Seroprevalence of VZV and HSV‑2 Antibodies among Women of Childbearing Age Referring to Health Centres of Mashhad, Iran: The Need for Consideration of VZV Vaccination Program

Masoud Youssefi; Farnaz Zahedi Avval; Hoda Ghasabzadeh; Majid Khadem‑Rezaiyan

Seroprevalence of VZV and HSV‑2 Antibodies among Women of Childbearing Age Referring to Health Centres of Mashhad, Iran: The Need for Consideration of VZV Vaccination Program

Masoud Youssefi, Farnaz Zahedi Avval, Hoda Ghasabzadeh, Majid Khadem‑Rezaiyan

Abstract

Background: Infections with herpes simplex virus type 2 (HSV‑2) and varicella‑zoster virus (VZV) are associated with serious maternal and neonatal health consequences. The literature review reveals a research gap regarding the seroprevalence of HSV‑2 and VZV among women of reproductive age in Mashhad, Northeast of Iran. The present study aims to evaluate the seroprevalence of these viruses among a group of women in Mashhad, Iran. Methods: Sera were collected by health center personnel using a cluster sampling method from healthy women with specific age characteristics residing in three distinct socioeconomic regions of the city. The participants, aged 20–35, were divided into three groups (20–25, 26–30, and 31–35 years). The levels of VZV and HSV‑2 IgG antibodies were evaluated using commercial ELISA kits. Subsequently, the results were analyzed using SPSS software. Results: A total of 93 women were included in the study. Anti‑HSV‑2 IgG antibody was detected in 3 out of 93 participants (7.5%), while anti‑VZV IgG antibody was found positive in 80 out of 93 individuals (83.3%). The HSV‑2 positive cases were concurrently positive for the VZV antibody. There was no significant difference in the positivity of anti‑HSV‑2 and anti‑VZV antibody positivity within age groups or socioeconomic status (P > 0.05). Conclusions: The high seroprevalence of VZV among nonvaccinated participants indicates a widespread presence of the virus and underscores its potentially serious impact on community health. Therefore, it is recommended that a VZV vaccination program be considered by the health system. Furthermore, the reactivation of latent HSV‑2, whether symptomatic or asymptomatic, during pregnancy should not be disregarded as a life‑threatening threat.

International Journal of Preventive Medicine 14():123, November 2023. | DOI: 10.4103/ijpvm.ijpvm_239_22

Corresponding Author: Dr. Majid Khadem‑Rezaiyan

E‑mail: Khademrm@mums.ac.ir

You can also search for this author in: PubMed Google Scholar

Keywords

Herpes simplex type 2; Iran; Mashhad; varicella‑Zoster virus

Full Text:

PDF

References

Barah F. Prevalence of herpes simplex types 1 and 2, varicella

zoster virus, cytomegalovirus, immunoglobulin G antibodies

among female university students in Syria. Saudi Med J

;33:990‑4.

Mayaux MJ, Dussaix E, Isopet J, Rekacewicz C, Mandelbrot L,

Ciraru‑Vigneron N, et al. Maternal virus load during pregnancy

and mother‑to‑child transmission of human immunodeficiency

virus type 1: The French perinatal cohort studies. serogest cohort

group. J Infect Dis 1997;175:172‑5.

James SH, Sheffield JS, Kimberlin DW. Mother‑to‑child

transmission of herpes simplex virus. J Pediatric Infect Dis Soc

;3(Suppl 1):S19‑23.

Straface G, Selmin A, Zanardo V, De Santis M, Ercoli A,

Scambia G. Herpes simplex virus infection in pregnancy. Infect

Dis Obstet Gynecol 2012;2012:385697.

Fa F, Laup L, Mandelbrot L, Sibiude J, Picone O. Fetal and

neonatal abnormalities due to congenital herpes simplex virus

infection: A literature review. Prenat Diagn 2020;40:408‑14.

Westhoff GL, Little SE, Caughey AB. Herpes simplex virus

and pregnancy: A review of the management of antenatal

and peripartum herpes infections. Obstet Gynecol Surv

;66:629‑38.

Caviness AC, Demmler GJ, Selwyn BJ. Clinical and

laboratory features of neonatal herpes simplex virus infection:

A case‑control study. Pediatr Infect Dis J 2008;27:425‑30.

Tronstein E, Johnston C, Huang ML, Selke S, Magaret A,

Warren T, et al. Genital shedding of herpes simplex virus among

symptomatic and asymptomatic persons with HSV‑2 infection.

JAMA 2011;305:1441‑9.

US Preventive Services Task Force, Bibbins‑Domingo K,

Grossman DC, Curry SJ, Davidson KW, Epling JW Jr, et al.

Serologic screening for genital herpes infection: Us preventive

services task force recommendation statement. JAMA

;316:2525‑30.

Turriziani O, Falasca F, Maida P, Gaeta A, De Vito C, Mancini P,

et al. Early collection of saliva specimens from bell’s palsy

patients: Quantitative analysis of HHV‑6, HSV‑1, and VZV.

J Med Virol 2014;86:1752‑8.

Amlie‑Lefond C, Gilden D. Varicella zoster virus: A common

cause of stroke in children and adults. J Stroke Cerebrovasc Dis

;25:1561‑9.

Nagel MA, Gilden D. The relationship between herpes zoster

and stroke. Curr Neurol Neurosci Rep 2015;15:16.

Coulson S, Croxson GR, Adams R, Oey V. Prognostic factors

in herpes zoster oticus (ramsay hunt syndrome). Otol Neurotol

;32:1025‑30.

