DEMONSTRATION OF EITHER ENDOGENOUS RECURRENCE OR EXOGENOUS REINFECTION BY RESTRICTION-ENDONUCLEASE CLEAVAGE ANALYSIS OF HERPES-SIMPLEX VIRUS FROM PATIENTS WITH RECRUDESCENT GENITAL HERPES

By using restriction endonuclease (RE) cleavage analysis, either endog enous recurrence or exogenous reinfection of herpes simplex virus (HSV ) was clarified in 45 male and 20 female subjects with recrudescent ge nital herpes. All of the plural (two to ten) isolates from 63 (205 iso lates) out of 65 subjects (97%) were HSV-2. Two iso lates from only on e of 65 subjects (1.5%) were HSV-1, and they showed the same RE profil e. in addition, an HSV-1 and five HSV-2 isolates were obtained from th e remaining one female patient (1.5%), indicating that an exogenous HS V-1 strain has been reinfected during HSV-2 recrudescences. HSV-2 isol ates were furthermore classified into genotypes of HSV-2 using 16 diff erent RE markers with five REs. Two hundred and ten HSV-2 isolates fro m 64 subjects were classified into 27 distinct genotypes, in which som e predominant genotypes and seven new genotypes were found. Plural HSV -2 isolates obtained from 63 out of 64 subjects, including one subject from whom an HSV-1 and five HSV-2 strains were isolated, were classif ied into the same genotypes, indicating that they may be regarded as r ecrudescent genital herpes by the reactivation of the same endogenous strain. However, the RE profiles of two HSV-2 strains from the remaini ng one subject were different. Thus, it was finally found that only tw o out of 65 subjects (3%) were reinfected with exogenous strains. Thes e results lead to the conclusion that almost all recrudescent genital herpes are due to the reactivation of an initially infected HSV-2 stra in, and are occasionally due to reinfection with distinct HSV strains of either the same or a different type. (C) 1995 Wiley-Liss, Inc.