Cervical herpes simplex virus in Benha University Hospital clinic: cytologic, virologic and colposcopic study

ABSTRACT

Our objective was to determine the isolation rate of cervical HSV in relation to different clinical conditions and colposcopic findings, among the patients attending the outpatient clinic of Benha University Hospital and to find out the sensitivity and specificity of Papanicolaou [Pap] smear and direct fluorescence antibody stain [DFA] in relation to tissue culture. Our study comprised 250 patients. For each patient a Pap. smear was obtained and two endocervical scrapings were collected. The first one was used for staining with DFA. The second one was used for isolation of HSV-2 on monolayer of Buffalo Green Monkey kidney [BGM] cell culture. Colposcopy was done in all patients. Punch biopsy was taken from cases suggestive of squamous intraepithelial lesion. Out of the 250 patients, 36 [14.4%,] were positive for HSV by culture on BGM cells, 29 [11.6%] by DFA staining and 16 [6.4%] by Pap. smear. DFA has higher sensitivity [58.3% versus 33.3%,] and negative predictive value [93.2% versus 89.7%] than Pap smear. The virus isolation rate was not sign higher in the multigravida, multipara, patients with a history of 2 or more abortions, pregnant females, women using pills or intrauterine contraceptive device [IUCD], or patients with atypical transformation zone. The isolation rate of cervical HSV is 14.4% in the patients attending the outpatient clinic of Benha University Hospital. Pap. Smear is not useful in detection of HSV. The virus isolation rate was significantly higher in the age group [20-30 years], patients with a history of herpetic like lesions on the genitalia, patients with cervical ectopy and patients with infected typical transformation zone