Rising Incidence of Genital Herpes over Two Decades in a Sexually Transmitted Disease Clinic in North India

Abstract

Genital herpes, which was considered to be a minor sexually transmitted disease (STD) in the past in developing countries, is rapidly increasing; in contrast, bacterial STDs are declining. This changing trend of various STDs prompted us to analyze our data retrospectively to see whether a similar change is occurring in this part of India as well. The records of sexually transmitted diseases (STDs) clinic attendees from January 1977 to December 2000 were analyzed. The demographic profile of patients with genital herpes was also considered for analysis. STDs were diagnosed clinically and by appropriate laboratory tests wherever applicable. VDRL test was done in all patients, and HIV antibody detection was performed from 1987 onwards. The incidences of chancroid, donovanosis, and gonorrhea were 12.2%, 6.3%, and 16.9%, respectively, from January 1977 to December 1985. The figures for the same decreased to 2.5%, 0.9%, and 2.3%, respectively, from January 1993 to December 2000. The decreasing incidence of the above bacterial STDs is statistically significant (p<0.001). However, there was an approximately two-fold increase in the incidence of genital herpes in recent years (20.5%) in comparison to the figures from the late 70s (11.4%). Molluscum contagiosum also showed an upward trend (1% in 1977-85 vs. 9.8% in 1993-2000). Condylomata accuminata remained almost unchanged (21.4% in 1977-85 vs. 20% in 1993-2000). To conclude, a significant increase in the number of viral STDs and a decline in the bacterial diseases were observed in recent years in comparison to the figures from the late 70s. This may be due to awareness of HIV, success of control programs, syndromic management of STDs, and adoption of safer sexual practices, which prevent bacterial STDs more efficiently than viral ones.

Multiple acquisitions of STIs: invitation to precision in clinical care and summons to intangibles in laboratory diagnosis

“…An earlier report from the present institution observed a decreasing trend from 32.7% in 2006 to 14.8% in 2014 culminating in the present 5%. This is comparable to a study from Andhra Pradesh where too a decreasing tendency was noted ( years has been documented to rising in reports from studies from Chandigarh, Rohtak, North-eastern India, and even Kerala [8,13,29,30] In the present study 90% of the HSV cases were serologically detected again highlighting the common subclinical existences of this infection.…”

An epidemiological study of sexually transmitted diseases cases at STD clinic, Gorakhpur

“…8 A marked decline in bacterial STIs, resulting in an apparent increase in viral STIs, has been reported from different regions of India. [9][10][11] Our study confirmed a similar pattern of higher incidence of viral STIs which could be due to the increased usage of antibiotics. 10 Person with multiple sexual partner have higher risk of acquiring and transmitting STIs and risk increases many folds if they have sexual contact with commercial sex workers (CSWs) because CSWs are very important source of infection in our country as they are usually less educated and most of them don't know about STIs and also the people who visit them usually have less knowledge regarding use and benefits of barrier contraceptives.…”

“…[9][10][11] Our study confirmed a similar pattern of higher incidence of viral STIs which could be due to the increased usage of antibiotics. 10 Person with multiple sexual partner have higher risk of acquiring and transmitting STIs and risk increases many folds if they have sexual contact with commercial sex workers (CSWs) because CSWs are very important source of infection in our country as they are usually less educated and most of them don't know about STIs and also the people who visit them usually have less knowledge regarding use and benefits of barrier contraceptives. In our study, a significant higher STI prevalence was found in people with history of contact with multiple partners or visiting CSW as compared to people with no such history (p<0.05).…”

Emerging trends in viral sexually transmitted infections in India

“…[5] An earlier study from Chandigarh has also shown a two-fold increase in its incidence (20.5% in 2000 vs. 11.4% in 1970). [18] A similar twofold rise (from 16.92 to 31.26%) was found in Rohtak from 2001 to 2006. [19,20] In north-east India also, it has increased in the last 10 years.…”