Abstract
SummaryBackgroundRapid identification of human herpesviruses from lesion swabs is necessary for timely initiation of antiviral treatment, especially with infections involving neonates and immunocompromised individuals. The aim of the study was to investigate the results of an in-house polymerase chain reaction (PCR) test for herpesviruses in patients with symptoms suggestive for a herpesvirus infection.Patients and methodsIn this single center retrospective study the results of 3677 lesion swab specimens tested for human herpes simplex virus 1 and 2 (HSV 1 and 2) and varicella zoster virus (VZV) were analyzed in the context of data sheets giving details of the suspected diagnosis, medical history as well as the demographic data of the patients. The PCR procedures for cytomegalovirus (CMV), Epstein-Barr virus (EBV) and human herpes virus 8 (HHV-8) were applied on special occasions.ResultsOf the samples 3369 (91.6%) were swabs and a minority were tissue or blood samples. Of the 3015 samples tested for HSV‑1, HSV‑2 and VZV concomitantly, 52.3% were positive for at least one of these viruses. Clinically distinct conditions, such as herpes zoster and varicella had a high rate of positive PCR results, ranging from 81% to 88%, respectively. Among HSV‑2 positive samples, 23.7% derived from human immunodeficiency virus (HIV) positive patients, in contrast to the 10.8% originating from immunocompetent patients, the difference being statistically significant (p < 0.002). The HSV‑2 was detected more often in women than in men.ConclusionDistinct clinical diagnoses have a high correlation rate with positive PCR results. A significantly higher number of HSV‑2 positive results were found in HIV positive patients and in women.
Highlights
Human herpesvirus (HHV) infections are common worldwide
A significantly higher number of HSV-2 positive results were found in human immunodeficiency virus (HIV) positive patients and in women
Due to similarities in the clinical presentations of infections caused by these three herpesviruses, a clinical diagnosis needs to be confirmed by laboratory testing and direct proof of the pathogen to prevent misdiagnosis and a delay in the initiation of appropriate antiviral treatment
Summary
Human herpesvirus (HHV) infections are common worldwide. Clinically, herpes simplex virus 1 and 2 (HSV-1 and HSV-2, respectively) and varicella zoster virus (VZV) result in a range of diseases involving the skin and mucous membranes, occasionally leading to severe complications, such as herpetic neuralgia and herpes encephalitis. Due to similarities in the clinical presentations of infections caused by these three herpesviruses, a clinical diagnosis needs to be confirmed by laboratory testing and direct proof of the pathogen to prevent misdiagnosis and a delay in the initiation of appropriate antiviral treatment. Early diagnosis with a highly sensitive method is mandatory [1]. Traditional laboratory methods for the diagnosis of cutaneous and mucocutaneous HSV-1, HSV-2, and VZV infections include the Tzanck smear, direct fluorescent assay (DFA), and cell culture. Viral culture has been considered the gold standard test, several reports have been published on the much higher sensitivity of polymerase chain reaction (PCR) assays for detecting HSV and VZV
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