 1 included subjects who were KSHV positive, KS positive, and human immunodeficiency virus (HIV) positive; group 2 included subjects who were KSHV positive, KS negative, and HIV positive; and group 3 included subjects who were KSHV positive, KS negative, and HIV negative. NAb titers were significantly lower among subjects with KS, compared with subjects who were infected with KSHV but who did not have clinical evidence of KS, in a multivariate model adjusted for HIV infection and CD4 T cell count. The data from the present study suggest that NAb may play a role in the control of KSHV infection and the prevention of progression of KSHV infection to KS.
- Published
- 2004
36. Inaccuracy of Certain Commercial Enzyme Immunoassays in Diagnosing Genital Infections With Herpes Simplex Virus Types 1 or 2
- Author
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Rhoda Ashley Morrow and David Friedrich
- Subjects
General Medicine - Published
- 2003
37. Human Immunodeficiency Virus Acquisition Associated with Genital Ulcer Disease and Herpes Simplex Virus Type 2 Infection: A Nested Case‐Control Study in Rakai, Uganda
- Author
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Maria J. Wawer, Rhoda Ashley Morrow, Noah Kiwanuka, Michael Z. Chen, Mary P. Meehan, Godfrey Kigozi, Nelson K. Sewankambo, David Serwadda, Ronald H. Gray, Fred Nalugoda, Fred Wabwire-Mangen, Thomas C. Quinn, and Tom Lutalo
- Subjects
Adult ,Male ,Rural Population ,Sexually transmitted disease ,medicine.medical_specialty ,Adolescent ,Herpesvirus 2, Human ,Blotting, Western ,HIV Infections ,Antibodies, Viral ,Polymerase Chain Reaction ,Virus ,Cohort Studies ,Interviews as Topic ,Internal medicine ,HIV Seropositivity ,medicine ,Humans ,Immunology and Allergy ,Uganda ,Longitudinal Studies ,Seroconversion ,Herpes Genitalis ,biology ,business.industry ,virus diseases ,Odds ratio ,Middle Aged ,biology.organism_classification ,Virology ,Genital ulcer ,Logistic Models ,Infectious Diseases ,Case-Control Studies ,Lentivirus ,Nested case-control study ,HIV-1 ,RNA, Viral ,Female ,Viral disease ,medicine.symptom ,business - Abstract
To assess the timing of symptomatic genital ulcer disease (GUD) relative to human immunodeficiency virus (HIV) seroconversion, we studied 248 case subjects who underwent HIV seroconversion and 496 HIV-negative control subjects, at 3 interview visits conducted at 10-month intervals: visit 1, before HIV acquisition; visit 2, after seroconversion; and visit 3, 10 months after detection of seroconversion. Odds ratios (ORs) and 95% confidence intervals (CIs), for HIV acquisition, were estimated by logistic regression. HIV load was measured by RNA-polymerase chain reaction, and herpes simplex virus type 2 (HSV-2) serologic testing used HerpeSelect EIA with Western blot confirmation. The OR of HSV-2 seropositivity associated with HIV acquisition was 1.7 (95% CI, 1.2-2.4). Prevalence of GUD was increased among case subjects, at visits 2 (OR, 3.2; 95% CI, 1.9-5.3) and 3 (OR, 2.1; 95% CI, 1.1-3.9). HIV load was increased in HSV-2-seropositive case subjects, compared with that in HSV-2-seronegative subjects, at 5 (P=.04) and 15 (P=.02) months after seroconversion. HIV acquisition is associated with HSV-2 seropositivity, and GUD is increased after seroconversion. HIV load is increased in HSV-2-positive subjects who seroconverted, suggesting a role for treatment of HSV-2 infection in HSV-2-seropositive, dually infected individuals.
- Published
- 2003
38. Antibody to HSV gD peptide induced by vaccination does not protect against HSV-2 infection in HSV-2 seronegative women
- Author
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Peter B. Gilbert, Nakorn Premsri, Sodsai Tovanabutra, Barton F. Haynes, Robert J. O'Connell, Merlin L. Robb, Donald P. Francis, Punnee Pitisuttithum, Nelson L. Michael, Hua-Xin Liao, Supachai Rerks-Ngarm, Lawrence Corey, Jean-Louis Excler, Jerome H. Kim, Georgia D. Tomaras, Phillip W. Berman, Sorachai Nitayaphan, Faruk Sinangil, Gustavo H. Kijak, Rhoda Ashley Morrow, Prayura Kunasol, David C. Montefiori, Lindsay N. Carpp, Carter Lee, and Jaranit Kaewkungwal
- Subjects
