Occurrence of genital ulcer due to herpes simplex virus type-1 (HSV-1) in attendees of a regional centre for sexually transmitted infections, central India: how disturbing is it?

Thenmozhi P.; Jayesh I. Mukhi; Manisha Sharma; Kalindi S. Deogade; Sonali S. Gosavi; Vandana A. Agarwal

doi:10.18203/2320-6012.ijrms20233375

Authors

Thenmozhi P. Department of Microbiology, GMCH, Nagpur, Maharashtra, India
Jayesh I. Mukhi Department of Skin and VD, GMCH, Nagpur, Maharashtra, India
Manisha Sharma Department of Microbiology, GMCH, Nagpur, Maharashtra, India
Kalindi S. Deogade Department of Microbiology, GMCH, Nagpur, Maharashtra, India
Sonali S. Gosavi Department of Microbiology, GMCH, Nagpur, Maharashtra, India
Vandana A. Agarwal Department of Microbiology, GMCH, Nagpur, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20233375

Keywords:

Genital ulcer, HSV-1, HSV-2, RT-PCR

Abstract

Background: Genital herpes is caused predominantly by Herpes simplex virus type 2 (HSV-2) and less commonly by HSV-1. Genital HSV-1 infection results from oral sex, with fewer recurrences, mild symptoms, less asymptomatic shedding and poor genital transmission. The present study was undertaken to identify frequency of occurrence of HSV-1 and HSV-2 in genital herpes by microscopy, serology and Real Time Polymerase Chain Reaction (RT-PCR).

Methods: Genital ulcer swabs and serum were collected at regional STI centre, Govt Medical College and Hospital, Nagpur. A total of 53 patients of Genital Ulcer Disease from December 2020 -22 were examined for etiology by microscopy, serum IgM and IgG against HSV-1 and 2 by ELISA and HSV-1 and 2 DNA by RT- PCR.

Results: Out of 53 genital swabs processed, 6 (11.3%) and 28 (52.8%) samples were positive for HSV-1 and 2 DNA respectively. Of the 6 HSV-1 DNA positive samples, seropositivity for HSV-1 IgM was in 2 (33.3%) samples and for HSV-1 IgG in 4 (66.7%) samples. Of the 28 HSV-2 DNA samples, HSV-2 IgM was positive in 4 (14.3%) samples and HSV-2 IgG was positive in 7 (25%) samples, multi nucleated giant cells were seen in 2 (7.14%) samples. The remaining 15 (53.6%) HSV-2 DNA positive samples were seronegative.

Conclusions: HSV-1 was detected in 6 (11.3%) samples. Though these genital ulcers may be mild, it is important to counsel the patients for abstinence or safe sex practices to prevent their partners from acquiring painful non-genital ulcers due to HSV-1.

Metrics

Metrics Loading ...

References

Horowitz R, Aierstuck S, Williams EA, Melby B. Herpes simplex virus infection in a university health population: clinical manifestations, epidemiology, and implications. J Am Coll Health. 2010;59(2):69-74.

Gupta R, Warren T, Wald A. Genital herpes. Lancet. 2007;370(9605):2127-37.

Ramchandani M, Kong M, Tronstein B, Selke S, Mikhaylova A, Huang M-L, et al. Herpes simplex virus type 1 in tears, and nasal and oral mucosa of healthy adults. Sex Transm Dis. 2016;43(12):756-60.

Edward S, Carane C. Oral Sex and the transmission of viral STIs. Sex Transm Infect Dis. 1998;74(1):6-10.

Benedetti J, Corey L, Ashley R. Recurrence rates in genital herpes after symptomatic first-episode infection. Ann Intern Med. 1994;121(11):847-54.

Brugha R, Keersmaekers K, Renton A, Meheus A. Genital herpes infection: a review. Int J Epidemiol. 1997;26(4):698-709.

Bernstein DI, Bellamy AR, Hook EW, Levin MJ, Wald A, Ewell MG, et al. Epidemiology, clinical presentation, and antibody response to primary infection with Herpes simplex virus type 1 and type 2 in young women. Clin Infect Dis. 2013;56(3):344-51.

Corey L, Adams HG, Brown ZA, Holmes KK. Genital herpes simplex virus infections: clinical manifestations, course, and complications. Ann Intern Med. 1983;98(6):958-72.

Lowhagen GB, Tunback P, Andersson K, Bergstrom T, Johan Nisson G. First episodes of genital herpes in Swedish STD population: a study of epidemiology and transmission by the use of Herpes simplex virus (HSV) typing and specific serology. Sex Trans Infect. 2000;76(3):179-82.

