title: Using centralized laboratory data to monitor trends in herpes simplex virus type 1 and 2 infection in British Columbia and the changing etiology of genital herpes.
abstract: OBJECTIVE
  Understanding the regional epidemiology of genital Herpes Simplex Virus (HSV) infections is important for clinical and public health practice, due to the increasing availability of type-specific serologic testing in Canada and the contribution of genital HSV-2 infection to ongoing HIV transmission. We used centralized laboratory data to describe trends in viral identifications of genital HSV in BC and assess the utility of these data for ongoing population surveillance.
  
  
  METHODS
  Records of viral identifications (1997-2005) were extracted from the Provincial Public Health Microbiology & Reference Laboratory database. Classification as genital or other site was based on documented specimen site. We conducted a descriptive analysis of trends over time, and calculated odds of HSV-1 infection among individuals with genital herpes.
  
  
  RESULTS
  Of 48,183 viral identifications, 56.8% were genital, 10.0% were peri-oral and 9.1% cutaneous; site was unknown for 22.9%. Among genital identifications, HSV-1 infection was more likely in females, younger age groups, and later time periods. The proportion of genital herpes due to HSV-1 increased over time from 31.4% to 42.8% in BC.
  
  
  CONCLUSIONS
  Our analysis of population-level laboratory data demonstrates that the proportion of genital herpes due to HSV-1 is increasing over time in BC, particularly among women and younger age groups; this has implications for clinical practice including the interpretation of type-specific serology. Provincial viral identification data are useful for monitoring the distribution of genital HSV-1 and HSV-2 infections over time. Improving clinical documentation of specimen site would improve the utility of these data.
authors.affiliation: Division of STI/HIV Prevention and Control, BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC V5Z 4R4. mark.gilbert@bccdc.ca
authors.forename: Mark
authors.initials: M
authors.lastname: Gilbert
authors.forename: Xuan
authors.initials: X
authors.lastname: Li
authors.forename: Martin
authors.initials: M
authors.lastname: Petric
authors.forename: Mel
authors.initials: M
authors.lastname: Krajden
authors.forename: Judith L
authors.initials: JL
authors.lastname: Isaac-Renton
authors.forename: Gina
authors.initials: G
authors.lastname: Ogilvie
authors.forename: Michael L
authors.initials: ML
authors.lastname: Rekart
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001955:British Columbia / Q000453:epidemiology; D005260:Female; D006558:Herpes Genitalis / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology*; D018259:Herpesvirus 1, Human / Q000302:isolation & purification; D018258:Herpesvirus 2, Human / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012698:Serologic Tests; D017678:Sex Distribution