A Retrospective Study on Presence of Herpesviruses in Suspected Herpes Encephalitis Patients in Sri Lanka

Abstract

Abstract: Background: Encephalitis is a rare and serious brain infection that can be fatal. Viruses are common infectious agents causing encephalitis. Prompt detection of human herpes viruses in Cerebrospinal fluid (CSF) is crucial for early diagnosis and timely initiation of appropriate treatment, as this can significantly improve patient outcomes. Aim: This study aimed to determine the presence of herpes simplex virus type 1, 2 (HSV-1, 2) and varicella–zoster virus (VZV) in cerebrospinal fluid samples (CSF) of suspected herpes encephalitis (HE) patients and to analyze demographic and associated clinical features. Method: All CSF samples from HE suspected patients from different hospitals and/or facilities received at Medical Research Institute in Sri Lanka from January 2022 to January 2023 were included in this retrospective study. Real-time PCR was used to detect HSV1, 2 and VZV in the samples. Results: From 1801 suspected herpes encephalitis cases (mean age 25.67; range 2 days to 88 years; male: female; 1003: 798), 18 (0.99%; male: female; 13: 5) were positive for herpes viruses; HSV-1(9, 0.50%), HSV-2 (5, 0.28%), HSV1 & 2 (1, 0.06%), and VZV (3, 0.17%). HSV-1 positivity: infants 0.54% (1/184), children 0.65% (4/618), adults 0.63% (4/627). HSV-2: children 0.16% (1/618), adults 0.48% (3/627), older adults 0.57% (1/175). VZV: adults 0.31% (2/627), older adults 0.57% (1/175). Prominent symptoms: fever and headache.