Male ,RNA viruses ,0301 basic medicine ,Immunoglobulin A ,Physiology ,Herpesvirus 2, Human ,viruses ,Glycobiology ,lcsh:Medicine ,HIV Infections ,Herpesvirus 1, Human ,HIV Antibodies ,HIV Envelope Protein gp120 ,Pathology and Laboratory Medicine ,Biochemistry ,Immunoglobulin G ,0302 clinical medicine ,Viral Envelope Proteins ,Immunodeficiency Viruses ,Immune Physiology ,Medicine and Health Sciences ,Medicine ,Public and Occupational Health ,030212 general & internal medicine ,lcsh:Science ,AIDS Vaccines ,Vaccines, Synthetic ,Vaccines ,Immune System Proteins ,Recombinant Vaccines ,Multidisciplinary ,biology ,Vaccination and Immunization ,Vaccination ,Infectious Diseases ,Medical Microbiology ,Herpes Simplex Virus-2 ,Viral Pathogens ,Viruses ,Female ,Pathogens ,Antibody ,Research Article ,Adult ,Herpesviruses ,Infectious Disease Control ,Immunology ,Placebo ,Microbiology ,Antibodies ,03 medical and health sciences ,Virology ,Retroviruses ,Humans ,Microbial Pathogens ,Glycoproteins ,Viral vaccines ,business.industry ,lcsh:R ,Lentivirus ,Organisms ,HIV vaccines ,Vaccine trial ,Biology and Life Sciences ,HIV ,Proteins ,Herpes Simplex ,Odds ratio ,Herpes Simplex Virus ,030104 developmental biology ,HIV-1 ,biology.protein ,lcsh:Q ,Preventive Medicine ,DNA viruses ,business ,Serostatus - Abstract
Background In the HIV-1 vaccine trial RV144, ALVAC-HIV prime with an AIDSVAX® B/E boost reduced HIV-1 acquisition by 31% at 42 months post first vaccination. The bivalent AIDSVAX® B/E vaccine contains two gp120 envelope glycoproteins, one from the subtype B HIV-1 MN isolate and one from the subtype CRF01_AE A244 isolate. Each envelope glycoprotein harbors a highly conserved 27-amino acid HSV-1 glycoprotein D (gD) tag sequence that shares 93% sequence identity with the HSV-2 gD sequence. We assessed whether vaccine-induced anti-gD antibodies protected females against HSV-2 acquisition in RV144. Methods Of the women enrolled in RV144, 777 vaccine and 807 placebo recipients were eligible and randomly selected according to their pre-vaccination HSV-1 and HSV-2 serostatus for analysis. Immunoglobulin G (IgG) and IgA responses to gD were determined by a binding antibody multiplex assay and HSV-2 serostatus was determined by Western blot analysis. Ninety-three percent and 75% of the vaccine recipients had anti-gD IgG and IgA responses two weeks post last vaccination, respectively. There was no evidence of reduction in HSV-2 infection by vaccination compared to placebo recipients over 78 weeks of follow-up. The annual incidence of HSV-2 infection in individuals who were HSV-2 negative at baseline or HSV-1 positive and HSV-2 indeterminate at baseline were 4.38/100 person-years (py) and 3.28/100 py in the vaccine and placebo groups, respectively. Baseline HSV-1 status did not affect subsequent HSV-2 acquisition. Specifically, the estimated odds ratio of HSV-2 infection by Week 78 for female placebo recipients who were baseline HSV-1 positive (n = 422) vs. negative (n = 1120) was 1.14 [95% confidence interval 0.66 to 1.94, p = 0.64)]. No evidence of reduction in the incidence of HSV-2 infection by vaccination was detected. Conclusions AIDSVAX® B/E containing gD did not confer protection from HSV-2 acquisition in HSV-2 seronegative women, despite eliciting anti-gD serum antibodies.
- Published
- 2017
39. Use of Commercial Enzyme Immunoassays To Detect Antibodies to the Herpes Simplex Virus Type 2 Glycoprotein G in a Low-Risk Population in Hanoi, Vietnam
- Author
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Thoai D. Ngo, Hanh La, Thomas C. Quinn, Wayne Hogrefe, Rhoda Ashley Morrow, and Oliver Laeyendecker
- Subjects
Microbiology (medical) ,Low risk population ,viruses ,Herpesvirus 2, Human ,Concordance ,Clinical Biochemistry ,Immunology ,Biology ,Antibodies, Viral ,medicine.disease_cause ,Sensitivity and Specificity ,Immunoenzyme Techniques ,Viral Envelope Proteins ,Seroepidemiologic Studies ,medicine ,Humans ,Immunology and Allergy ,False Positive Reactions ,Glycoprotein G ,Clinical and Diagnostic Laboratory Immunology ,Herpes Simplex ,Virology ,Africa, Western ,Herpes simplex virus ,Vietnam ,Immunoenzyme techniques ,biology.protein ,Female ,Reagent Kits, Diagnostic ,Enzyme immunoassays ,Antibody - Abstract
Sera from 1,238 Vietnamese women in Hanoi were tested for herpes simplex virus type 2 (HSV-2). HSV-2 prevalence was 2.0%. The Kalon and Biokit assays showed significantly higher concordance to Western blotting data than did the Focus assay ( P < 0.01). Screening by Focus and then retesting with Kalon/Biokit of positive samples can reduce falsely positive results significantly ( P < 0.01).
