title: Herpes simplex virus type 1 and type 2 in the Netherlands: seroprevalence, risk factors and changes during a 12-year period.
abstract: Genital herpes results in considerable morbidity, including risk of neonatal herpes, and is increasingly being caused by Herpes Simplex Virus (HSV) type 1. Possibly children are less often HSV-1 infected, leaving them susceptible until sexual debut. We assessed changes in the Dutch HSV-1 and HSV-2 seroprevalence over time and determinants associated with HSV seropositivity.
  
  
  
  We used data from two population-based seroepidemiological studies conducted in 1995-6 and 2006-7 with a similar study design. Serum samples of 6 months to 44-year-old participants were tested for type-specific HSV antibodies using HerpesSelect® with a cut-off level of >1.10 for seropositivity. Age and sex-specific HSV-1 and HSV-2 seroprevalence was weighted for the Dutch population. Logistic regression was performed to investigate determinants associated with HSV seropositivity.
  
  
  
  Overall, weighted HSV-1 seroprevalence was significantly lower in 2006-7 [42.7 % 95 % confidence interval (CI) 39.9-45.4] than in 1995-6 (47.7 % 95 % CI 44.8-50.7), especially among 10- to 14-year-olds. Overall, weighted HSV-2 seroprevalence remained stable: 6.8 % in 1995-6 and 6.0 % in 2006-7. Adults who ever had sexual intercourse were more often seropositive for HSV-1 [adjusted Odds Ratio (aOR) 1.69 95 % CI 1.33-2.16] and HSV-2 (aOR 2.35 95 % CI 1.23-4.52). Age at sexual debut was the only sexual risk determinant associated with HSV-1 seropositivity.
  
  
  
  Because of the lower HSV-1 seroprevalence in 2006-7 compared to 1995-6, more adults are susceptible to genital HSV-1, including women of reproductive age. Given the higher risk of neonatal herpes when HSV is acquired during pregnancy, prevention and control measures during pregnancy also targeting HSV-1, are important.
authors.affiliation: Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. Petra.Woestenberg@rivm.nl.
authors.forename: Petra J
authors.initials: PJ
authors.lastname: Woestenberg
authors.affiliation: Department of Medical Microbiology, Laboratory for Pathology and Medical Microbiology (PAMM), Veldhoven, The Netherlands.
authors.forename: Jeroen H T
authors.initials: JH
authors.lastname: Tjhie
authors.affiliation: Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
authors.forename: Hester E
authors.initials: HE
authors.lastname: de Melker
authors.affiliation: Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
authors.forename: Fiona R M
authors.initials: FR
authors.lastname: van der Klis
authors.affiliation: Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.|STI AIDS Netherlands, Amsterdam, The Netherlands.|Department of General Practice, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Jan E A M
authors.initials: JE
authors.lastname: van Bergen
authors.affiliation: Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.|Julius Center, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Marianne A B
authors.initials: MA
authors.lastname: van der Sande
authors.affiliation: Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
authors.forename: Birgit H B
authors.initials: BH
authors.lastname: van Benthem
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006558:Herpes Genitalis / Q000453:epidemiology; D006561:Herpes Simplex / Q000453:epidemiology; D018259:Herpesvirus 1, Human / Q000276:immunology* / Q000472:pathogenicity; D018258:Herpesvirus 2, Human / Q000276:immunology*; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012725:Sexual Behavior; D055815:Young Adult
keywords: Genital herpes; HSV-1; HSV-2; Herpes simplex virus; Public health; Seroprevalence