{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T13:52:02Z","timestamp":1792417922006,"version":"4.4.0"},"reference-count":40,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Patients in intensive care units (ICU) under mechanical ventilation, particularly those with SARS\u2010CoV\u20102 infection, are highly susceptible to Herpes simplex virus (HSV) reactivation. Given the lack of data on the SARS\u2010CoV\u20102 Omicron and Delta variants, this study aimed to assess the prevalence of pulmonary HSV reactivation in mechanically ventilated patients with SARS\u2010CoV\u20102 pneumonia. The impact of HSV replication on SARS\u2010CoV\u20102 replication, and conversely, was investigated, along with the susceptibility of HSV strains to antiviral therapies. This retrospective study included 381 mechanically ventilated ICU patients in Lyon. Overall, 103 patients (27.0%) experienced HSV reactivation, with a trend toward a higher prevalence among SARS\u2010CoV\u20102\u2010positive patients (32.8%) compared to SARS\u2010CoV\u20102\u2010negative (24.1%;\n                    <jats:italic>p<\/jats:italic>\n                    value\u2009=\u20090.058). HSV reactivation was significantly higher with the Delta variant (46.2%) compared to Omicron (27.1%;\n                    <jats:italic>p<\/jats:italic>\n                    value\u2009=\u20090.045); the Delta variant was associated with a 2.38\u2010fold increased risk of HSV reactivation. HSV\u2010positive patients exhibited a 1\u2010log lower SARS\u2010CoV\u20102 viral load compared to HSV\u2010negative patients, a finding indicative of the natural course of SARS\u2010CoV\u20102 infection followed by HSV reactivation, rather than viral interference. Unexpectedly, acyclovir resistance mutations appeared in the\n                    <jats:italic>UL23<\/jats:italic>\n                    gene in at least 13.6% of HSV\u20101 strains in patients with an HSV load above 10\n                    <jats:sup>5<\/jats:sup>\n                    copies\/mL. Complementary phenotypic and genotypic approaches allowed to identify three novel substitutions in\n                    <jats:italic>UL30<\/jats:italic>\n                    : Q217R, D741A, and E756K, classified as polymorphisms. Further optimization is needed in the management of mechanically ventilated ICU patients with pulmonary HSV reactivation, especially regarding antiviral resistance testing.\n                  <\/jats:p>","DOI":"10.1002\/jmv.71170","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:45:29Z","timestamp":1791380729000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pulmonary Herpes Simplex Virus Reactivation in Invasively Mechanically Ventilated Patients With COVID\u201019 in Intensive Care Unit"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5289-9649","authenticated-orcid":false,"given":"Bastien","family":"Zarlenga","sequence":"first","affiliation":[{"name":"Hospices Civils de Lyon, Laboratoire de Virologie, Institut des Agents Infectieux, Groupement Hospitalier Nord Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florent","family":"Wallet","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, M\u00e9decine Intensive et R\u00e9animation, Centre Hospitalier Universitaire Lyon Sud Universit\u00e9 Claude Bernard Lyon 1 Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Gaymard","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Laboratoire de Virologie, Institut des Agents Infectieux, Groupement Hospitalier Nord Lyon France"},{"name":"Virpath, Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, ENS Lyon Universit\u00e9 Claude Bernard Lyon 1 Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne\u2010Claire","family":"Lukaszewicz","sequence":"additional","affiliation":[{"name":"Anesthesia and Critical Care Medicine Department, Hopital Edouard Herriot, Hospices Civils de Lyon Universit\u00e9 de Lyon, EA 7426 \u00ab Pathophysiology of Injury\u2010Induced Immunosuppression \u00bb, (Universit\u00e9 Claude Bernard Lyon 1\u2014Hospices Civils de Lyon\u2014bioM\u00e9rieux) Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Destras","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Laboratoire de Virologie, Institut des Agents Infectieux, Groupement Hospitalier Nord Lyon France"},{"name":"Virpath, Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, ENS Lyon Universit\u00e9 Claude Bernard Lyon 1 Lyon France"},{"name":"GenEPII Sequencing Platform, Institut des Agents Infectieux, Hospices Civils de Lyon Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Ginevra","sequence":"additional","affiliation":[{"name":"GenEPII Sequencing Platform, Institut des Agents Infectieux, Hospices Civils de Lyon Lyon 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France"},{"name":"Universit\u00e9 Lyon 1 Villeurbanne France"},{"name":"CNRS, UMR 5558, Laboratoire de Biom\u00e9trie et Biologie \u00c9volutive, \u00c9quipe Biostatistique\u2010Sant\u00e9 Villeurbanne France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salom\u00e9","family":"Avenas","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, P\u00f4le Sant\u00e9 Publique, Service de Biostatistique et Bioinformatique Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Trecourt","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Claude Bernard Lyon 1 Service de Pathologie Multi\u2010Site, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genevi\u00e8ve","family":"Billaud","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Laboratoire de Virologie, Institut des Agents Infectieux, Groupement 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