|Year : 2004 | Volume
| Issue : 4 | Page : 244-246
Seroprevalence of herpes simplex virus-1 and 2 antibodies in STD clinic patients
A Aggarwal , R Kaur
Department of Microbiology, Government Medical College, Amritsar, Punjab, India
|Date of Submission||26-Aug-2003|
|Date of Acceptance||25-Sep-2003|
Department of Microbiology, Government Medical College, Amritsar, Punjab, India
The present study was conducted on 250 serum samples of STD clinic patients and 50 serum samples of asymptomatic women to determine seroprevalence of herpes simplex-1 and 2 (HSV-1 and 2) IgM antibodies and HIV-1 and 2 antibodies. The samples were also screened for syphilis by VDRL test and confirmed by TPHA test. Seropositivity of HSV in STD clinic patients was 44/250 (17.6%) and 12/50 (24%) in asymptomatic women. In 11/44 (25%) seropositive persons for HSV, HIV 1 and 2 antibodies were present. In 10/44 (22.7%) HSV seropositive persons, coinfection with syphilis was also present, whereas in 7/44 (15.9%) HSV seropositive persons, both HIV and syphilis were present. In the control group, coinfection with other sexually transmitted infections (STIs) was not observed.
|How to cite this article:|
Aggarwal A, Kaur R. Seroprevalence of herpes simplex virus-1 and 2 antibodies in STD clinic patients. Indian J Med Microbiol 2004;22:244-6
|How to cite this URL:|
Aggarwal A, Kaur R. Seroprevalence of herpes simplex virus-1 and 2 antibodies in STD clinic patients. Indian J Med Microbiol [serial online] 2004 [cited 2020 May 31];22:244-6. Available from: http://www.ijmm.org/text.asp?2004/22/4/244/12816
Sexually transmitted infections (STIs) are markers of high risk sexual behaviour in an individual/spouse/sexual partner. Infections due to herpes simplex virus (HSV) are extremely common. While most infections are asymptomatic or mild, some can be transmitted to neonates and are associated with other STIs and cervical neoplasia. Immunoglobulin M (IgM) antibodies to HSV-2 are increased to four times the normal value 2-4 weeks after the infection and the enzyme linked immuno sorbent assy (ELISA) is a specific, sensitive and simple test which confirms the infection by HSV. HSV-2 may contribute more to human immunodeficiency virus (HIV) infection because of its higher frequency than other STIs. Thus, because of the recurrence of genital herpes, high prevalence of genital herpes in populations at risk for HIV infection and large number of herpes infected persons who continue their sexual activities despite being infectious, genital herpes is a risk factor for acquisition of HIV-1 infection. HSV-2 infection is also significantly associated with syphilis. Considering that herpes is a life long infection, not cured by antimicrobial treatment, HSV-2 antibodies are a much more reliable indicator of risky behaviour than Treponema pallidum i>antibodies. However, a large number of genital infections are also caused by HSV-1. The present study was thus undertaken for finding IgM antibodies against HSV-1 and HSV-2, antibodies to HIV-1 and 2 and screening for syphilis in STD patients.
| ~ Materials and Methods|| |
Two hundred fifty blood samples were collected from patients attending the STD clinic attached to Govt. Medical College, Amritsar. Fifty blood samples of asymptomatic women from community were also collected who served as control group. The sera were tested for HSV-1 and 2 IgM antibodies by ELISA (Bioplus Inc. 780, South San Francisco, USA). These were also screened for HIV-1 and 2 antibodies by ELISA (Biotest Anti-HIV Tetra ELISA by M/S Biotest AG Landsteiner, Germany). Immunocomb test was performed on reactive samples (Comb Aids-RS, Span Diagnostics Ltd., Surat, India). The samples were screened for syphilis by VDRL test- (antigen provided by Institute of serology, Calcutta) and TPHA test was done (TPHA-200, New Market Laboratories Ltd, Kentford, U.K). The sera which were also positive by TPHA test were taken as positive. Complete history of patient regarding age, sex, contact history, occupation and other risk factors was also collected after taking consent. The results were analyzed statistically.
| ~ Results|| |
Out of 250 STD patients, 136 (54.4%) were males while 114 (45.6%) were females. Forty-four of these (17.6%) were positive for HSV-1 and 2 IgM antibodies. Out of these, 25 (56.8%) were males and 19 (43.2%) were females. Eleven of 44 (25%) patients were positive for HIV-1 and 2 and 10/44 (22.7%) were reactive to VDRL antigen and TPHA positive. HSV seropositive persons had mixed clinical features [Table - 1] while most HIV reactive or VDRL reactive persons had genital ulcers with or without other features. Seven of 44 (15.9%) patients were reactive to both HIV-1 and 2 antibodies and VDRL antigen. In the asymptomatic group, 12/50 (24%) women were positive for HSV, while none was reactive to HIV antibodies or VDRL antigen. Highest HSV seroprevalence in STD patients was in the age group of 21-30 years (45.5%) and who were of young age at first sexual contact, i.e., 15-25 years (97.7%). Prevalence was also high in housewives (40.9%), patients with non-specific discharge (50%) and genital ulcers (34.1%). Prevalence in bad obstetric history (BOH) and mouth ulcer cases was 1/44 (2.27%) each. Prevalence was also high in illiterate patients (70.4%) and those with multiple partners (56.8%). Co-infection with HSV and HIV was found in 11/44 (25%) patients. Ten out of 44 (22.7%) persons were reactive to both HSV antibodies and VDRL antigen. The three STIs (HSV, HIV and syphilis) were present in 7/44 (15.9%) patients. In the control group, seropositivity was high in the age group of 21-30 years (50%) and in those who were of young age (15-25 years) at first contact (91.6%).
