Herpes simplex encephalitis: involvement of apolipoprotein E genotype
- aMolecular Neurobiology Laboratory, Department of Optometry and Neuroscience, UMIST, Manchester M60 1QD, UK, bDepartment of Clinical Neurology, University of Oxford, Oxford, UK, and Oxford Radcliffe NHS Trust, Oxford OX2 6HE, UK, cNuffield Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK
- Professor R F Itzhaki
- Received 21 March 2000
- Revised 30 June 2000
- Accepted 15 August 2000
It was previously found that herpes simplex type 1 virus (HSV1) when present in the brain, is a risk factor for Alzheimer's disease in carriers of the type 4 allele of the gene for apolipoprotein E (apoE ε4), and apoE ε4 is a risk factor for herpes labialis. Whether a specific allele of the gene is involved in susceptibility to another disorder caused by HSV1—herpes simplex encephalitis (HSE)—has now been investigated. DNA was prepared from formalin-fixed, paraffin-embedded blocks of specimens from the brain or spleen of 14 United Kingdom patients with HSE, confirmed by necropsy, and from the CSF of seven United Kingdom clinical patients with HSV1 in their CSF detected by polymerase chain reaction (PCR). ApoE genotype of the DNA from blocks was determined by seminested PCR, and of the DNA from CSF by one step PCR, followed by restriction endonuclease digestion. The apoE allele frequencies were compared with values previously obtained for 238 normal people from the United Kingdom. The apoE ε2 allele frequency of the patients with HSE was 26%, significantly higher than the value of 7% for the normal subjects (OR=4.6, 95% confidence interval (95% CI) 2.0–10.8). The apoE ε3 and ε4 allele frequencies did not differ significantly between the two groups. Thus, it seems that apoE ε2 is a risk factor for HSE.