title: Can duodenal ulcer perforation be linked to herpes simplex virus infection?
abstract: BACKGROUND
  Both Herpes simplex infection and duodenal ulcer recur frequently, tend to remain localized, and show remissions and exacerbations. Published data on a link between the two are contradictory, and there are no data on the association of Herpes simplex infection with perforated duodenal ulcer.
  
  
  METHODS
  187 patients in four groups were studied: group I--controls (n = 35), group II--non-ulcer dyspepsia (n = 35), group III--chronic non-perforated duodenal ulcer (n = 35), and group IV--perforated duodenal ulcer (n = 82). Titers of IgG antibodies against HSV-1 and HSV-2 were determined using enzyme immunoassays.
  
  
  RESULTS
  The seropositivity rate for both HSV-1 (80%) and HSV-2 (77%) was high in the control population. Among patients with perforated duodenal ulcer, antibodies against HSV-1 (94%) but not those against HSV-2 (83%), were found more frequently than in groups I and III. HSV-1 seropositivity was significantly higher in patients with a short duration of preperforation symptoms. Absolute titers for both anti-HSV-1 and anti-HSV-2 were higher in patients with perforated duodenal ulcer than in controls and those with chronic non-perforated duodenal ulcer.
  
  
  CONCLUSIONS
  Herpes simplexvirus, especially HSV-1, may have a role in the causation of perforated duodenal ulcers.
authors.affiliation: Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605 006.
authors.forename: V Ranjit
authors.initials: VR
authors.lastname: Hari
authors.forename: N
authors.initials: N
authors.lastname: Ananthakrishnan
authors.forename: V
authors.initials: V
authors.lastname: Kate
authors.forename: S
authors.initials: S
authors.lastname: Badrinath
mesh_terms: D004381:Duodenal Ulcer / Q000821:virology*; D005260:Female; D006561:Herpes Simplex / Q000150:complications*; D006801:Humans; D007416:Intestinal Perforation / Q000821:virology*; D008297:Male