Arvin AM, Prober CG. Herpes simplex viruses. In: Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH, eds. Manual of clinical Microbiology, 7th ed. Washington: ASM Press;1999:878-87.

Crane LR, Gutterman PA, Chapel T, Lerner AM. Incubation of swab materials with Herpes simplex virus. J Infect Dis. 1980;141:531.

Lillie RD. A Giemsa stain of quite constant composition and performance, Made in the laboratory from Eosin and Methylene Blue. Public Health reports. 1896-1970;58(11):449-52.

James C, Harfouche M, Welton NJ, Turner KM, Abu-Raddad LJ, Gottlieb SL et al. Herpes simplex virus: Global infection prevalence and incidence estimates, 2016. Bull World Health Organ. 2020;98(5):315-29.

Durukan D, Fairley CK, Bradshaw CS, Read TRH, Druce J, Catton M, et al. Increasing proportion of Herpes simplex virus type-1 among women and men diagnosed with first episode anogenital herpes: A retrospective observational study over 14 years in Melbourne, Australia. Sex Transm Infect. 2019;95(4):307-13.

Stanberry LR, Rosenthal SL, Mills L, Succop PA, Biro FM, Morrow RA, et al. Longitudinal risk of Herpes simplex virus (HSV) type 1, HSV type 2, and cytomegalo virus infections among young adolescent girls. Clin Infect Dis. 2004;39(10):1433-38.

Roberts CM, Pfister JR, Spear SJ. Increasing proportion of Herpes simplex virus type 1 as a cause of genital herpes infection in college students. Sex Transm Dis. 2003;30(10):797-800.

Jain VK, Dayal S, Aggarwal K, Jain S. Changing trends of sexually transmitted diseases at Rhotak. Ind J Sex Tranm Dis. 2008;29(1):23-5.

Cowan FM, Copas A, Johnson AM, Ashley R, Corey L, Mindel A. Herpes simplex virus type 1 infection: a sexually transmitted infection of adolescence? Sex Transmit Infect. 2002;78(5):346-48.

Al Mukdad S, Harfouche M, Farooqui us, Aldos L, Abu Raddad LJ. Epidemiology of herpes simplex virus type-1 and genital herpes in Australia and New Zealand: systemic review, meta- analyses and meta- regressions. Epidemiol Infect. 2023;151:e33.

Dabestani N, Katz DA, Dombrowski J, Magaret A, Wald A & Jhonston C. Time trends in first-episode genital Herpes simplex virus infections in an urban sexually transmitted disease clinic. Sex Transm Dis. 2019;46(12):795-800.

Yousuf W, Ibrahim H, Harfouche M, Abu Hijleh F, Abu Raddad L. Herpes simplex virus type 1 in Europe: systematic review, meta-analyses and meta-regressions. BMJ Global Heal. 2020;5(7):e002388.

Sukik L, Alyafel M, Harfouche M, Abu Raddad LJ. Herpes simplex virus type 1 epidemiology in Latin America and the Caribbean: systematic review and meta-analytics. PLoS. 2019;14(4):e0215487.

Khadr L, Harfouche M, Omori R, Schwarzer G, Chemaitelly H, Abu Raddad LJ. The epidemiology of herpes simplex virus type 1 in Asia: systematic review, meta-analyses, and meta-regressions. Clin Infect Dis. 2019;68(5):757-72.

Roberts CM, Pfister JR, Spear SJ. Increasing proportion of herpes simplex virus type 1 as a cause of genital herpes infection in college students. Sex Transm Dis. 2003;30(10):797-800.

Mathew R, Najeem B, Sobhakumary K, Sunny B,Pinheiro C, Anukumar B. Herpes simplex virus 1 and 2 in Herpes genitalis: A Polymerase chain Reaction based study from Kerela. Ind J Dermatol. 2018;63(6):475-78.

Murlidhar S, Talwar R, Kumar DA, Kumar J, Bala M, Khan N, Ramesh V. Genital ulcer diseases: How to worrisome Is It today? A status report from new Delhi, India. Ind J Sex Tranms Dis. 2013;8:203636.

Brijwal M, Rawre J, Dhawan B, Khanna N, Choudhary A, Dar L. Herpes simplex virus type 1 genital ulcer disease at a tertiary care hospital in North India. Clin Infect Dis. 2019;68(10):1783-4.