Herpes Simplex Virus Gene Variants among Asymptomatic Women in Ghana: a pilot study

Abstract

Herpes simplex virus infections account for a large burden of disease worldwide. HSV-1 is traditionally considered to cause orofacial infections, whereas HSV-2 is known for genital infections. A number of studies have suggested an increase of genital herpes infections caused by HSV-1. As reporting of diseases caused by herpes simplex virus is not mandatory in Ghana, reliable statistics on the epidemiology of infections are not available. We took advantage of the Cervicare program in Ghana to screen for the presence of HSV variants 1 and 2 among a convenient subset of asymptomatic women presenting for cervical screening in Accra, Ghana (n = 94). Genetic markers for both HSV 1 and 2 were detected in cervical swabs. There was a preponderance of HSV-1 (12.8%) genital infections in our study sample: compared to HSV-2 (4.8%). HSV-1 and 2 co-infection was detected in 4.3% of study population. Among positive cases for HSV-1 DNA, 92% had confirmed seropositive HSV-1 status and 8% were borderline result. All positive HSV-2 DNA were confirmed seropositive HSV-2 status. We have successfully demonstrated the presence of herpes simplex virus type 1 and type 2 gene variants in genital swabs. Owing to the lack of epidemiological data on genital HSV-1 infection in Ghana, the role of sexual transmission for HSV-1 is unclear: the findings of our pilot study have important public health implications. A bigger surveillance study is recommended in Ghana to identify the etiology of genital herpes and estimate the true burden of asymptomatic herpes infection in the population.