Journal of Clinical Virology - Volume 82 - Supplement 1 - September 2016

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S92 Abstracts / Journal of Clinical Virology 82S (2016) S1–S142
retroviral resistance, weremainly detected in non-B subtypes, with
some being classified as subtype “signatures”.
The identification of HIV-1mutations associatedwith resistance
to PIs in women whose prophylactic regimens during pregnancy
included this class of drugs may have implications for the preven-
tion of vertical transmission, stressing the importance of mutation
surveillance.
Abstract no: 320
Presentation at ESCV 2016: Poster 143
Substantial increase of newly reported cases of
HIV related to MSM in the Czech Republic
V. Nemecek ∗, M. Maly, H. Zakoucka,
M. Maresova, M. Linka, B. Mackova
National Institute of Public Health, Czech Republic
The Czech Republic (10.5 millions inhabitants) belongs to
countries with low prevalence of HIV. Since the year 1985 until
2015, 2620 HIV cases have been reported. Considerable continu-
ous increase of newly reported cases of HIV begun in the year 2002
(50 cases) and reached 266 cases in the year 2015. The predominat-
ing mode of transmission was sexual with prevailing homosexual
transmission. Proportion of HIV infected men who have sex with
men (MSM) continuously rose and reached 78% in 2015 while that
of heterosexual transmission decreased to 17%. Proportion of HIV
infected intravenous drug users was steadily low not exceeding 5%.
Over a long period, about half of the newly diagnosed HIV cases had
place of residence in Prague. The foreigners with long-term stay in
the Czech Republic comprise 20–30% of newly reported HIV cases.
About 15% of new cases were detected in acute stage, and another
15% were late presenters. Annual numbers of new AIDS cases var-
ied in the range 18–32 during the last decade. In about 2/3 of these
cases HIV infectionwas newly detected only at this stage. HIV infec-
tion in the Czech Republic, in spite of low overall prevalence, shows
an increasing trend due to growing incidence in theMSM. High-risk
behaviour of MSM is illustrated by steeply increasing occurrence of
early syphilis and lymphogranuloma venereum. Currently, the pro-
portion of MSM in newly diagnosed HIV cases in the Czech Republic
is among the highest in Europe.
Supported by the project for the conceptual development of
research organization VZ MZ 75010330 NIPH of the Ministry of
Health of the Czech Republic.
Abstract no: 327
Presentation at ESCV 2016: Poster 144
Genital herpes in a STD outpatient clinic in
Lisbon
S. Lopo ∗, C. Roque , I. Costa , M.J. Borrego ,
J. Azevedo
1 Department of Infectious Diseases, National
Institute of Health, Lisbon, Portugal
2 Unidade DST/CAD, Lapa, Portugal
Introduction: Genital Herpes is the major cause of genito-
ulcerative disease affecting a considerable number of individuals
worldwide and is a chronic, life-long viral infection caused by
both HSV1 or HSV2. Most cases of recurrent genital herpes are
caused by HSV2, being the leading cause of genital ulcer disease
in developing countries, but the proportion of anogenital herpetic
infections attributed to HSV1 are increasing, especially in young
women and MSM. The prevalence in the general population ranges
from 10% to 80% and depends on socio-economic factors. Seropos-
itivity rates are higher in women than in men and increase with
age. Reactivation and subclinical shedding is more frequent in gen-
ital infections caused by HSV2 than by HSV1, which reaffirm the
importance of laboratory confirmation of clinical diagnosis.
Aims: Retrospective study of the role of HSV1 and HSV2
infections in genital ulcerations from a population of a Sexually
Transmitted Diseases Outpatient Clinic, according to epidemiolog-
ical, laboratory and clinical data.
Methodology: 56 ulcer genital/urethral swabs from patients
suspected of HSV infection were sent to the National Institute of
Health (NIH), in Lisbon, between April 2015–April 2016. HSV1 and
HSV2were determined by a quantitative commercial real-time PCR
kit, which targets a fragment of 162 bp of a region located in the US7
gene for HSV1 and a fragment of 177 bp of a region located in the
US2 gene for HSV2. The 56 swabs were also inoculated in Vero cell
cultures for determination of cytopathic effect.
Results: HSV infection in genital/urethral swabs were detected
in 30 (53.6%) of 56 samples. The symptoms of the positive cases
were genital ulcerations in vulva or penis and/or perineum and the
clinical diagnosiswas genital herpes infection. In7 of the 30 positive
cases (23.3%) HSV1 DNA was detected (2 man and 5 women with
age ranges between17 and 27 years old); and in23 of the 30 positive
cases (76.7%) HSV2 DNA was detected (18 man and 5 women, with
age ranges between 17 and 62 years old).
Five of the 7 HSV1 positive cases were primoinfections (71.4%)
and in the 23 HSV2 positive cases, 3 (13.0%) were primoinfections
and 8 (34.8%) were the first ulcer episode but not primoinfections.
HSV DNA viral load values varied between
21848–87474493 cop/ml in HSV1 cases and between
1177–31160846336 cop/ml in HSV2 cases. We did not find
direct correlation between viral load and primary vs recurrent
infection although the higher viral load was found in HSV2 first
episode cases. Cytopathic effect was observed in all positive
PCR cases. All positive cases were treated with valacyclovir and
resolved after treatment.
Comments: To identify HSV genital infections is important for
the specific treatment, for preventing the transmission of HSV to
partners, and to prevent the risk of acquiring and transmitting
HIV. In our study 53.6% cases were positive for HSV genital infec-
tion; because of social, demographic and migratory tendency, the
population at risk for STI continues to grow and experience an
increased burden of disease. We also observed in this population an
increasing proportion of HSV1 genital primoinfection, which is in
accordance to the literature. In the present study we confirmed the
usefulness of real-time PCR for HSV DNA detection in genital ulcer-
ations. Concerning the correlation of viral load with subtype, the
differences should be further evaluated with an increase number
of clinical cases.