Evaluation of Immunological and Molecular Methods for Rapid Diagnosis of Herpes Simplex Type-1 Encephalitis

Abstract

Introduction: Herpes Simplex Encephalitis (HSE) is an acute or subacute illness that causes both general and focal signs of cerebral dysfunction. There are no pathognomonic clinical findings associated with HSE and the exact incidence of the disease is difficult to estimate since only severe cases report to hospital. Rapid diagnosis of Herpes simplex virus related infections of CNS is required to initiate antiviral therapy and thereby, reducing the morbidity and mortality associated with the disease. Aim: To evaluate molecular and immunological methods for rapid diagnosis of HSE. Materials and Methods: Study was conducted over a period of two years in Department of Microbiology in collaboration with Department of Neurology, JIPMER. Cerebrospinal Fluid (CSF) samples were collected from all clinically suspected cases of viral encephalitis and tested by two methods- Nested Polymerase Chain Reaction (PCR) for detection of glycoprotein D gene for HSV and Dot-ELISA (Enzyme Linked Immuno-Sorbent Assay) for HSV antigen detection. Results: A total of 45 CSF samples were collected, out of which 4 samples were positive by Nested multiplex PCR. None of the samples were positive by Dot-ELISA. Conclusion: Rapid diagnosis of HSE by molecular methods is helpful for early diagnosis and timely initiation of acyclovir therapy leading to a better clinical outcome. Nested PCR of the CSF is a useful method for diagnosis of HSE while antigen detection has little or no practical value.

Keywords

• cerebrospinal fluid (csf)
• dot-elisa
• herpes simplex virus
• nested multiplex pcr