- Published
- 2008
40. Risk Factors for Herpes Simplex Virus Transmission to Pregnant Women: A Couples Study
- Author
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Judy Zeh, Rhoda Ashley Morrow, Stacy Selke, Anna Wald, Zane A. Brown, Lawrence Corey, and Carolyn Gardella
- Subjects
Adult ,Washington ,medicine.medical_specialty ,Herpesvirus 2, Human ,viruses ,Blotting, Western ,Herpesvirus 1, Human ,Antibodies, Viral ,Serology ,Pregnancy ,Risk Factors ,Epidemiology ,Odds Ratio ,Humans ,Medicine ,Prospective Studies ,Risk factor ,Pregnancy Complications, Infectious ,Prospective cohort study ,Cervix ,Subclinical infection ,Gynecology ,Herpes Genitalis ,business.industry ,Obstetrics ,Transmission (medicine) ,Obstetrics and Gynecology ,Herpes Simplex ,General Medicine ,Odds ratio ,medicine.disease ,Infectious Disease Transmission, Vertical ,Neonatal infection ,Logistic Models ,Sexual Partners ,medicine.anatomical_structure ,Gestation ,Female ,Viral disease ,business ,Oral herpes - Abstract
An estimated 60% to 80% of neonatal herpes simplex virus (HSV) infections are a result of the mother acquiring HSV-1 or HSV-2 close to the time of delivery. Although it is relatively uncommon for HSV to be acquired at the end of pregnancy, transmission takes place efficiently. This suggests that preventing maternal acquisition of HSV during pregnancy may effectively lower the risk of neonatal infection. This couples study was done to identify risk factors for acquiring HSV in at-risk pregnant women who were participating in a prospective study of HSV in pregnancy. They invited their partners to undergo serologic testing for type-specific HSV. A total of 3192 couples took part in the study. Serum samples were taken at the initial prenatal visit and again at the time of labor, and swabs were taken at labor from the external genitalia and cervix. Antibodies to HSV-1 and HSV-2 were sought by the Western blot technique. Just over one fifth of women in the study were at risk of acquiring HSV. Of 582 who were seronegative for HSV-1 and whose partners were seropositive, 14 (3.5% when adjusted for gestational length) did acquire HSV-1. Having a partner with a history of oral herpes correlated with acquisition of HSV-1 (odds ratio [OR] 8.1; 95% confidence interval [CI], 1.8-36) and accounted for three fourths of incident infections. Of 125 women at risk for acquiring HSV-2, 17 (20% when adjusted for gestational length) became infected. Partnership for 12 months or less correlated with acquiring HSV-2 (OR, 7.8; 95% CI, 2.3-25.7) and accounted for 63% of incident infections. The presence of HSV-1 antibodies did not influence the rate of acquiring HSV-2 to any substantial degree. The rate of subclinical infection in 31 women who acquired HSV from their partners during pregnancy was 68%. The rate did not depend on whether the women acquired HSV-1 or HSV-2. There was a single case of neonatal herpes. No set of clinical features was found that identified a majority of susceptible women having serologically discordant partners. These findings imply that serologic screening may be necessary to identify women who are at risk of acquiring HSV while pregnant. Acquisition rates, especially those for HSV-2, are high for serologically discordant couples. Further studies are needed to determine the cost of serologically screening pregnant women and to what degree this practice will prevent maternal and neonatal HSV infections.
- Published
- 2006
41. Daily acyclovir to decrease herpes simplex virus type 2 (HSV-2) transmission from HSV-2/HIV-1 coinfected persons: a randomized controlled trial
- Author
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James Kiarie, William Kanweka, Sinead Delany-Moretlwe, Hiv Transmission Study Team, Lawrence Corey, Anna Wald, Rhoda Ashley Morrow, David Coetzee, Amalia Magaret, Mubiana Inambao, Carey Farquhar, Orange Farm, Craig R. Cohen, James McIntyre, Jairam R. Lingappa, Joseph Makhema, Mary S. Campbell, Rachel Manongi, Jared M. Baeten, James I. Mullins, Helen Rees, Grace John-Stewart, Elizabeth Bukusi, Connie Celum, James P. Hughes, Amalia S. Magaret, Bellington Vwalika, Kenneth H. Fife, Susan Allen, Glenda Gray, Max Essex, Etienne Karita, Andrew Mujugira, Guy de Bruyn, Kayitesi Kayitenkore, Nelly Mugo, M. Juliana McElrath, Elly Katabira, Elizabeth A. Bukusi, Robert W. Coombs, Edwin Were, Allan Ronald, and Saidi Kapiga
- Subjects
Adult ,Male ,viruses ,Herpesvirus 2, Human ,Acyclovir ,HIV Infections ,Disease ,Kaplan-Meier Estimate ,medicine.disease_cause ,Placebo ,Antiviral Agents ,Drug Administration Schedule ,law.invention ,Major Articles and Brief Reports ,Randomized controlled trial ,law ,medicine ,Immunology and Allergy ,Humans ,Proportional Hazards Models ,Herpes Genitalis ,business.industry ,Transmission (medicine) ,Coinfection ,Incidence (epidemiology) ,Incidence ,virus diseases ,medicine.disease ,Virology ,Genital ulcer ,Infectious Diseases ,Herpes simplex virus ,Treatment Outcome ,Immunology ,Multivariate Analysis ,HIV-1 ,Female ,medicine.symptom ,business - Abstract
Herpes simplex virus type 2 (HSV-2) is highly prevalent among human immunodeficiency virus type 1 (HIV-1)–infected persons in sub-Saharan Africa [1–4]. Epidemiologic studies suggest synergy between HSV-2 and HIV-1 facilitates the spread of both viruses; HSV-2 reactivation increases HIV-1 concentrations in plasma and genital secretions, increasing the risk of HIV-1 transmission and disease progression, while HIV-1 infection increases HSV-2 shedding and reactivation frequency [5–8]. Thus, coinfection with HIV-1 likely increases the risk of HSV-2 transmission. Daily therapy with valacyclovir reduces HSV-2 transmission in HSV-2–serodiscordant, HIV-1–seronegative-concordant healthy, immunocompetent, heterosexual couples by 48%, likely by decreasing the frequency and amount of HSV-2 shed in the genital tract by the HSV-2–infected partner [9, 10]. HIV-1–infected persons tend to reactivate HSV-2 both more frequently and at higher copy number than their immunocompetent counterparts [7, 8]. It is unknown whether treatment of HSV-2/HIV-1–infected persons with acyclovir reduces transmission of HSV-2 to their HSV-2/HIV-1–susceptible partner. The Partners in Prevention Trial was a double-blind, randomized, controlled trial among HIV-1–serodiscordant couples to determine whether treatment of HSV-2 infection would reduce the transmission of HIV-1. As previously reported, HSV-2 suppression provided to the HIV-1–infected partners did not reduce the risk of HIV-1 transmission to their initially HIV-1–uninfected partners despite a sustained 0.25 log10 copies/mL reduction in the plasma HIV-1 RNA load, a 73% reduction in genital ulcer disease (GUD) incidence, and a 16%–19% decrease in HIV-1 disease progression [3]. We conducted an analysis of the effect of daily acyclovir on the risk of HSV-2 transmission in the subset of participants randomly assigned to receive acyclovir or placebo whose partners who were susceptible to HSV-2 and HIV-1.
