A Study on Seroprevalence of HSV-1 In Clinically Suspected Cases

Background: Herpes Simplex Virus (HSV) type 1 infects 60%–80% of people throughout the world. The prevalence of HSV-2 infection in adults varies markedly from country to country. A high percentage of genital infections are being caused by HSV-1. HSV-1 is misdiagnosed and overdiagnosed as aphthous ulcers and erythema multiforme due to similar manifestations. Patients of acantholytic disorders are also prone to co- infections by HSV.Objectives: (1) To correlate the seroprevalence with the age and gender of patients. (2) To detect the antibodies against HSV-1 and HSV-2 in clinically suspected cases using IgM ELISA. (3) To evaluate the significance of IgM ELISA as a diagnostic tool in conjunction with provisional clinical diagnosis.Methods: Cross sectional study conducted from January to December 2020. 2-3 ml blood was taken from patients and serum samples were tested for the presence of both HSV-1 and HSV-2 IgM antibodies by ELISA.Results: 82 patients were included in our study. 18.2% showed seropositivity for HSV-1 IgM and 8.5% for HSV-2 IgM, while co-infection was seen in 2.4% patients. 44% patients were in the age group of 21-40 years (p value<0.05) which also accounted for maximum number of positive cases. Higher seropositivity for both HSV-1 (22.5%) and HSV-2 (12.2%) was seen among the patients hailing from urban areas belonging to lower socioeconomic strata. 36.5% were provisionally diagnosed as herpes labialis. 30% of these were positive for HSV-1 IgM antibodies. 23.2% were diagnosed and treated as pemphigus vulgaris. 15.8% of these cases and 14.3% of aphthous ulcers had co-infection with HSV-1.Conclusion: Serological testing for both types of Herpes viruses is recommended in all suspected cases. Differential diagnoses should be considered in seronegative patients. Laboratory confirmation can avoid misdiagnosis and erroneous treatment modalities