Herpes Simplex Virus Type 1 is the Leading Cause of Genital Herpes in New Brunswick

Abstract

INTRoDuCTIoN:Little is known about the role of herpes simplex virus (HSV) type 1 (HSV1) in the epidemiology of genital herpes in Canada. Data on herpes viral cultures for two consecutive years obtained from L'Hôpital Dr GL Dumont, which performs all the viral culture testing in New Brunswick, were reviewed. It was hypothesized that HSV1 was the main cause of genital herpes in New Brunswick. MeTHoDs: Samples of genital origin sent to the laboratory for HSV culture testing between July 2006 and June 2008 were analyzed. Samples from an unspecified or a nongenital source were excluded from analysis. Multiple positive samples collected from the same patient were pooled into a single sample. ResuLTs: HSV was isolated from 764 different patients. HSV1 was isolated in 62.6% of patients (male, 55%; female, 63.8%). HSV1 was isolated in 73.2% of patients 10 to 39 years of age and in 32% of patients ≥40 years of age. The difference in rates of HSV1 infection between the 10 to 39 years of age group and the ≥40 years of age group was statistically significant (P<0.001 [χ 2 ]). In a similar Canadian study performed in Nova Scotia, HSV1 was recovered in 53.7% of positive cultures (male, 36.7%; female, 58.1%). The rates of HSV1 infection reported by this study and the present study were significantly different (P<0.001 [χ 2 ] for male, P=0.012 for female). CoNCLusIoN: In New Brunswick, HSV1 is the dominant type of HSV isolated in samples collected from a genital site. Significant rate differences were demonstrated between the groups 10 to 39 years of age and ≥40 years of age. (1), but either HSV type 1 (HSV1) or HSV2 may be the cause (2). The relative role of HSV1 in herpes simplex genital infections varies from 3.9% to 78% (3,4). Most studies have relied on herpes simplex type-specific serology in estimating the significance of HSV2 in causing sexually transmitted infections. However, HSV1 is commonly acquired as an orolabial infection, so antibodies against it cannot be conclusively linked to genital infections. Using methods such as viral culture or molecular assays, it is possible to ascertain the role of HSV1 in causing genital ulcers. In our experience, many samples of genital origin tested in our laboratory grew HSV1. Given that our laboratory has tested all samples from New Brunswick for HSV since 2006 and given the sparsity of Canadian data, we decided to analyze two years of sample results (July 2006 to June 2008, hypothesizing that HSV1 would be the dominant type of HSV identified in those samples. MeTHoDsThere are no privately operated laboratories in New Brunswick. L'Hôpital Dr GL Dumont, located in southeast New Brunswick, is the only viral testing laboratory in the province, and has provided HSV culture services since 1992. New Brunswick laboratories ceased referring samples for HSV culture outside the province during the spring of 2006, when New Brunswick had a population of 748,000 (5). A review of the number of samples referred from other laboratories before and after the spring of 2006 confirmed that all sam...

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