Abstract
BackgroundGenital herpes is one of the most prevalent sexually-transmitted diseases, and accounts for a substantial morbidity. Genital herpes puts newborns at risk for very severe disease and also increases the risk of horizontal HIV transmission. It thus stands as an important public health problem. The recent availability of type-specific gG-based assays detecting IgG against HSV-1 and HSV-2 allows to establish the prevalence of each subtype. Worldwide, few data have been published regarding the seroprevalence in general populations of HSV-2, the major causative agent for genital herpes, while no data exist regarding the Swiss population.MethodsTo evaluate the prevalence of IgG antibodies against HSV-1 and HSV-2 in Switzerland, we used a population-based serum repository from a health examination survey conducted in the Western and Southern area of Switzerland in 1992–93. A total of 3,120 sera were analysed by type-specific gG-based ELISA and seroprevalence was correlated with available volunteers characteristics by logistic regression.ResultsOverall, seroprevalence rates were 80.0 ± 0.9% (SE, 95% CI: 78.1–81.8) for HSV-1 and 19.3 ± 0.9% (SE, 95% CI: 17.6–21.1) for HSV-2 in adults 35–64 year old. HSV-1 and HSV-2 seroprevalence increased with age, with a peak HSV-2 seroprevalence in elderly gentlemen, possibly a seroarcheological evidence of sexually transmitted disease epidemics during World War II. Risk factors for HSV-2 infection included female sex, marital status other than married, and size of town of residence larger than 1500 inhabitants. Unexpectedly and conversely to HSV-1, HSV-2 seroprevalence increased with educational level. HSV-2 infection was less prevalent among HSV-1 infected individuals when compared to HSV-1 uninfected individuals. This effect was most apparent among women at high risk for HSV-2 infection.ConclusionsOur data demonstrate that by the early nineties, HSV-2 had spread quite largely in the Swiss population. However, the epidemiology of HSV-2 in Switzerland presents paradoxical characteristics, e.g. positive correlation with education level, that have not been observed elsewhere.
Highlights
Genital herpes is one of the most prevalent sexually-transmitted diseases, and accounts for a substantial morbidity
Infection rate was higher in women than in men for Herpes simplex virus type 1 (HSV-1) (82.7% versus 77.2 %, p = 0.004) and for HSV-2 (20.9 % and 17.7 %, p = 0.073), but the difference was statistically significant for HSV-1 only (Tables 1 and 2)
Seroprevalence rates were higher in the Ticino region than in the Vaud-Fribourg region for HSV-1 (87.7 % versus 77.0%, p < 0.001), as was HSV-2 prevalence (20.5% versus 18.9 %, p = 0.309), but statistical significance was reached for HSV-1 for both genders and for HSV-2 for females only
Summary
Genital herpes is one of the most prevalent sexually-transmitted diseases, and accounts for a substantial morbidity. Genital herpes puts newborns at risk for very severe disease and increases the risk of horizontal HIV transmission. It stands as an important public health problem. Few data have been published regarding the seroprevalence in general populations of HSV-2, the major causative agent for genital herpes, while no data exist regarding the Swiss population. While Herpes simplex virus type 1 (HSV-1) is a virus transmitted in casual contacts during childhood and in sexual contacts, leading to very high prevalence rate, HSV-2 is mostly transmitted sexually to cause genital herpes [1]. As a cause for substantial suffering due to recurrent clinical herpes [9], for catastrophic neonatal infection [14] and as a cofactor favoring HIV infection [15], the public health significance of genital herpes cannot be overestimated
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