Trends in Herpes Simplex Virus Type 1 and Type 2 Seroprevalence in the United States

Xu, Fujie; Sternberg, Maya; Kottiri, Benny J.; McQuillan, Geraldine M.; Lee, Francis K.; Nahmias, André J.; Berman, Stuart M.; Markowitz, Lauri E.

doi:10.1001/jama.296.8.964

Cited by 896 publications

(723 citation statements)

References 54 publications

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“…2 Among persons infected with HSV-1 but not HSV-2, a higher percentage reported a diagnosis of genital herpes in 1999-2004 compared with 1988-94 (1.8% versus 0.4%). 2 HSV-1 has emerged as a major cause of genital herpes among college-age populations, in which up to 80% of new cases of genital HSV were caused by HSV-1. [14][15][16] Epidemiological studies suggest that oral genital contact is the major risk factor for the acquisition of genital HSV-1.…”

Section: Epidemiology Of Genital Herpesmentioning

confidence: 94%

“…Among those infected with HSV-2, the percentage who reported being diagnosed was 14.3% in 1999-2004 and 9.9% in 1988-94, suggesting that more providers are aware of genital herpes, and able to make appropriate diagnoses. 2 However, the vast majority of people infected with HSV-2 remain undiagnosed and, therefore, untreated and able to spread the infection. Between 75% and 90% of HSV-2-infected people are not aware of having the infection.…”

Section: Epidemiology Of Genital Herpesmentioning

confidence: 99%

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Prevention of neonatal herpes

Gardella

Brown

2010

BJOG

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Neonatal herpes can occur when the neonate is exposed to herpes simplex virus in the maternal genital tract during labour. Attack rates are highest when the mother has a newly acquired infection and, therefore, does not have antibodies to protect the neonate. Even with early therapy, there is significant morbidity and mortality associated with neonatal herpes, suggesting that preventing neonatal herpes simplex virus exposure or early recognition of exposure is important. The incidence of neonatal herpes has not declined despite national guidelines for prevention. This suggests that the prevention guidelines need to be re-addressed.Keywords Herpes, neonate, prevention.Please cite this paper as: Gardella C, Brown Z. Prevention of neonatal herpes. BJOG 2011;118:187-192. Epidemiology of genital herpesBased on serological data from a large National Health and Nutrition Examination Survey (NHANES), 22% of pregnant women in the USA are infected with herpes simplex virus 2 (HSV-2), 63% are HSV-1 seropositive, 13% have both HSV-1 and HSV-2, and 28% are seronegative. 1 In the general population, for the first time since the 1976 inception of NHANES, the seroprevalence of HSV-2 has decreased; overall, the age-adjusted HSV-2 seroprevalence was 17% in 1999-2004, compared with 21% in 1988-94, a relative decrease of 19% between the two study periods. Among those infected with HSV-2, the percentage who reported being diagnosed was 14.3% in 1999-2004 and 9.9% in 1988-94, suggesting that more providers are aware of genital herpes, and able to make appropriate diagnoses. 2 However, the vast majority of people infected with HSV-2 remain undiagnosed and, therefore, untreated and able to spread the infection. Between 75% and 90% of HSV-2-infected people are not aware of having the infection. [3][4][5][6] This is important because most sexual transmission of HSV occurs during episodes of subclinical reactivation among persons with unrecognized infection. 4,7-10 Virtually all HSV-2 seropositive people have intermittent shedding from the genital mucosa, and most have mild (and hence unrecognized and undiagnosed) disease. 5 In the absence of symptoms, HSV-2 can be detected in the genital tract, by viral culture, on 3% of days for the first year after initial infection, then on 1% of days for the next 2 years. HSV-2 DNA can be detected by polymerase chain reaction testing 15-20% of days. 11,12 Recent data suggest that HSV reactivation may occur much more frequently than previously understood, and may be characterised by frequent short bursts of viral shedding that do not correlate with symptoms. 13 As HSV-2 seroprevalence decreased, HSV-1 seroprevalence in the USA increased to 62% in 1988-94 from 57.7% in 1999-2004. 2 Among persons infected with HSV-1 but not HSV-2, a higher percentage reported a diagnosis of genital herpes in 1999-2004 compared with 1988-94 (1.8% versus 0.4%). 2 HSV-1 has emerged as a major cause of genital herpes among college-age populations, in which up to 80% of new cases of genital HSV were caused by HSV-1. [14][1...

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Section: Epidemiology Of Genital Herpesmentioning

confidence: 94%

Section: Epidemiology Of Genital Herpesmentioning

confidence: 99%

Prevention of neonatal herpes

Gardella

Brown

2010

BJOG

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“…Over 90% of the human population is seropositive for HSV-1 (Xu et al, 2006). Furthermore, a recent study from our laboratory (Kaufman et al, 2005) reports that 98% (49/50) of asymptomatic subjects tested shed HSV-1 DNA in tears or saliva at least once in a 30-day trial.…”

Section: Introductionmentioning

confidence: 99%

Effect of human apolipoprotein E genotype on the pathogenesis of experimental ocular HSV-1

