Longitudinal study of genital infection by herpes simplex virus type 1 in western Scotland over 15 years

Abstract

and the likelihood of finding healthy elderly people colonised with MRSA is relatively small. Carriage of MRSA can, however, be expected in patients who have chronic conditions or who have had recent admissions to hospital. MRSA in the community seems to be a consequence of a "spill over" of an uncontrolled hospital epidemic, and the few isolates found in the community are classic hospital strains. It continues to be safe to treat community acquired S aureus infections in England with conventional antistaphylococcal agents effective against methicillin sensitive strains, and third line antibiotics should be considered only when typical risk factors can be ascertained.Contributors: HG designed and coordinated the study. AT took part in every aspect of the study and carried out the statistical analysis. SH and MH carried out the bacteriological investigations and the genetic typing. All authors were involved in collecting samples and recording data. RS coordinated the general practitioner and community participation. HG wrote the manuscript and was supported by AT and RS in the final draft. HG and RS are the guarantors.Funding: The study was supported by a grant from Nottingham Health Authority.Competing interests: None declared. Recurrence rates, viral shedding, and the mode of acquiring HSV-1 infection are different from those for HSV-2, so counselling and clinical management strategies may need to be revised. We studied longitudinal trends in laboratory reports of genital HSV-1 infection. Methods and resultsThe West of Scotland Specialist Virology Centre processes 99% of all herpes simplex virus culture samples in the region. All genital samples of herpes simplex processed between 1 January 1986 and 31 December 2000 were reviewed for source of referral, patient's sex and age (stratified into seven bands: <20, 21-25, 26-30, 31-35, 36-40, 41-45, and > 45 years), and the type of virus isolated.Samples were cultured and then typed using fluorescein labelled monoclonal antibodies to HSV-1 and HSV-2 (Syva Microtrak). From January 1999, the virus was detected and typed using a polymerase chain reaction method and restriction fragment length polymorphism. 2 The referral patterns and age and sex profiles of patients did not change during the period of analysis.We compared the proportion of HSV-1 in all positive swabs between sexes and ages using 2 tests, and over the three year time bands by the Cochran Armitage trend test (both overall and within four subgroups with age categorised as <25 years or > 25 years for each sex) using SAS 8.2.Of 10 547 swabs, the virus was identified in 3181 (30%); 3126 were typed, 1530 (49%) as HSV-1 and 1596 (51%) as HSV-2. Of the swabs testing positive for HSV, 2004 (63%) were from women and 1177 (37%) were from men. Age was recorded for 3099 (97.4%) patients, with 555 (18%) aged <20, 885 (29%) aged 21-25, 686 (22%) aged 26-30, 413 (13%) aged 31-35, 239 (8%) aged 36-40, 159 (5%) aged 41-45, and 162 (5%) aged > 45 years. The origin of the request to detect the virus was recorded for 10 47...

Herpes Simplex Virus Type 1 Remains the Principal Cause of Initial Anogenital Herpes in Edinburgh, Scotland

“…[5][6][7] The median age of heterosexual men and women infected with HSV-1 was significantly lower than that of those infected with HSV-2, a finding that is consistent with other reports. 7,8 In common with other reports, 9 HSV-1 infection was the predominant infecting viral type among women, especially among young women (that is, those aged less than 25 years). This finding, however, does not explain the difference of the prevalence of HSV-1 between heterosexual men and women.…”

Effector CD4+T-Cell Involvement in Clearance of Infectious Herpes Simplex Virus Type 1 from Sensory Ganglia and Spinal Cords

“…While seroprevalence of HSV-1 in the United States appears to be declining, the actual number of genital herpes cases attributed to HSV-1 is on the rise (50,67). Several reports note an increase in the number of genital herpes cases caused by HSV-1, a phenomenon seen in developed nations including the United States (34,46,52,64,67). Although HSV-2 is typically thought of as the virus responsible for causing genital lesions, the current trend in the United States, especially among adolescents, finds HSV-1 as the most common cause of newly diagnosed genital HSV infections (50).…”

Increasing role of herpes simplex virus type 1 in first-episode anogenital herpes in heterosexual women and younger men who have sex with men, 1992-2006

“…Herpes simplex virus (HSV) type 1 is causing an increasing proportion of anogenital herpes; however, it is unknown if this is true for men who have sex with men (MSM) 1 2 3 4 5. As the majority of studies were laboratory based, there were few reporting the gender of sexual partners or anatomical site and most were unable to distinguish first-episode from recurrent disease.…”