- Published
- 2013
42. Performance of a Commercial, Type-Specific Enzyme-Linked Immunosorbent Assay for Detection of Herpes Simplex Virus Type 2-Specific Antibodies in Ugandans
- Author
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Wayne Hogrefe, Ruby H.-N. Nguyen, Oliver Laeyendecker, Bobbi Jo Horne, David Serwadda, Ronald H. Gray, Noah Kiwanuka, Rhoda Ashley Morrow, Maria J. Wawer, Charla Henson, and Thomas C. Quinn
- Subjects
Microbiology (medical) ,Herpesvirus 2, Human ,Blotting, Western ,Population ,Enzyme-Linked Immunosorbent Assay ,Antibodies, Viral ,medicine.disease_cause ,Sensitivity and Specificity ,Virus ,Herpesviridae ,Virology ,HIV Seronegativity ,Alphaherpesvirinae ,HIV Seropositivity ,medicine ,Humans ,Uganda ,education ,Herpes Genitalis ,education.field_of_study ,biology ,biology.organism_classification ,Herpes simplex virus ,biology.protein ,Reagent Kits, Diagnostic ,Antibody - Abstract
Two hundred forty-eight human immunodeficiency virus (HIV)-positive and 496 HIV-negative subjects in Uganda were tested by HerpeSelect herpes simplex virus type 2 enzyme-linked immunosorbent assay (ELISA) and Western blotting to optimize the ELISA for use in this population. A higher index cutoff value was required for optimal sensitivity and specificity, and overall performance of the assay was not affected by HIV status.
- Published
- 2004
43. Efficacy Results of a Trial of a Herpes Simplex Vaccine
- Author
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Anna Wald, Joann Schulte, Myron J. Levin, Iris Gorfinkel, Gary Dubin, Jack T. Stapleton, Robert B. Belshe, David I. Bernstein, Marian G. Ewell, Thomas C. Heineman, Carolyn Deal, Abbie Stokes-Riner, Rhoda Ashley Morrow, and Peter A. Leone
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Herpesvirus 2, Human ,viruses ,Population ,Disease ,Herpesvirus 1, Human ,Article ,law.invention ,Young Adult ,Randomized controlled trial ,Double-Blind Method ,Viral Envelope Proteins ,law ,Risk Factors ,Internal medicine ,Medicine ,Humans ,Viral shedding ,education ,Herpes Genitalis ,Herpes Simplex Virus Vaccines ,education.field_of_study ,business.industry ,General Medicine ,Genitalia, Female ,Vaccine efficacy ,Virus Shedding ,Treatment Outcome ,Immunology ,Population study ,Female ,business - Abstract
Two previous studies of a herpes simplex virus type 2 (HSV-2) subunit vaccine containing glycoprotein D in HSV-discordant couples revealed 73% and 74% efficacy against genital disease in women who were negative for both HSV type 1 (HSV-1) and HSV-2 antibodies. Efficacy was not observed in men or HSV-1 seropositive women.We conducted a randomized, double-blind efficacy field trial involving 8323 women 18 to 30 years of age who were negative for antibodies to HSV-1 and HSV-2. At months 0, 1, and 6, some subjects received the investigational vaccine, consisting of 20 μg of glycoprotein D from HSV-2 with alum and 3-O-deacylated monophosphoryl lipid A as an adjuvant; control subjects received the hepatitis A vaccine, at a dose of 720 enzyme-linked immunosorbent assay (ELISA) units. The primary end point was occurrence of genital herpes disease due to either HSV-1 or HSV-2 from month 2 (1 month after dose 2) through month 20.The HSV vaccine was associated with an increased risk of local reactions as compared with the control vaccine, and it elicited ELISA and neutralizing antibodies to HSV-2. Overall, the vaccine was not efficacious; vaccine efficacy was 20% (95% confidence interval [CI], -29 to 50) against genital herpes disease. However, efficacy against HSV-1 genital disease was 58% (95% CI, 12 to 80). Vaccine efficacy against HSV-1 infection (with or without disease) was 35% (95% CI, 13 to 52), but efficacy against HSV-2 infection was not observed (-8%; 95% CI, -59 to 26).In a study population that was representative of the general population of HSV-1- and HSV-2-seronegative women, the investigational vaccine was effective in preventing HSV-1 genital disease and infection but not in preventing HSV-2 disease or infection. (Funded by the National Institute of Allergy and Infectious Diseases and GlaxoSmithKline; ClinicalTrials.gov number, NCT00057330.).
