Evaluation of the Correlation Between Herpes Simplex Virus-2 Infection and Adverse Birth Outcomes Among Rural Pregnant Women In Mysore District, India

Abstract

Project Title: Evaluation of the correlation between herpes simplex virus-2 infection and adverse birth outcomes among rural pregnant women in Mysore district, India.

Background: Herpes simplex virus type 2 (HSV-2) is one of the most common sexually transmitted infections worldwide and the main cause of genital ulcers. Although HSV-2 prevalence varies among countries and population, it is more prevalent in developing countries rather than developed countries. HSV-2 can be transmitted sexually, when ulcers or lesions are present, or when skin is broken. HSV-2 is a lifelong asymptomatic infection, however, antivirals can be used to suppress the virus shedding. People with HSV-2 infection are at increased risk for HIV acquisition and transmission, thus the increase in risk of perinatal transmission. Infants exposed to HSV-2 during vaginal delivery can have severe disabilities and malformations. Objective: The objective of this project is to evaluate the prevalence of HSV-2 among pregnant women during childbirth and the correlation HSV-2 has with adverse birth outcomes.

Materials and Methods: Blood samples were collected from pregnant women from Mysore subdistrict, India, in a previously completed project that Public Health Research Institute of India (PHRII) conducted in 2011-2014 called Saving Children Improving Lives (SCIL). All women were administered informed consent prior to the blood draw. Pregnancy outcomes were documented immediately after birth, 3 months and 6 months after delivery. From the SCIL study, 306 random serum samples were analyzed based on their adverse birth outcomes. HerpeSelect 2 ELISA IgG kit (Focus Diagnostics, USA) was used to test the serum samples for HSV-2 specific antibodies. An HSV-2 IgG/IgM Rapid Test kit was also used to retest the ELISA positive serum samples.

Results: Out of the 306 serum samples tested using ELISA there were 17 (5.5%) positive samples with nine (2.9%) high positive (> 3.5 Index Value) and eight (2.6%) low positive (1.10 – 3.5 Index Value), two equivocal and the remaining serum samples were negative. The HSV-2 IgG/IgM Rapid test detected nine samples positive for HSV-2 IgG antibodies; eight from the high positive and one from the low positive serum samples.

Conclusion: Of the 306 serum samples tested from women during childbirth, 5.6% were positive for HSV-2. Data analysis to evaluate the correlation between positive serum samples and the birth outcomes is ongoing.