HERPES-SIMPLEX VIRUS TYPE-2 IN THE UNITED-STATES, 1976 TO 1994

Background Herpes simplex virus type 2 (HSV-2) infection is usually tr ansmitted sexually and can cause recurrent, painful genital ulcers. In neonates the infection is potentially lethal. We investigated the ser oprevalence and correlates of HSV-2 infection in the United States and identified changes in HSV-2 seroprevalence since the late 1970s. Meth ods Serum samples and questionnaire data were collected during the Nat ional Health and Nutrition Examination Surveys (NHANES) II (1976 to 19 80) and III (1988 to 1994). HSV-2 antibody was assessed with an immuno dot assay specific for glycoprotein gG-2 of HSV-2. Results From 1988 t o 1994, the seroprevalence of HSV-2 in persons 12 years of age or olde r in the United States was 21.9 percent (95 percent confidence interva l, 20.2 to 23.6 percent), corresponding to 45 million infected people in the noninstitutionalized civilian population. The seroprevalence wa s higher among women (25.6 percent) than men (17.8 percent) and higher among blacks (45.9 percent) than whites (17.6 percent). Less than 10 percent of all those who were seropositive reported a history of genit al herpes infection. In a multivariate model, the independent predicto rs of HSV-2 seropositivity were female sex, black race or Mexican-Amer ican ethnic background, older age, less education, poverty, cocaine us e, and a greater lifetime number of sexual partners. As compared with the period from 1976 to 1980, the age-adjusted seroprevalence of HSV-2 rose 30 percent (95 percent confidence interval, 15.8 to 45.8 percent ). The seroprevalence quintupled among white teenagers and doubled amo ng whites in their twenties. Among blacks and older whites, the increa ses were smaller. Conclusions Since the late 1970s, the prevalence of HSV-2 infection has increased by 30 percent, and HSV-2 is now detectab le in roughly one of five persons 12 years of age or older nationwide. Improvements in the prevention of HSV-2 infection are needed, particu larly since genital ulcers may facilitate the transmission of the huma n immunodeficiency virus. (C) 1997, Massachusetts Medical Society.