Sero-epidemiological and -sociological patterns of herpes simplex virus infection in the world
Nahmias, A.J.; Lee, F.K.; Beckman-Nahmias, S.
Scandinavian Journal of Infectious Diseases. Supplementum 69: 19-36
1990
ISSN/ISBN: 0300-8878 PMID: 2175939 Document Number: 376251
This is a review of the implications of epidemiology of herpes simplex virus types 1 and 2 accrued over 19 years of use of an enzyme immunoassay on over 40,000 sera from 18 countries from 1964 to 1983. HSV-1, which typically causes intraoral ulcers and fever blisters, is usually acquired in childhood and adolescence, and more often by socioeconomically less advantaged populations. Genital HSV-1 when it occurs is usually a primary genital herpes, is more often acquired by sexual activity, and usually causes severe disease in neonates. Prior HSV-1 confers moderate protection against getting HSV-2, and reduces its severity. There were 2 national settings with a typical infection patterns, Brazzaville, Congo and Wuhan, China. Here a high percentage of HSV-2 antibodies alone suggested that primary, probably neonatal, HSV-2 protected from subsequent HSV-1 infection. The prevalence of HSV-2 antibodies in 18 countries was correlated with number of sexual partners, from zero in nuns and 0.3% in U.S. children, to 50% in pregnant Blacks from Haiti. Prevalence in African countries ranged from 6-97%. Studies showed that most HSV-2 infections were subclinical. 22-28% of pregnant women shed HSV-2 particles vaginally from micro-ulcers only detectable by colposcopy. An association between HSV-2 and HIV infections has been documented in several studies. HSV-2 infections increased in some populations in the 1960-1970s, notably in Western countries undergoing a sexual revolution. Many White Americans experienced severe HSV-2 symptoms possibly because of lack of protection from prior HSV-1.