HERPES SIMPLEX VIRUS–2 INFECTION: An Emerging Disease?
Section snippets
Seroepidemiology
Studies from the 1960s revealed that HSV–1 was more frequently associated with oral disease, whereas HSV–2 was associated with genital disease.48 These observations led to the commonly held colloquialism that HSV–1 causes disease “above the belt” and HSV–2 causes disease “below the belt.” In fact, HSV–1 is a significant cause of genital herpes, and up to 30% to 40% of new cases of genital herpes are caused by HSV–1.57 Genital HSV–1, however, reactivates clinically and subclinically much less
FACTORS ASSOCIATED WITH INCREASING PREVALENCE OF HSV–2
As discussed previously, incidence rate data and serial seroprevalence studies indicate that in developed and developing countries, genital HSV infections, especially genital HSV–2 infections, are becoming more frequent. In some patient populations the increase is dramatic. What accounts for this? The next section of this article discusses some of the biological and health care practice aspects of this rise. Like all public health problems, the factors associated with the HSV–2 epidemic are
Herpes Simplex Virus as a Risk Factor for Human Immunodeficiency Virus Acquisition
The presence of genital ulcers has been recognized as a potential risk factor for HIV acquisition ever since the start of the HIV epidemic. Numerous epidemiologic studies have supported the association of genital ulcers in general, and genital herpes in particular, with acquisition of HIV infection. Herpes simplex viruses are the most common cause of genital ulcers worldwide. This has been well documented in developed countries and has recently been shown in studies in the developing world.
SUMMARY
Genital herpes infections continue to increase in the world. As outlined previously, several factors play a role in the continued transmission of genital herpes worldwide. Reducing the medical consequences of HSV–2 infection will not be easy. It is also sobering to realize that widespread penetration of HSV–2 into the population had preceded the spread of sexually acquired HIV in most countries. The biological rationale for a connection between HIV and HSV continues to be strengthened.
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2017, Journal of EpidemiologyCitation Excerpt :Of the new HSV type 2 infections, 37% were symptomatic, 82% of which were given a correct clinical diagnosis at presentation.34 Detection of the signs or symptoms of HSV infections at an early stage of hospitalization in GBS patients may be useful to estimate the risk of the need for ventilatory support.35 Considering that 63% of all HSV type 2 infections were asymptomatic,34 the risk of requiring MV may be underestimated.
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Address reprint requests to Lawrence Corey, MD, Program in Infectious Diseases, M–115, Fred Hutchinson Cancer Research Center, 1124 Columbia St., Seattle, WA 98104-2092
This work is supported by NIH Grants AI-20381 and AI-07140
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From the Department of Medicine, University of Washington School of Medicine, and Program in Infectious Diseases, Fred Hutchinson Cancer Research Center, Seattle, Washington