title: The frequency of unrecognized type 2 herpes simplex virus infection among women. Implications for the control of genital herpes.
abstract: To evaluate the prevalence of symptomatic versus asymptomatic or unrecognized type 2 herpes simplex virus (HSV-2) infection, the authors performed physical examination, viral cultures, and type-specific serologic assays in 776 randomly selected women attending an STD clinic and 636 female university students. Forty-six percent of women attending the STD clinic compared with 8.8% of the university students had serologic evidence of HSV-2 infection. Clinical or historical evidence of genital herpes was present in only 34% of the HSV-2 seropositive women attending the STD clinic and in 29% of the HSV-2 seropositive women attending the university clinic. Among women attending the STD clinic, the prevalence of recognized genital infection was more common among those with HSV-2 antibodies only versus those with HSV-1 and -2 antibodies (odds ratio = 2.39; 95% confidence interval = 1.30-4.37), suggesting that HSV-1 infection reduces the likelihood of recognizing HSV-2 infection. In view of the high proportion of seropositive individuals with unrecognized HSV-2 infection in both high and low prevalence HSV-2 seropositive populations, newly developed HSV type-specific serologic methods should be evaluated for detecting carriers of HSV-2 infection and counseling these individuals about strategies for avoiding sexual and perinatal transmission of HSV-2.
authors.affiliation: Department of Epidemiology, School of Public Health, University of Washington, Seattle 98105.
authors.forename: L A
authors.initials: LA
authors.lastname: Koutsky
authors.forename: R L
authors.initials: RL
authors.lastname: Ashley
authors.forename: K K
authors.initials: KK
authors.lastname: Holmes
authors.forename: C E
authors.initials: CE
authors.lastname: Stevens
authors.forename: C W
authors.initials: CW
authors.lastname: Critchlow
authors.forename: N
authors.initials: N
authors.lastname: Kiviat
authors.forename: C M
authors.initials: CM
authors.lastname: Lipinski
authors.forename: P
authors.initials: P
authors.lastname: Wølner-Hanssen
authors.forename: L
authors.initials: L
authors.lastname: Corey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000032:analysis*; D015153:Blotting, Western; D005260:Female; D006558:Herpes Genitalis / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D016036:Seroepidemiologic Studies; D018139:Simplexvirus / Q000302:isolation & purification*; D014481:United States
chemical_list: D000914:Antibodies, Viral