Blumental S, Lepage P. Management of varicella in neonates and

infants. BMJ Paediatr Open 2019;3:e000433.

Nanthakumar MP, Sood A, Ahmed M, Gupta J. Varicella zoster

in pregnancy. Eur J Obstet Gynecol Reprod Biol 2021;258:283‑7.

Harger JH, Ernest JM, Thurnau GR, Moawad A, Momirova V,

Landon MB, et al. Risk factors and outcome of varicella‑zoster

virus pneumonia in pregnant women. J Infect Dis

;185:422‑7.

Mustonen K, Mustakangas P, Valanne L, Professor MH,

Koskiniemi M. Congenital varicella‑zoster virus infection after

maternal subclinical infection: Clinical and neuropathological

findings. J Perinatol 2001;21:141‑6.

Lamont RF, Sobel JD, Carrington D, Mazaki‑Tovi S,

Kusanovic JP, Vaisbuch E, et al. Varicella‑zoster

virus (chickenpox) infection in pregnancy. BJOG

;118:1155‑62.

Shrim A, Koren G, Yudin MH, Farine D, MATERNAL

FETAL MEDICINE COMMITTEE. Management of varicella

infection (chickenpox) in pregnancy. J Obstet Gynaecol Can

;34:287‑92.

Cohen A, Moschopoulos P, Stiehm RE, Koren G. Congenital

varicella syndrome: The evidence for secondary prevention with

varicella‑zoster immune globulin. CMAJ 2011;183:204‑8.

Qutub M, Klapper P, Vallely P, Cleator G. Genital herpes

in pregnancy: Is screening cost‑effective?. Int J STD AIDS

;12:14‑6.

Pinninti SG, Kimberlin DW. Maternal and neonatal herpes

simplex virus infections. Am J Perinatol 2013;30:113‑9.

McQuillan G, Kruszon‑Moran D, Flagg EW, Paulose‑Ram R.

Prevalence of herpes simplex virus type 1 and type 2 in persons

aged 14‑49: United States, 2015‑2016. NCHS Data Brief

;X:1‑8.

Looker KJ, Magaret AS, Turner KM, Vickerman P, Gottlieb SL,

Newman LM. Global estimates of prevalent and incident

herpes simplex virus type 2 infections in 2012. PLoS One

;10:e114989.

Smith JS, Robinson NJ. Age‑specific prevalence of infection with

herpes simplex virus types 2 and 1: A global review. J Infect Dis

;186(Suppl 1):S3‑28.

Arabzadeh A, Fekri A, Shamsadini S, Zohoor A. The prevalence

of HSV2 antibodies in Blood Transfusion Department (2002)

from university of medical sciences. J Kerman Univ Med Sci

;10:53‑9.

Tayyebi D, Tabatabaee M, Rahsaz M. Seroepidemiology of

infection with Herpes Simplex Virus type 2 (HSV2) among

asymptomatic students attending Islamic Azad University of

Kazeroun, southwest of Iran. Retrovirology 2010;7:1‑1.

KASRAIAN M, Movaseghii M, FOTOUHI GA.

Seroepidemiological study of herpes simplex virus

type 2 (HSV‑2) antibody in Shiraz, Iran. 2004;1:189‑93.

Shahraki AD, Moghim S, Akbari P. A survey on herpes simplex

type 2 antibody among pregnant women in Isfahan, Iran. J Res

Med Sci 2010;15:243.

Malary M, Abedi G, Hamzehgardeshi Z, Afshari M,

Moosazadeh M. The prevalence of herpes simplex virus type 1

and 2 infection in Iran: A meta‑analysis. Int J Reprod Biomed

;14:615‑24.

Bollaerts K, Riera‑Montes M, Heininger U, Hens N,

Souverain A, Verstraeten T, et al. A systematic review of varicella

seroprevalence in European countries before universal childhood

immunization: Deriving incidence from seroprevalence data.

Epidemiol Infect 2017;145:2666‑77.

Luan L, Shen X, Qiu J, Jing Y, Zhang J, Wang J, et al.

Seroprevalence and molecular characteristics of varicella‑zoster

virus infection in Chinese Children. BMC Infect Dis

;19:643.

Helmuth IG, Poulsen A, Suppli CH, Mølbak K. Varicella in

Europe‑A review of the epidemiology and experience with

vaccination. Vaccine 2015;33:2406‑13.

Amjadi O, Rafiei A, Haghshenas M, Navaei RA, Valadan R,

Hosseini‑Khah Z, et al. A systematic review and meta‑analysis

of seroprevalence of varicella zoster virus: A nationwide

population‑based study. J Clin Virol 2017;87:49‑59.

Allami A, Mohammadi N. Varicella immunity in Iran: An

age‑stratified systematic review and meta‑analysis. Iran J

Microbiol 2014;6:372‑81.

Ranjan V, Mishra A, Kesarwani A, Mohan KV, Lal SN, Puliyel J,

et al. Mother‑to‑child transfer of reactivated varicella‑zoster

virus DNA and varicella‑zoster IgG in Pregnancy. Viral Immunol

;33:72‑6.

Gabutti G, Bolognesi N, Sandri F, Florescu C, Stefanati A.

Varicella zoster virus vaccines: An update. Immunotargets Ther

;8:15‑28.

Varela FH, Pinto LA, Scotta MC. Global impact of varicella

vaccination programs. Hum Vaccin Immunother 2019;15:645‑57.