Correlation of Serology, Tissue Culture and PCR in Identification of Herpes Simplex Type-2 infection among HIV Patients 1190-1194
Shameem Banu A .S.
Professor & Head, Department of Microbiology,
Saveetha Medical College & Hospital, Saveetha University,
Thandalam, Kancheepuram District â€“ 602 105
Background: Herpes infection in Acquired Immunodeficiency Syndrome (AIDS) patients is more severe and in atypical location. Diagnosis becomes difficult as the clinical presentation tend to be atypical. There are numerous laboratory methods to identify Herpes Simplex Virus (HSV) infection and it also becomes essential as a early initiation of antiherpetic treatment has shown to decrease Human Immunodeficiency Virus (HIV) replication and acyclovir resistance. In this study we have correlated serology of HSV type 2 with tissue culture and Polymerase Chain reaction (PCR).
Materials and Methods: This study was performed in the Institute of Microbiology, Madras Medical College and the Department of Virology, King Institute of Preventive Medicine. The sample size was 60 cases all with genital lesions such as ulcers and vesicles were selected. Out of which 30 were known HIV positive and 30 were HIV negative attending out patient Sexually Transmitted Diseases Department, Government General Hospital (GH) Chennai. Thirty cases of blood donors were taken as control population from the Blood Bank, GH Chennai. Laboratory diagnostic procedures such as serological tests, virus culture, immunoflourescence and PCR were done keeping PCR as a gold standard test for diagnosing HSV infection.
Results: Out of 60 patients, 30 were HIV positive and remaining negative. Among HIV positive patients 56.6% had IgM antibody and 83.3% had IgG antibody, were as among HIV negative patients IgM were 36.6% and 70% had IgG. Control group serological parameters for IgM, IgG HSV-2 were 6.6% and 56.6% respectively. Virus isolation was positive for three samples and PCR for six samples. On comparing with gold standard test, sensitivity and specificity for serology is 100% and 59%, for tissue culture the sensitivity is 50% and specificity is 100%.
Conclusion: HSV 2 antibody detection by type specific serology kit can be used as an effective tool in screening infection both in typical and atypical presentations before initiating treatment, as antibody detection is much easier and feasible screening test when compared to PCR and tissue culture.