- Published
- 2012
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44. Performance of commercial herpes simplex virus type-2 antibody tests using serum samples from Sub-Saharan Africa: a systematic review and meta-analysis
- Author
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Rhoda Ashley Morrow, Helen A. Weiss, Heiner Grosskurth, Philippe Mayaud, and Samuel Biraro
- Subjects
Microbiology (medical) ,Sexually transmitted disease ,Sub saharan ,viruses ,Herpesvirus 2, Human ,Blotting, Western ,Enzyme-Linked Immunosorbent Assay ,Dermatology ,medicine.disease_cause ,Antibodies, Viral ,Sensitivity and Specificity ,Herpesviridae ,Virus ,Serology ,Immunoenzyme Techniques ,parasitic diseases ,medicine ,Humans ,Serologic Tests ,Africa South of the Sahara ,Herpes Genitalis ,biology ,business.industry ,Public Health, Environmental and Occupational Health ,Virology ,United States ,Europe ,Infectious Diseases ,Herpes simplex virus ,Meta-analysis ,biology.protein ,Reagent Kits, Diagnostic ,Antibody ,business - Abstract
Several commercial type-specific serologic tests are available for herpes simplex virus type 2 (HSV-2). Poor specificity of some tests has been reported on samples from sub-Saharan Africa.To summarize the performance of the tests using samples from sub-Saharan Africa, we conducted a systematic review of publications reporting performance of commercially available HSV-2 tests against a gold standard (Western Blot or monoclonal antibody-blocking EIA). We used random-effects meta-analyses to summarize sensitivity and specificity of the 2 most commonly evaluated tests, Kalon gG2 enzyme-linked immunosorbent assay (ELISA), and Focus HerpeSelect HSV-2 ELISA.We identified 10 eligible articles that included 21 studies of the performance of Focus, and 12 of Kalon. The primary analyses included studies using the manufacturers' cut-offs (index value = 1.1). Focus had high sensitivity (random effects summary estimate 99%, 95% confidence interval [CI]: 99%-100%) but low specificity (69%, 95% CI: 59%-80%). Kalon had sensitivity of 95% (95% CI: 93%-97%) and specificity of 91% (95% CI: 86%-95%). Specificity of Focus was significantly lower (P = 0.002) among HIV-positive (54%, 95% CI: 40%-68%) than HIV-negative individuals (69%, 95% CI: 56%-82%). When the cut-off optical density index was increased above the recommended value of 1.1 to between 2.2 and 3.5, the specificity of Focus increased to 85% (95% CI: 77%-92%).Sensitivity and specificity of HSV-2 tests used in sub-Saharan Africa vary by setting, and are lower than reported from studies in the United States and Europe. Increasing the cut-off optical density index may improve test performance. Evaluation of test performance in a given setting may help deciding which test is most appropriate.
- Published
- 2010
45. Rapid polymerase chain reaction assay to detect herpes simplex virus in the genital tract of women in labor
- Author
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Meei Li Huang, Carolyn Gardella, Amalia Magaret, Anna Wald, Lawrence Corey, Stacy Selke, and Rhoda Ashley Morrow
- Subjects
Adult ,medicine.medical_specialty ,Adolescent ,medicine.disease_cause ,Polymerase Chain Reaction ,Article ,Young Adult ,Pregnancy ,medicine ,Humans ,Simplexvirus ,Sex organ ,Viral shedding ,Risk factor ,Pregnancy Complications, Infectious ,Herpes Genitalis ,Labor, Obstetric ,business.industry ,Transmission (medicine) ,Obstetrics ,Incidence (epidemiology) ,Obstetrics and Gynecology ,medicine.disease ,Herpes simplex virus ,ROC Curve ,Immunology ,Female ,business - Abstract
Neonatal HSV occurs in up to 1 per 3200 live births (1), with an estimated incidence of 1,500 cases in the United States annually (2). Neonatal HSV causes disseminated or CNS disease in approximately 50% of cases; up to 30% of these neonates die and up to 40% of survivors have neurologic damage, despite anti-viral therapy (2). Current guidelines for prevention of neonatal herpes recommend visual inspection for maternal herpetic genital lesions at the time of labor with cesarean delivery if lesions are present (3); this strategy has not resulted in an appreciable reduction in incidence (4). The main mode of transmission to the neonate is exposure to infected maternal secretions at the time of passage through the birth canal. Isolation of HSV from the maternal genital tract at the time of labor is the primary risk factor for neonatal HSV with an estimated relative risk of >300 for infection (1). As such, prevention of neonatal exposure to HSV during birth by identifying women with HSV in the genital tract during labor is a potential approach for reducing risk of infection. Interventions that could be tested among women shedding HSV during labor include cesarean delivery, anti-viral prophylaxis for mother and/or the neonate, and enhanced observation for signs of neonatal HSV infection. Currently, there is no clinically useful method to detect HSV in the genital