title: 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.
  
  
  OBJECTIVE
  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.
authors.affiliation: Department of Sexually Transmitted Diseases, Royal Free and University College Medical School, University College London, London, UK. frances@uz-ucsf.co.zw
authors.forename: F M
authors.initials: FM
authors.lastname: Cowan
authors.forename: R S
authors.initials: RS
authors.lastname: French
authors.forename: P
authors.initials: P
authors.lastname: Mayaud
authors.forename: R
authors.initials: R
authors.lastname: Gopal
authors.forename: N J
authors.initials: NJ
authors.lastname: Robinson
authors.forename: S Artimos
authors.initials: SA
authors.lastname: de Oliveira
authors.forename: T
authors.initials: T
authors.lastname: Faillace
authors.forename: A
authors.initials: A
authors.lastname: Uusküla
authors.forename: M
authors.initials: M
authors.lastname: Nygård-Kibur
authors.forename: S
authors.initials: S
authors.lastname: Ramalingam
authors.forename: G
authors.initials: G
authors.lastname: Sridharan
authors.forename: R
authors.initials: R
authors.lastname: El Aouad
authors.forename: K
authors.initials: K
authors.lastname: Alami
authors.forename: M
authors.initials: M
authors.lastname: Rbai
authors.forename: N P
authors.initials: NP
authors.lastname: Sunil-Chandra
authors.forename: D W
authors.initials: DW
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004957:Estonia / Q000453:epidemiology; D005260:Female; D006561:Herpes Simplex / Q000453:epidemiology*; D018259:Herpesvirus 1, Human / Q000276:immunology; D018258:Herpesvirus 2, Human / Q000276:immunology; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009018:Morocco / Q000453:epidemiology; D016017:Odds Ratio; D015995:Prevalence; D016036:Seroepidemiologic Studies; D013188:Sri Lanka / Q000453:epidemiology