Herpes simplex virus infections are prevalent worldwide. They are caused by Herpes simplex virus Type-1 (HSV-1) and type-2 (HSV-2). HSV-1 causes orolabial disease. Genital herpes may be caused by either HSV-2 or HSV-1, large majority of cases being caused by HSV-2. HSV-1 is acquired during early childhood by most of the individuals. The acquisition of HSV-2 starts around puberty or thereafter.
The ability of the virus to successfully avoid clearance by the immune system by entering a non-replicating state known as latency leads to life long persistence of infection with unpredictable reactivation and transmission. Detecting antibodies plays an important role in identifying those infected. Type specific tests have been developed that are based on the protein Glycoprotein G from HSV-2 (gG2) or Glycoprotein G from HSV-1 (gG1). As very limited sequence homology exists between gG1 and gG2, assays based on detecting these type specific epitopes using ELISA can reliably differentiate between antibodies to HSV-1 and HSV-2.
1. To study the Seroprevalence of Herpes simplex virus infection in patients attending the STI clinic.
2. To study the risk factors and other socioepidemiological factors associated with HSV-2 seropositivity.
3. To study the seroprevalence of HSV infection in HIV positive individuals.
4. To study the proportion of subclinical seropositives for HSV infection.
Material and methods: The study was carried out from July 2017 to June 2019. All patients reporting to DVL OPD at GITAM institute of Medical sciences & Research, Visakhapatnam, Andhra Pradesh were examined and evaluated. 82 consecutive patients of both sexes with STI complaints, in the age group of 15-70 years were studied. Patients with genital herpes as well as patients with other STI complaints including both HIV positive and HIV negative patients were included in the study.
With prior permission from ethical committee and consent from patients, blood samples were collected and tested for HSV-1 IgG and IgM antibodies and HSV-2 IgG and IgM antibodies.
Results: Out of 82 patients 42 (51%) were females and 40 (49%) were males; 41 (50%) were HIV positive and the other 41(50%) were HIV negative.
Out of 82 patients, 39(47.6%) had genital herpes and 43 (52.5%) had other STDs which include genital candidiasis (18.3%), non specific urethritis (13.4%), Condyloma acuminate (14.6%) and genital molluscum contagiosum (6.1%).
Out of 82 patients, 2(2.4%) were seropositive for HSV-1 IgM and 68 (82.9%) were seropositive for HSV-1 IgG.
Out of 82 patients, 4(5%) were seropositive for HSV-2 IgM and 40(48.8%) are seropositive for HSV-2 IgG.
Out of 39 patients with genital herpes 21(53.8%) were seropositive for HSV-2 and out of 43 patients with other STDs without genital herpes 19 (44.2%) were seropositive for HSV-2, indicating that the proportion of subclinical seropositivity was 44.2% in our study
Conclusion: From our study we conclude that Herpes simplex virus infection is common in STI clinic attendees in our hospital. Prevalence of HSV-1 and HSV-2 serum antibodies provide an epidemiological measure of population burden of these infections. The high seroprevalence of HSV-2 in HIV patients potentiates the need for regular HSV-2 screening in HIV positive individuals and proper counselling and treatment of HSV-2 seropositives during outbreaks will efficiently lower the frequency of recurrences and decrease the transmission of both HSV and HIV infections.