The frequency of unrecognized type 2 herpes simplex virus infection among women. Implications for the control of genital herpes.
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.
Koutsky
L A
LA
Department of Epidemiology, School of Public Health, University of Washington, Seattle 98105.
Ashley
R L
RL
Holmes
K K
KK
Stevens
C E
CE
Critchlow
C W
CW
Kiviat
N
N
Lipinski
C M
CM
Wølner-Hanssen
P
P
Corey
L
L
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
D000914:Antibodies, Viral