Background: In spite of the large prevalence and growing incidence of herpes simplex infection (HSV-1 and HSV-2), relatively few large serological surveys are available worldwide and it is still difficult compare frequencies of HSV contaminations in various countries. We present the results of HERPIMAX, the first epidemiological inquiry on HSV prevalence in the general French population. Methods: Of a cohort of 12 735 presumed healthy adult volunteers included in the prospective study SU.VI.MAX, designed to assess the relation between nutritional supplementations and degenerative diseases, HERPIMAX randomly selected 4412 subjects (females 66.5%, males 33.5%). All serum samples were assessed for HSV-1 and HSV-2 IgG antibodies with a HSV type specific, enzyme immunosorbent assay (EIA). Equivocal result were retested with another HSV type specific immunoblot assay combined with a type common HSV IgG EIA in order to give a definitive interpretation. Results: The mean seroprevalence was 67% for HSV-1 and 17.2% for HSV-2. For HSV-2 the seroprevalence was higher in females (17.9%) compared with males (13.7%) (p <0.001). For both HSV types, there was no significant difference in prevalence as regards age distribution in males and females, whereas prevalence increased significantly with age in females for HSV-1. Univariate analysis showed a significant association between HSV-1 prevalence and education level in males and females (p <0.001) and between HSV-2 prevalence and marital status in both sexes (p <0.001). There were geographical disparities, with a higher HSV-2 prevalence in the south of France as well as in Paris. Conclusion: These results confirm a high prevalence of HSV infection in France. They are also in agreement with previous results of other survey carried out in other developed countries as regards higher prevalence of HSV-2 infection in women, the stability of seroprevalence for both HSV types after 35 years of age in females and 45 years of age in males. H erpes simplex virus (HSV) infections are quite common throughout the world. 1 Apart from the morbidity due to symptomatic episodes, HSV infections may have severe consequences in immunosuppressed hosts or neonates. 2 Furthermore, genital ulcer disease due to HSV is a risk factor for sexual acquisition and transmission of HIV infection. 3 Assessing the extent of HSV infections is notoriously difficult for a variety of reasons: in most countries, they are not notified diseases, the majority of infected subjects are asymptomatic 4 or unaware of their infection. However, since the 1980s, serological methods have made it possible to study the epidemiology of HSV infection and recent improvements in available tests allow discrimination between HSV-1 and HSV-2.Here, we report the results of the HERPIMAX survey, which was the first epidemiological assessment of HSV prevalence carried out in France in the general population. METHODS Study populationThe survey population was a random sample of the SU.VI.MAX programme, which was primarily a French prospective, ...

In order to assess psychological morbidity in France related to genital herpes infection, we carried out a transversal study comparing infected patients with a control group. A total of 236 patients with genital herpes were first identified by means of a postal survey, then matched against a witness group of 236 noninfected persons. Detailed questionnaires were sent out to each person in the 2 groups. A total of 150 herpes patients and 200 non-infected persons answered the questionnaire, which enabled us to measure the incidence of the disease by means of 2 indicators: a herpes-specific scale and the SF-36 quality of life questionnaire. Emotional trauma due to genital herpes was reported amongst 23% of the participants. Of the participants, 57% indicated that herpes interfered with their sexual relationships; 50% felt it difficult to live with genital herpes; and 37% felt that herpes ruins their lives. An analysis assessing health-related quality of life indicated significant differences between the scores of the 2 groups and showed that quality of life is lower amongst herpes patients. Respondents with genital herpes required more frequent consultations with GPs (81% vs. 73%), and significantly more frequent consultations with specialists (59% vs. 45%). Our study confirms that substantial psychological morbidity exists in patients with genital herpes.

Appreciable improvements were achieved only after we had developed and introduced a standardised admissions form. Full results of our 12 months' experience will appear elsewhere.'