A PRAGMATIC APPROACH FOR ANTENATAL SCREENING OF GENITAL HERPES IN PREGNANT FEMALES AT RESOURCE CONSTRAINED CLINICAL SETTINGS: A NARRATIVE REVIEW

Abstract

It is estimated that around 67% of the world’s population under the age of 50 years is anticipated to acquire genital herpes simplex virus (HSV) infection; the reported incidence, however, fluctuates considerably among different regions. Pregnant women, due to suppressed immunity, are more prone to herpes virus infection and thus bear an increased risk for dissemination to the fetus. Data regarding the screening of pregnant females for HSV utilizing sensitive but affordable laboratory techniques is scarce in developing countries. The current narrative review briefly emphasizes the value of screening of pregnant females for infectious viral diseases such as Herpes simplex virus 1 & 2 despite the constraints in clinical and laboratory resources in developing countries. Online databases of relevant published articles up to December 2022 were searched using PubMed, Google Scholar and Web of Science. The data exhibits that with the advancement and introduction of new laboratory techniques worldwide, cytological methods using liquid-based cytology (LBC), cell blocks, immunohistochemistry (IHC), immunofluorescence (IF), and serum analysis through Enzyme-Linked Immunoassays (ELISA) may be the first line diagnostic modalities for herpes virus in developing countries. Although polymerase chain reaction (PCR) is the gold standard but IF is a rapid, cost-effective, and easy-to-perform technique even in the moderate-level laboratory settings of remote areas thus offering a sensitive and specific test for HSV detection to the general population. Early and effective diagnosis of cervicovaginal infections especially subclinical HSV infections in pregnant females may lead to reduced morbidity and mortality by integrated health service delivery involving advanced laboratory techniques and promotion of preventive educational strategies.