tract at the time of labor. Lesions consistent with genital herpes indicate an increased risk of HSV, however, both sensitivity and specificity of genital lesions for viral shedding is poor (5–7). Most women with HSV in the genital tract at the time of labor are without signs or symptoms of genital herpes (1). In the past, viral cultures of genital swabs collected in the third trimester of pregnancy were used to identify women at risk of perinatal HSV transmission. However, results from these prenatal specimens rarely correlated with culture results of swabs collected at the time of delivery, and thus were not helpful in predicting neonatal exposure (8). Therefore, this practice was abandoned in the late 1980s (3). Viral cultures to detect HSV from genital swabs collected at the time of labor are not practical because results are not available in a time frame that would allow for effective interventions. Moreover, false negative viral cultures were reported in up to 30% cases of neonatal HSV. In most reports, PCR- based assays detected HSV in these negative viral cultures (1, 5). Real-time quantitative PCR has proved to be sensitive and reproducible in the diagnosis and management of vial diseases (9). However, due to the complexity of the procedures involved and the potential of contamination, clinical diagnostic PCR usually is performed in state-of-the-art clinical laboratories. Transfer of specimens from clinical sites to comprehensive clinical laboratories often takes hours or even days. Once received, the entire analytic procedure, including nuclear acid extraction and 45 cycles of Taqman PCR, takes about 4 hours. Although point-of-care (POC) molecular diagnostic systems are available for adaptation (10), to adopt one of these systems for specific pathogen detection will heavily involve the commercial proprietary issues, higher cost per test and less flexibility for any in house development. As such, we chose to develop an in-house, sensitive, specific, rapid, automated, self-contained PCR assay using the extraction and PCR equipment available commercially that could be utilized to detect HSV-1 or HSV-2 from samples taken in the delivery room and reported back rapidly (within 2 hours) to clinicians providing care of the laboring woman and newborn. The assay is designed to be utilized by any trained laboratory technician, so as to be feasibly implemented in at any hour of the day in a clinical laboratory serving obstetrical patients.
- Published
- 2010
46. Acyclovir and transmission of HIV-1 from persons infected with HIV-1 and HSV-2
- Author
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James I. Mullins, Edwin Were, Katherine K. Thomas, James Kiarie, G de Bruyn, Nelly Mugo, Elizabeth A. Bukusi, Renee Ridzon, Linda E Barnes, David Coetzee, Connie Celum, Robert W. Coombs, Craig R. Cohen, Andrew Mujugira, Kayitesi Kayitenkore, Wendy S. Stevens, Susan Allen, Richard S. Wang, Mubiana Inambao, Myron Essex, James P. Hughes, Allan R. Ronald, Lawrence Corey, M J McElrath, Kenneth H. Fife, Etienne Karita, William L. H. Whittington, Saidi Kapiga, Glenda Gray, Anna Wald, William Kanweka, Rachel Manongi, Sinead Delany, J.R. Lingappa, Helen Rees, Grace John Stewart, James McIntyre, Carey Farquhar, Elly Katabira, Campbell, Rhoda Ashley Morrow, Bellington Vwalika, Joseph Makhema, Jared M. Baeten, and Amalia Magaret
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Herpesvirus 2, Human ,Acyclovir ,HIV Infections ,Kaplan-Meier Estimate ,Antiviral Agents ,Article ,Young Adult ,Pharmacotherapy ,Acquired immunodeficiency syndrome (AIDS) ,Pregnancy ,Internal medicine ,medicine ,Humans ,Aciclovir ,Sida ,Adverse effect ,Herpes Genitalis ,AIDS-Related Opportunistic Infections ,Unsafe Sex ,biology ,business.industry ,virus diseases ,General Medicine ,biology.organism_classification ,medicine.disease ,Virology ,CD4 Lymphocyte Count ,Intention to Treat Analysis ,Relative risk ,Lentivirus ,HIV-1 ,Patient Compliance ,RNA, Viral ,Female ,Viral disease ,business ,Follow-Up Studies ,medicine.drug - Abstract
BACKGROUND: Most persons who are infected with human immunodeficiency virus type 1 (HIV-1) are also infected with herpes simplex virus type 2 (HSV-2), which is frequently reactivated and is associated with increased plasma and genital levels of HIV-1. Therapy to suppress HSV-2 reduces the frequency of reactivation of HSV-2 as well as HIV-1 levels, suggesting that suppression of HSV-2 may reduce the risk of transmission of HIV-1. METHODS: We conducted a randomized, placebo-controlled trial of suppressive therapy for HSV-2 (acyclovir at a dose of 400 mg orally twice daily) in couples in which only one of the partners was seropositive for HIV-1 (CD4 count, > or = 250 cells per cubic millimeter) and that partner was also infected with HSV-2 and was not taking antiretroviral therapy at the time of enrollment. The primary end point was transmission of HIV-1 to the partner who was not