Abstract
Herpes simplex virus type 1 (HSV1) and 2 (HSV2) infection can lead to significant morbidity, and HSV2 is considered a risk factor for HIV transmission. The majority of HSV-infected people are asymptomatic and unaware of their infection. We aimed to determine the HSV1 and HSV2 prevalence among various ethnic groups in a large urban area in the Netherlands. In 2004, serum samples from a population-based serum repository of 1,325 people over 18 years living in Amsterdam were tested for HSV1 and HSV2 antibodies in order to determine high-risk groups. Prevalence ratios were estimated and all analyses were weighted by sex, age, and ethnicity. In the general population of Amsterdam, 67% had HSV1 antibodies, 22% had HSV2 antibodies, 15% had HSV1 and HSV2 antibodies, and 26% had no indication of HSV infection. In multivariate analyses, HSV1 seroprevalence increased with age, and was higher among people of Turkish and Moroccan origin, homosexual men, and individuals with low educational level. HSV2 seroprevalence was associated with increasing age, Surinamese/Antillean background, and having a history of sexually transmitted infections (STI). These differences between ethnic groups in Amsterdam regarding the distribution of HSV1 and HSV2 infection emphasise the importance of an ethnic-specific approach of serological testing as well as campaigns aimed at behavioural change and counselling to raise awareness of the risk of HSV transmission.
Highlights
Herpes simplex virus (HSV) causes oral-facial, genital and cutaneous infections
Prevalence of HSV infection Overall, 67% (95% confidence interval (CI): 63.5-71.0) of the population had herpes simplex virus type 1 (HSV1) antibodies, 22% were positive for HSV2, and 15% were co-infected with HSV1 and HSV2
Twenty-six percent of the population had no serological evidence of HSV infection
Summary
Herpes simplex virus (HSV) causes oral-facial, genital and cutaneous infections. Both people with symptomatic lesions and asymptomatic individuals can shed virus particles particles and transmit HSV. HSV causes neonatal herpes, which can lead to neurological damage or death [1]. The increase in genital transmission of herpes simplex virus type 1 (HSV1) and the evolving evidence that genital HSV infection is a potent facilitator of the sexual transmission of human immunodeficiency virus (HIV) are a considerable public health concern [2,3,4,5]. Sero-epidemiological studies suggest that serologic testing for genital herpes identifies more infected individuals than are recognised clinically [1,6]. Control strategies at the population level will not be fully effective if limited to symptom management
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