The spectrum of genital herpes simplex virus infection in men attending a sexually transmitted disease clinic.
BACKGROUND
The spectrum of genital herpes (GH) has been understudied in men, especially African American men.


METHODS
Consecutive men attending a sexually transmitted diseases clinic were enrolled in a study of GH epidemiology. Consenting participants answered questionnaires detailing their sexual and social activities and underwent serological testing for herpes simplex virus types 1 and 2 (HSV-1 and -2) and collection of genital swabs for viral detection.


RESULTS
Of the 516 men enrolled, 465 (90%) were African American. Antibodies to HSV-1 were present in 315 (61%) of participants, and 233 (45%) had antibodies to HSV-2. Factors associated with HSV-2 infection included older age and African American race. HSV was detected in genital swabs from 52 men; 43 (82.7%) swabs were HSV-2 positive, and 9 (17.3%) were HSV-1 positive. The overall viral shedding rate among men (n = 247) with evidence of GH (HSV-1 or HSV-2 infection) was 21.1%, and the asymptomatic shedding rate in this same group was 5.2%. The sensitivities of culture for detection of HSV-1 and HSV-2 were .22 and .58, respectively, compared with that of polymerase chain reaction.


CONCLUSIONS
Genital HSV infections are common and largely unrecognized among this segment of the population. HSV-1 infection constitutes a nontrivial proportion of GH in these men.
Sizemore
James M
JM
Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, USA. sizemore@uab.edu
Lakeman
Fred
F
Whitley
Richard
R
Hughes
Annalee
A
Hook
Edward W
EW
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000367:Age Factors; D000368:Aged; D000554:Ambulatory Care Facilities; D004279:DNA, Viral / Q000032:analysis; D005832:Genital Diseases, Male / Q000453:epidemiology* / Q000821:virology*; D006558:Herpes Genitalis / Q000453:epidemiology* / Q000821:virology*; D018259:Herpesvirus 1, Human / Q000302:isolation & purification*; D018258:Herpesvirus 2, Human / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D014776:Virus Cultivation; D017201:Virus Shedding
D004279:DNA, Viral