Abstract
Estimate the prevalence of human herpesvirus type 1 HSV-1 DNA in placental samples, its incidence in umbilical cord blood of newborns and the associated risk factors. Placental biopsies and umbilical cord blood were analyzed, totaling 480 samples, from asymptomatic parturients and their newborns at a University Hospital. Nested polymerase chain reaction (PCR) and gene sequencing were used to identify the virus; odds ratio (OR) and relative risk (RR) were performed to compare risk factors associated with this condition. The prevalence of HSV-1 DNA in placental samples was 37.5%, and the incidence in cord blood was 27.5%. Hematogenous transplacental route was identified in 61.4% from HSV-1+ samples of umbilical cord blood paired with the placental tissue. No evidence of the virus was observed in the remaining 38.6% of placental tissues, suggesting an ascendant infection from the genital tract, without replication in the placental tissue, resulting in intra-amniotic infection and vertical transmission, seen by the virus in the cord blood. The lack of condom use increased the risk of finding HSV-1 in the placenta and umbilical cord blood. The occurrence of HSV-1 DNA in the placenta and in cord blood found suggests vertical transmission from asymptomatic pregnant women to the fetus.
Highlights
MethodsHuman herpesvirus type 1 (HSV-1) is a ubiquitous neurotropic virus in humans
Hematogenous transplacental route was identified in 61.4% from HSV-1þ samples of umbilical cord blood paired with the placental tissue
The prevalence of HSV-1 found in the placenta was 37.5% (n 1⁄4 60) and the incidence in cord blood was 27.5% (n 1⁄4 44)
Summary
MethodsHuman herpesvirus type 1 (HSV-1) is a ubiquitous neurotropic virus in humans. The main characteristics are the lifelong latent/persistent infection in the sensory ganglia innervating the primary infection site, and the production of vesicular lesions upon reactivation.[1,2] Typically associated with orofacial lesions, HSV-1 has emerged as a pathogen of genital infections, especially in the Americas among people between 15 and 49 years old, which is the reproductive age group.[2,3,4]Genital HSV-1 is the main cause of the first episode of genital herpes in women in high income countries, as its seroprevalence is declining during childhood as a cause of oral lesions.[5,6] adolescents and young adults have their first exposure to the virus with the initiation of sexual activity.[1,7] All over the world, $ 132 million women have incident or prevalent HSV infection during pregnancy.[8]. The main characteristics are the lifelong latent/persistent infection in the sensory ganglia innervating the primary infection site, and the production of vesicular lesions upon reactivation.[1,2] Typically associated with orofacial lesions, HSV-1 has emerged as a pathogen of genital infections, especially in the Americas among people between 15 and 49 years old, which is the reproductive age group.[2,3,4]. Another study investigated the prevalence of HSV-1 and HSV-2 by polymerase chain reaction (PCR) in cervical samples of 261 Brazilian women and found the occurrence of HSV-1 in 23% of the samples, while 5.4% had the HSV-2 DNA detected.[3]
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