title: Role of type-specific herpes simplex virus-1 and 2 serology as a diagnostic modality in patients with clinically suspected genital herpes: A comparative study in Indian population from a tertiary care hospital.
abstract: BACKGROUND
  Type-specific serology (TSS) test for herpes simplex virus (HSV) have been used as a research tool in seroepidemiological studies for some years. However, TSS as a diagnostic modality for diagnosis of current episode of genital herpes is not well documented.
  
  
  OBJECTIVE
  To measure the seroprevalence of type-specific HSV Type 1 (HSV-1) and Type 2 (HSV-2) IgG antibodies in cases provisionally diagnosed as primary and recurrent genital herpes and to evaluate the role of TSS as a diagnostic modality for diagnosis of genital herpes versus polymerase chain reaction (PCR).
  
  
  METHODS
  A cross-sectional study was performed over a period of 10 months in which 44 adult patients with clinically suspected genital herpes were recruited. An in-house glycoprotein G gene base PCR was performed directly from the genital lesion specimen for simultaneous detection and typing of HSV. TSS was performed to detect IgG antibody against HSV-1 and 2 in all patients using commercially available kits, and the results were compared.
  
  
  RESULTS
  Seroprevalence of HSV-1 IgG was 43% among primary and 65% among recurrent genital herpes cases (P = 0.22). Whereas that of HSV-2 IgG was found to be 14% and 83% in respective patient group (P = 0.0001). When compared to PCR results HSV-1 IgG detection in both primary and recurrent genital herpes diagnosis had poor specificity, positive predictive value, and sensitivity. Whereas, HSV-2 serology had a sensitivity of 13.33% and 73.33% in primary and recurrent genital herpes and specificity of 83.33% and 85.71%, respectively.
  
  
  CONCLUSIONS
  HSV-2 IgG detection helps in strengthening the diagnosis of recurrent HSV-2 disease, whereas the absence of HSV-2 IgG antibody helps in excluding genital herpes as a likely cause of recurrent genital ulceration. However, detection of HSV-1 IgG antibody may not be useful for diagnosis in patients of genital ulcer disease.
authors: Department of Microbiology, Maulana Azad Medical College, New Delhi, India.
authors: Vrushali
authors: V
authors: Patwardhan
authors: Department of Microbiology, Maulana Azad Medical College, New Delhi, India.
authors: Preena
authors: P
authors: Bhalla
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006558:Herpes Genitalis / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology*; D018259:Herpesvirus 1, Human / Q000302:isolation & purification*; D018258:Herpesvirus 2, Human / Q000302:isolation & purification*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016036:Seroepidemiologic Studies; D012698:Serologic Tests; D012703:Serotyping; D062606:Tertiary Care Centers; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G