Prevalence of herpes simplex virus-1 in hospitalized adult patients with clinical diagnosis of meningoencephalitis using real-time polymerase chain reaction: A single-center, cross-sectional study

Early diagnosis of herpes simplex virus‑1 (HSV‑1) meningoencephalitis is very important because antiviral therapy significantly decreases mortality and morbidity. Polymerase chain reaction (PCR) is a reliable method with high sensitivity and specificity in detection of HSV‑1. The aim of this study is to determine the prevalence of HSV‑1 in patients with diagnosis of meningoencephalitis using real‑time PCR. The cerebrospinal fluid samples were collected from 126 patients with clinical diagnosis of HSV‑1 meningoencephalitis in Alzahra Referral Hospital in Isfahan, Iran. After deoxyribonucleic acid (DNA) extraction, real‑time PCR was performed by fluorescence resonance energy transfer assay and participants underwent brain magnetic resonance imaging, as well. Among 126 patients, 68.3% were male and 31.7% were female. The mean age of the participants was 41.96 ± 22.36 years. Most of the participants were in the age group of 20–29 years. Three patients (2.4%) had positive and 123 patients (97.6%) had negative HSV‑1 DNA test. Among three positive cases, two were in the age group of 20–29 years and one in the age group of ≥80 years. No HSV‑2 DNA was detected. According to the estimated prevalence of HSV‑1 meningoencephalitis in the current study, it seems that the prevalence of HSV‑1 meningoencephalitis is not too high in our community; therefore, initial empiric acyclovir therapy is frequently overused.