Seroepidemiological study of herpes simplex virus types 1 and 2 in Brazil, Estonia, India, Morocco, and Sri Lanka

Abstract

Background:The association between herpes simplex virus type 2 (HSV-2) and human immunodeficiency virus (HIV) and the development of HSV vaccines have increased interest in the study of HSV epidemiology. Objectives: To estimate the age and sex specific seroprevalence of HSV-1 and HSV-2 infections in selected populations in Brazil, Estonia, India, Morocco, and Sri Lanka. Methods: Serum samples were collected from various populations including children, antenatal clinic attenders, blood donors, hospital inpatients, and HIV sentinel surveillance groups. STD clinic attenders were enrolled in Sri Lanka, male military personnel in Morocco. Sera were tested using a common algorithm by type specific HSV-1 and HSV-2 antibody assay. Results: 13 986 samples were tested, 45.0% from adult females, 32.7% from adult males, and 22.3% from children. The prevalence of HSV-1 varied by site ranging from 78.5%-93.6% in adult males and from 75.5%-97.8% in adult females. In all countries HSV-1 seroprevalence increased significantly with age (p<0.001) in both men and women. The prevalence of HSV-2 infection varied between sites. Brazil had the highest age specific rates of infection for both men and women, followed by Sri Lanka for men and Estonia for women, the lowest rates being found in Estonia for men and India for women. In all countries, HSV-2 seroprevalence increased significantly with age (p<0.01) and adult females had higher rates of infection than adult males by age of infection. Conclusions: HSV-1 and HSV-2 seroprevalence was consistently higher in women than men, particularly for HSV-2. Population based data on HSV-1 and HSV-2 will be useful for designing potential HSV-2 vaccination strategies and for focusing prevention efforts for HSV-1 and HSV-2 infection.

Seroepidemiological study of herpes simplex virus type 2 in patients with the acquired immunodeficiency syndrome in the city of Niterói, Rio de Janeiro, Brazil

“…There is increasing evidence that HSV-2 facilitates HIV transmission (Wasserheit 1992, Wald & Link 2002, which strengthens the importance of the implementation of available HSV control methods and the development of vaccines (Corey & Handsfield 2000, WHO & UNAIDS 2001, Cowan et al 2003. The majority of HSV infections are unrecognized and most people who are infected shed virus at some time and are, therefore, potentially infectious.…”

“…Nonetheless, data on the prevalence of HSV-2 infection among HIV-positive individuals are scarce. Recently, commercially available type-specific serologic assays allowed more extensive study of the epidemiology of HSV-2 infections (Ashley et al 1998, Cowan et al 2003, Turner et al 2003.The objectives of the current study were to determine the seroprevalence of HSV-2 and its association with age, sex as well as other demographic and behavioural factors among HIV-positive patients from a large general hospital in Niterói, state of Rio de Janeiro, Brazil. …”

“…Therefore, seroepidemiological studies are critical to understanding the pattern and distribution of infection within populations (Cowan et al 2003). Nonetheless, data on the prevalence of HSV-2 infection among HIV-positive individuals are scarce.…”

“…In countries where co-infection with human immunodeficiency virus (HIV) and HSV-2 is common the significance of HSV-2 as a cause of ulceration has probably been underestimated (Cowan et al 2003). The ulceration that occurs in immunocompromised individuals is frequently atypical, severe, and persistent (McGrath & Newman 1994, Suligoi et al 2002 and may mimic ulceration caused by other organisms, such as syphilis and chancroid (Chen et al 2000).…”

“…Nonetheless, data on the prevalence of HSV-2 infection among HIV-positive individuals are scarce. Recently, commercially available type-specific serologic assays allowed more extensive study of the epidemiology of HSV-2 infections (Ashley et al 1998, Cowan et al 2003, Turner et al 2003.…”