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Seroepidemiological study of herpes simplex virus types 1 and 2 in Brazil, Estonia, India, Morocco, and Sri Lanka
  1. F M Cowan1,
  2. R S French1,
  3. P Mayaud2,
  4. R Gopal3,
  5. N J Robinson4,
  6. S Artimos de Oliveira5,
  7. T Faillace6,
  8. A Uusküla7,
  9. M Nygård-Kibur8,
  10. S Ramalingam9,
  11. G Sridharan9,
  12. R El Aouad10,
  13. K Alami11,
  14. M Rbai12,
  15. N P Sunil-Chandra13,
  16. D W Brown3
  1. 1Department of Sexually Transmitted Diseases, Royal Free and University College Medical School, University College London, London, UK
  2. 2Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
  3. 3Enteric, Respiratory and Neurological Virus Laboratory, Central Public Health Laboratories, Colindale, London, UK
  4. 4Worldwide Epidemiology, GlaxoSmithKline R&D, Greenford, Middlesex, UK
  5. 5University Federal Fluminense, Niteroi, Brazil
  6. 6Policlinica Comunitaria Santa Rosa, Niteroi, Brazil
  7. 7University of Tartu, Tartu, Estonia
  8. 8Institute of Experimental and Clinical Medicine, Tallinn, Estonia
  9. 9Christian Medical College Hospital, Vellore, India
  10. 10Institut National d’Hygiene de la Sante, Rabat, Morocco
  11. 11Programme National de Lutte contre le SIDA/MST, Ministere de la Santé Publique, Rabat, Morocco
  12. 12Hopital d’Instruction Militaire Mohammed V, Rabat, Morocco
  13. 13University of Kelaniya, Ragama, Sri Lanka
  1. Correspondence to:
    Frances M Cowan, Department of STD, UCL, Mortimer Market Centre, Off Capper Street, London WC1 6AU, UK;


Background: The association between herpes simplex virus type 2 (HSV-2) and human immunodeficiency virus (HIV) and the development of HSV vaccines have increased interest in the study of HSV epidemiology.

Objectives: To estimate the age and sex specific seroprevalence of HSV-1 and HSV-2 infections in selected populations in Brazil, Estonia, India, Morocco, and Sri Lanka.

Methods: Serum samples were collected from various populations including children, antenatal clinic attenders, blood donors, hospital inpatients, and HIV sentinel surveillance groups. STD clinic attenders were enrolled in Sri Lanka, male military personnel in Morocco. Sera were tested using a common algorithm by type specific HSV-1 and HSV-2 antibody assay.

Results: 13 986 samples were tested, 45.0% from adult females, 32.7% from adult males, and 22.3% from children. The prevalence of HSV-1 varied by site ranging from 78.5%–93.6% in adult males and from 75.5%–97.8% in adult females. In all countries HSV-1 seroprevalence increased significantly with age (p<0.001) in both men and women. The prevalence of HSV-2 infection varied between sites. Brazil had the highest age specific rates of infection for both men and women, followed by Sri Lanka for men and Estonia for women, the lowest rates being found in Estonia for men and India for women. In all countries, HSV-2 seroprevalence increased significantly with age (p<0.01) and adult females had higher rates of infection than adult males by age of infection.

Conclusions: HSV-1 and HSV-2 seroprevalence was consistently higher in women than men, particularly for HSV-2. Population based data on HSV-1 and HSV-2 will be useful for designing potential HSV-2 vaccination strategies and for focusing prevention efforts for HSV-1 and HSV-2 infection.

  • seroepidemiological study
  • herpes simplex virus
  • age
  • sex
  • Brazil
  • Estonia
  • India
  • Morocco
  • Sri Lanka
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