initially infected with HIV-1; linkage of transmissions was assessed by means of genetic sequencing of viruses. RESULTS: A total of 3408 couples were enrolled at 14 sites in Africa. Of the partners who were infected with HIV-1, 68% were women, and the baseline median CD4 count was 462 cells per cubic millimeter. Of 132 HIV-1 seroconversions that occurred after randomization (an incidence of 2.7 per 100 person-years), 84 were linked within couples by viral sequencing: 41 in the acyclovir group and 43 in the placebo group (hazard ratio with acyclovir, 0.92, 95% confidence interval [CI], 0.60 to 1.41; P=0.69). Suppression with acyclovir reduced the mean plasma concentration of HIV-1 by 0.25 log(10) copies per milliliter (95% CI, 0.22 to 0.29; P
- Published
- 2010
47. Characteristics of HIV-1 Discordant Couples Enrolled in a Trial of HSV-2 Suppression to Reduce HIV-1 Transmission: The Partners Study
- Author
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James Kiarie, Edwin Were, Nelly Mugo, Rachel Manongi, Connie Celum, Jared M. Baeten, James McIntyre, Susan Allen, Erin M. Kahle, Saidi Kapiga, Hiv Transmission Study Team, William L. H. Whittington, Myron Essex, Elly Katabira, Elizabeth A. Bukusi, Carey Farquhar, Craig R. Cohen, Guy deBruyn, Allan R. Ronald, Mubiana Inambao, Kayitesi Kayitenkore, Helen Rees, Grace John Stewart, Jairam R. Lingappa, William Kanweka, Amalia Magaret, Robert W. Coombs, Sinead Delany, Andrew Mujugira, Bellington Vwalika, Anna Wald, Glenda Gray, Etienne Karita, Kenneth H. Fife, Joseph Makhema, Lawrence Corey, Rhoda Ashley Morrow, David Coetzee, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, and Emery, Sean
- Subjects
Male ,Herpesvirus 2, Human ,lcsh:Medicine ,Public Health and Epidemiology/Infectious Diseases ,Acyclovir ,Chlamydia trachomatis ,HIV Infections ,medicine.disease_cause ,Cohort Studies ,Medicine ,Viral ,lcsh:Science ,Multidisciplinary ,Transmission (medicine) ,virus diseases ,Infectious Diseases/HIV Infection and AIDS ,Infectious Diseases ,Sexual Partners ,6.1 Pharmaceuticals ,Serodiscordant ,Cohort ,HIV/AIDS ,Herpes simplex virus-2 ,RNA, Viral ,Female ,Infection ,Human ,Cohort study ,Research Article ,Adult ,medicine.medical_specialty ,General Science & Technology ,Clinical Trials and Supportive Activities ,Sexually Transmitted Diseases ,Antiviral Agents ,Acquired immunodeficiency syndrome (AIDS) ,Clinical Research ,Internal medicine ,Trichomonas vaginalis ,Infectious Diseases/Sexually Transmitted Diseases ,Humans ,Heterosexuality ,Demography ,Herpes Genitalis ,business.industry ,Herpesvirus 2 ,Prevention ,lcsh:R ,Evaluation of treatments and therapeutic interventions ,HIV ,medicine.disease ,CD4 Lymphocyte Count ,Clinical research ,Partners HSV-2/HIV-1 Transmission Study Team ,Immunology ,Africa ,Public Health and Epidemiology/Preventive Medicine ,HIV-1 ,RNA ,Sexually Transmitted Infections ,lcsh:Q ,business ,Follow-Up Studies - Abstract
BackgroundThe Partners HSV-2/HIV-1 Transmission Study (Partners Study) is a phase III, placebo-controlled trial of daily acyclovir for genital herpes (HSV-2) suppression among HIV-1/HSV-2 co-infected persons to reduce HIV-1 transmission to their HIV-1 susceptible partners, which requires recruitment of HIV-1 serodiscordant heterosexual couples. We describe the baseline characteristics of this cohort.MethodsHIV-1 serodiscordant heterosexual couples, in which the HIV-1 infected partner was HSV-2 seropositive, had a CD4 count >or=250 cells/mcL and was not on antiretroviral therapy, were enrolled at 14 sites in East and Southern Africa. Demographic, behavioral, clinical and laboratory characteristics were assessed.ResultsOf the 3408 HIV-1 serodiscordant couples enrolled, 67% of the HIV-1 infected partners were women. Couples had cohabitated for a median of 5 years (range 2-9) with 28% reporting unprotected sex in the month prior to enrollment. Among HIV-1 susceptible participants, 86% of women and 59% of men were HSV-2 seropositive. Other laboratory-diagnosed sexually transmitted infections were uncommon (500 relative to
- Published
- 2009
48. Herpes Simplex Virus Type 2 Antibody Detection Performance in Kisumu, Kenya, using the HerpeSelect ELISA, Kalon ELISA, Western Blot and Inhibition Testing
- Author
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D J Westreich, Jennifer S. Smith, Wayne Hogrefe, Kawango Agot, Jeckoniah O. Ndinya-Achola, Ian Maclean, S Moses, Rhoda Ashley Morrow, and Robert C. Bailey
- Subjects
Sexually transmitted disease ,Adult ,Male ,Adolescent ,Herpesvirus 2, Human ,Population ,Blotting, Western ,Enzyme-Linked Immunosorbent Assay ,Dermatology ,Antibodies, Viral ,Sensitivity and Specificity ,Article ,Serology ,Young Adult ,Western blot ,HIV Seronegativity ,medicine ,Seroprevalence ,Humans ,Serologic Tests ,education ,Randomized Controlled Trials as Topic ,education.field_of_study ,Herpes Genitalis ,biology ,medicine.diagnostic_test ,business.industry ,Reproducibility of Results ,Virology ,Kenya ,Blot ,Infectious Diseases ,Circumcision, Male ,Immunoglobulin G ,Immunology ,biology.protein ,Antibody ,business - Abstract
