Genital Herpes: A clinical and seroepidemiological study of patients attending a sexually transmitted diseases clinic in South India

Background  Genital herpes has been emerging as one of the leading cause of sexually transmitted infections. Serology has an important role in the diagnosis of genital herpes. Our objective was to know the hospital based prevalence, other epidemiological parameters, co-infections and serological utility in genital herpes. Methods This was a cross-sectional, descriptive study of patients attending sexually transmitted diseases clinic of our hospital. A total of 820 consecutive patients of both the sexes attending the clinic over a period of 18 months, were screened for the features of genital ulcer disease. Among 128 patients with genital ulcer disease, 76 clinically suspected with genital herpes were subjected to serology. Results The hospital based prevalence of genital herpes among sexually transmitted diseases patients and genital ulcer disease was 9.3% and 59.4% respectively. Males were predominantly affected. Maximum prevalence, 30 (39.5%) patients was seen in the age group of 30-39 years. Sixty (78.9%) were married, 58 (76.3%) belonged to lower class. Among women, majority of them were housewives. Among patients with genital herpes, 22 (28.9%) had primary disease, while 54 (71.1%) had recurrent disease. Common clinical features were only erosions in 24 (31.6%), erosions with crusting, 24 (31.6 percent). Herpes simplex virus (HSV) 1 and 2 coexistence was seen in 34 (44.7%), followed by HSV 2 alone 26 (34.2%) and HSV 1 in 10 (13.2%) of patients. Serological reactivity for HIV I and II in 24 (31.6%), syphilis in 10 (13.2%) and HbsAg in 4 (5.3%) were seen. Polymerase chain reaction for HSV was positive in 38 (50%), of patients. Conclusion The hospital based prevalence of genital herpes among STD patients was 9.3 percent. Lower socioeconomic status, illiteracy and number of sexual partners may contribute to the higher incidence of genital herpes. Serology can be used in adjunct to clinical examination and the diagnosis can be confirmed by specific polymerase chain reaction.