Herpes complex
- 1Denver Public Health Department and University of Colorado Denver, Schools of Medicine and Public Health, Denver, Colorado, USA
- 2University of Bern, Institute of Social and Preventive Medicine, Bern, Switzerland
- Dr Cornelis A Rietmeijer, Denver Public Health Department, 605 Bannock Street, Denver, CO 80204-4507, USA; kees.rietmeijer{at}dhha.org
- Accepted 8 July 2008
In a blood-red splatter, the word “Herpes” adorned the cover of Time Magazine of 2 August 1982 along with the tagline: “Today’s Scarlet Letter”. It appeared to herald an era of heightened public interest for herpes simplex virus (HSV) as a “new” sexually transmitted infection (STI). Of course, this attention was quickly overshadowed by increasing awareness of a really new, but much more serious STI: HIV. In the past 25 years, although perhaps less sensational than the progress in HIV research, studies into HSV, especially the genital variant HSV-2, have yielded many important insights that are now leading to renewed efforts to push the prevention of genital herpes to the foreground, inviting the question as to whether aggressive HSV-2 control efforts are now feasible and, from a public health view, warranted.
First, HSV-2 is much more prevalent than was previously thought. Among the general US population, 17% show serological evidence of infection; up to 40% in the African-American subpopulation.1 The article by Glynn and colleagues2 (see p 356) shows that HSV-2 infection was widely spread in parts of sub-Saharan Africa even before the HIV epidemic and that HSV prevalence over time does not seem to have been strongly influenced by the co-occurrence of HIV.
Second, controlling HSV-2 has been seen as a potentially important tool in HIV prevention because of the ample evidence that HSV-2 is an important co-factor in the acquisition of HIV.3 Third, control of HSV may reduce the incidence of neonatal herpes, …