Background: In certain parts of Africa, type-specific herpes simplex virus type 2 (HSV-2) ELISAs may have limited specificity. To date, no study has been conducted to validate HerpeSelect and Kalon type-specific HSV-2 ELISAs using both the Western blot and recombinant gG ELISA inhibition testing as reference standards. Methods: A total of 120 men who were HIV seronegative (aged 18–24 years) provided blood samples. HSV-2 IgG serum antibodies were detected using four different methods: HerpeSelect HSV-2 ELISA (n = 120), Kalon HSV-2 ELISA (n = 120), University of Washington Western blot (n = 101) and a recombinant inhibition test (n = 93). Results: HSV-2 seroprevalence differed significantly by HSV-2 detection method, ranging from 24.8% with the Western blot to 69.8% with the HerpeSelect ELISA. Using the Western blot as the reference standard, the HerpesSelect had the highest sensitivity for HSV-2 antibody detection (100%) yet lowest specificity (40%). Similar results were obtained using the inhibition test as the reference standard. The sensitivity and specificity of the Kalon test versus the Western blot were 92% and 79%, respectively, and 80% and 82% versus the inhibition test. Using the inhibition test as the reference standard, the sensitivity of the Western blot appeared low (49%). Conclusions: In men in western Kenya who were HIV seronegative, the HerpeSelect and Kalon type-specific ELISAs had high sensitivities yet limited specificities using the Western blot as reference standard. Overall, the Kalon ELISA performed better than the HerpeSelect ELISA in these young men from Kisumu. Further understanding is needed for the interpretation of HSV-2 inhibition or ELISA test positive/ Western blot seronegative results. Before HSV-2 seropositivity may be reliably reported in selected areas of Africa, performance studies of HSV-2 serological assays in individual geographical areas are recommended.
- Published
- 2008
49. Comparison of Three Commercial Immunoassays for Detection of Herpes Simplex Virus Type 2 Antibodies in Commercial Sex Workers in Yunnan Province, China▿
- Author
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Thoai D. Ngo, Rhoda Ashley Morrow, Shenghan Lai, Oliver Laeyendecker, and Thomas C. Quinn
- Subjects
Microbiology (medical) ,China ,Herpesvirus 2, Human ,Clinical Biochemistry ,Immunology ,Blotting, Western ,Sex workers ,Biology ,medicine.disease_cause ,Antibodies, Viral ,Sensitivity and Specificity ,parasitic diseases ,medicine ,Immunology and Allergy ,Clinical Laboratory Immunology ,Humans ,Herpes Genitalis ,Immunoassay ,medicine.diagnostic_test ,Blotting western ,Virology ,Herpes simplex virus ,ROC Curve ,biology.protein ,Female ,Reagent Kits, Diagnostic ,Antibody - Abstract
Five hundred commercial sex workers in China were tested for herpes simplex virus type 2 by three immunoassays and Western blotting. Sensitivities for the Focus, Kalon, and Biokit assays were 86.7%, 82.3%, and 34.9%, respectively, and specificities were 91.8%, 94.2%, and 60.1%, respectively. The Focus assay performed optimally at an index of 1.5 (95.2% sensitivity and 93.4% specificity), and the Kalon assay performed optimally at an index of 1.2 (93.3% sensitivity and 95.2% specificity).
- Published
- 2008
50. Improved Performance of Enzyme-Linked Immunosorbent Assays and the Effect of Human Immunodeficiency Virus Coinfection on the Serologic Detection of Herpes Simplex Virus Type 2 in Rakai, Uganda▿
- Author
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Ronald H. Gray, Thomas C. Quinn, Aaron A.R. Tobian, Steven J. Reynolds, Rhoda Ashley Morrow, Oliver Laeyendecker, Jordyn Gamiel, and David Serwadda
- Subjects
Microbiology (medical) ,Adult ,Male ,Adolescent ,Herpesvirus 2, Human ,Clinical Biochemistry ,Immunology ,Human immunodeficiency virus (HIV) ,Enzyme-Linked Immunosorbent Assay ,medicine.disease_cause ,Antibodies, Viral ,Sensitivity and Specificity ,Serology ,HIV Seropositivity ,medicine ,Immunology and Allergy ,Clinical Laboratory Immunology ,Humans ,Uganda ,Herpes Genitalis ,chemistry.chemical_classification ,biology ,business.industry ,HIV ,medicine.disease ,Virology ,Improved performance ,Enzyme ,Herpes simplex virus ,chemistry ,Coinfection ,biology.protein ,Female ,Reagent Kits, Diagnostic ,Antibody ,business - Abstract
Ugandan subjects (820) were tested by Focus HerpeSelect enzyme-linked immunosorbent assay (ELISA), Kalon herpes simplex virus type 2 ELISA, and BioKit rapid test, and the results were compared to those of Western blotting. Higher-than-standard-index cutoff values gave optimal sensitivity and specificity. Kalon ELISA was the optimal assay when an index value of 1.5 was used (sensitivity, 91.7%; specificity, 92.4%).
- Published
- 2008
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