Bhattacharjee

Neumann

Foster

et al. 2008

Experimental Eye Research

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The isoform-specific role of human apolipoprotein E (apoE) has been assessed in a mouse model of ocular herpes. Female, age-matched transgenic mice knocked-in for the human allele apoE3 or apoE4 and their parent C57Bl/6 mice were inoculated corneally with HSV-1 strain KOS. Ocular HSV-1 pathogenesis was monitored through viral replication and clinical progression of stromal opacity and neovascularization by slit-lamp examination. Establishment of latency was determined by analysis of HSV-1 DNA (copy number) by specific real-time PCR in the cornea, trigeminal ganglia (TG), and brain. Representative groups of transgenic mice were sacrificed for the analysis of gene expression of vascular endothelial growth factor (VEGF) by reverse-transcription PCR, and apoE expression by Western blot analysis. At 6 days post-infection (P.I.), the ocular infectious HSV-1 titer was significantly higher (p < 0.05) in apoE4 mice compared with apoE3 and C57Bl/6 mice. Corneal neovascularization in apoE4 mice was significantly higher (p < 0.05) than apoE3 and C57Bl/6 mice. The onset of corneal opacity in apoE4 mice was accelerated during days 9--11 P.I.; however, no significant difference in severity was seen on P.I. days 15 and beyond. At 28 days P.I., infected mice of all genotypes had no significant differences in copy numbers (range 0--15) of HSV-1 DNA in their corneas, indicating that HSV-1 DNA copy numbers in cornea are independent of apoE isoform regulation. At 28 days P.I., both apoE4 and C57Bl/6 mice had a significantly higher (p = 0.001) number of copies of HSV-1 DNA in TG compared with apoE3. ApoE4 mice also had significantly higher (p = 0.001) copies of HSV-1 DNA in their TGs compared with C57Bl/6 mice. In brain, both apoE4 and C57Bl/6 mice had significantly higher numbers (p ≤ 0.03) of copies of HSV-1 DNA compared with apoE3 mice. However, the number of HSV-1 DNA copies in the brain of C57Bl/6 mice was not significantly different than that of apoE4 (p = 0.1). Comparative molecular analysis between apoE3 and apoE4 mice on selected days between 7 and 28 P.I., inclusive, revealed that the corneas of apoE4 mice expressed VEGF. None of the corneas in the apoE3 mice expressed VEGF Corresponding author: James M. Hill, Ph.D., LSU Eye Center, 2020 Gravier Street, Suite B, New Orleans, LA 70112, USA, Telephone: (504) 568 2274, Fax: (504) 568 2385, E-mail: jhill@lsuhsc.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Western blot analysis showed proteolytic cleavage of the apoE protein in the corneas of the apoE4 mice. Through days 14 to 28 P.I., a ~29 kDa C-terminal truncated apoE f...

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“…Genital herpes is highly prevalent worldwide and a significant cause of genital ulcer disease 1 . Following an initial symptomatic outbreak with herpes simplex virus type 2, most patients (> 90%) have at least one lifetime recurrence with frequent episodes (≥ 6/year) occurring in approximately one-third of patients 2,3 .…”

Section: Introductionmentioning

confidence: 99%

Single-day famciclovir for the treatment of genital herpes: follow-up results of time to next recurrence and assessment of antiviral resistance

Bodsworth¹,

Fife

Koltun

et al. 2009

Current Medical Research and Opinion

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Background Episodic therapy of genital herpes is usually recommended for patients with infrequent symptomatic recurrences and where transmission is not a concern. While shorter courses are as effective as standard 5-day regimens, it is unknown whether abbreviated therapy has detrimental effects on natural history and the development of antiviral resistance. Objectives To assess time to next recurrence and development of antiviral resistance in patients with recurrent genital herpes treated with either single-day famciclovir (1 g twice-daily) or 3-day valacyclovir (500 mg twice-daily). Methods Longer-term, follow-up data on the time to next recurrence and antiviral sensitivity were collected from a previously reported multicenter, multinational, double-blind, parallel group study in which 1179 immunocompetent adults were randomized 1:1 to receive either single-day famciclovir or 3-day valacyclovir. Treatment was self-initiated within 6 hours of a recurrence. Swabs for viral culture and sensitivity testing were collected for two sequential recurrences. Results The median time to next recurrence from treatment initiation was 33.5 days for famciclovir and 38.0 days for valacyclovir. No drug resistance to penciclovir, the active metabolite of famciclovir, was observed at baseline nor did any develop by the time of the next recurrence. Limitations The study had no placebo arm, typing of viral isolates was not performed and viral resistance testing was restricted to penciclovir only. Conclusion Treatment with single-day famciclovir for recurrent genital herpes did not shorten the time to the next recurrence. Drug resistance to penciclovir continues to be a rare event in immunocompetent patients.

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Trends in Herpes Simplex Virus Type 1 and Type 2 Seroprevalence in the United States

Abstract: These data show declines in HSV-2 seroprevalence, suggesting that the trajectory of increasing HSV-2 seroprevalence in the United States has been reversed. Seroprevalence of HSV-1 decreased but the incidence of genital herpes caused by HSV-1 may be increasing.

Cited by 896 publications

References 54 publications

Prevention of neonatal herpes

Prevention of neonatal herpes

Effect of human apolipoprotein E genotype on the pathogenesis of experimental ocular HSV-1

Single-day famciclovir for the treatment of genital herpes: follow-up results of time to next recurrence and assessment of antiviral resistance

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