| ~ Discussion|| |
HSV seropositivity was highest in the young age group of 21-30 years because of their sexually active life., Adolescents are known to be at increased risk of acquiring STIs because of fewer protective antibodies and increased susceptibility of cervix. Seropositivity was more in housewives as most women have little awareness of sexual and reproductive life and symptoms are generally ignored. Also, transmission of HSV-2 is more efficient from men to women compared with women to men. Seropositivity was high in illiterate persons because of ignorance and in persons with multiple partners because of high risk behaviour. High seropositivity was also seen in persons with non-specific discharge and genital ulcers., Regarding prevalence in BOH cases, HSV is one of the TORCH organisms and infection in pregnancy accounts for half of the morbidity and mortality among neonates. It may also lead to abortion/prematurity/intrauterine growth retardation and disseminated infection of neonates., HSV predisposes to other STIs as it causes mucosal erosions and may increase the concentration of HIV and other STIs in semen and vaginal fluids. In the control group, a seropositivity of 12/50 (24%) for HSV-1 and 2 was seen. Women are more vulnerable to STIs as they have less say in the contraception methods, less opportunity for early diagnosis and treatment and are more prone to infections because of procedures like MTP, IUD insertions etc. Asymptomatic shedding can infect their neonates and they themselves are at more risk to develop cervical cancer, therefore, it is important to screen them.
In summary, this study shows that genital herpes infection is a risk factor for acquisition of HIV and other STIs and the study of seroprevalence of HSV in STD patients is important to plan STI control strategies which may help keeping the HIV status at a low level.
| ~ References|| |
|1.||Venkitaraman AR, Seigneurin JM, Lenoir GM, John TJ. Infections due to the human herpes-viruses in southern India: A seroepidemiological survey. Int J Epidemiol 1986;15(4):561-566. |
|2.||Hook EW, Cannon RO, Nahmias AJ, Lee FF, Campbell CH Jr., Glasser D, Quinn TC. Herpes simplex virus infection as a risk factor for human immunodeficiency virus infection in heterosexuals. J Infect Dis 1992;165:251-255. |
|3.||Bogaerts J, Ahmed J, Akhter N, Begum N, Rahman M, Nahar S, Ranst MV, Verhaegen J. Sexually transmitted infections among married women in Dhaka, Bangladesh: unexpected high prevalence of herpes simplex type 2 infection. Sex Transm Inf 2001;77:114-119. |
|4.||Agarwal N, Gupta S. Reproductive tract infection in adolescent females. Obs Gynae Today 2000;5(7):410-412. |
|5.||Malkin JE, Morand P, Malvy D, Ly TD, Chanzy B, Labareyre CD, Hasnaoui AE, Hercberg S. Seroprevalence of HSV-1 and HSV-2 infection in the general French population. Sex Transm Infect 2002;78:201-203. |
|6.||Mbizvo EM, Sia EM, Pedersen BS, Chirenje MZ, Munjome M, Hussain A. Association of herpes simplex virus type 2 with the human immunodeficiency virus among urban women in Zimbabwe. Int J STD AIDS 2002;13:343-348. |
|7.||Legori M. Prevalence of sexually transmitted infections and HBsAg among female sex workers of Thiruvananthapuram, Kerala, India. J Acad Clin Microbiol 2001;3(1):5-9. |
|8.||Mookherjee N, Gogate A. Incidence of HSV infection in bad obstetrics history (BOH) cases. Indian J Med Microbiol 1994;12(1):60-64. |
|9.||Turbadkar D, Mathur M, Rele M. Seroprevalence of TORCH infection in bad obstetric history. Indian J Med Microbiol 2003;21(2):108-110. |
|10.||Kumar A, Gupta N, Sharma JB. Genital Herpes-A Reappraisal. Obs Gynae Today 2000;5(7):426-428. |
|11.||Pandey SN, Joshi JV, Vaidya RA, Vaidya AB. Reproductive tract infection. A scourge for women's health. J Obst Gyn India 2001; 51(1):71-77. |
|12.||Shukla A, Das K, Mathur A, Mehra P. Herpes simplex virus type-2 in carcinoma cervix: A controlled serological study. J Obst and Gynae India 1984;34(2):315-318. |