HERPES-SIMPLEX VIRUS TYPE-2 ANTIBODY IN PATIENTS ATTENDING ANTENATAL OR STD CLINICS

Objective: To determine the prevalence of antibody to herpes simplex v irus type 2 (HSV-2) in patients attending a general public antenatal c linic and three public sexually transmitted disease (STD) clinics in S ydney. Background: Highly specific tests for herpes simplex type 2 ant ibody, using the glycoprotein G2, have been recently introduced, allow ing determination of past asymptomatic infection. Overseas studies hav e confirmed the long held suspicion that asymptomatic infection is mor e common than clinical genital herpes. The seroprevalence of HSV-2 in antenatal and STD clinic patients varies markedly in different countri es. These are the first data available for Australia by means of this highly specific test. Design: Cross-sectional study of seroprevalence in these two patient groups. Sera used in the antenatal study were tho se submitted for routine antenatal screening for viral markers. Partic ipants: Two hundred and twenty-nine consecutive patients attending the Westmead Hospital antenatal clinics, and 107 consecutive patients att ending three public STD clinics. Hypotheses: That Australian populatio ns show a relatively high prevalence of post asymptomatic infection wi th HSV-2; and that higher rates of infection will be found in patients attending STD clinics and with past or current histories of STDs. Mai n outcome measures: Comparison of HSV-2 seroprevalence between antenat al clinic patients and STD clinic patients; and associations of HSV-2 antibody with age, sex, occupation, country of birth, a history of cur rent or past STDs and antibody to HSV-1. Results: Antibody to HSV-2 wa s found in 14.5% of antenatal clinic patients and 40% of STD clinic pa tients. None of the antenatal patients and less than half of the serop ositive STD clinic patients reported clinical genital herpes. Associat ions with age, socioeconomic status and previous HSV-1 infection were less marked than in studies from the United States. Female STD clinic patients had a significantly higher seroprevalence than males and thre e times the seroprevalence of age-matched antenatal clinic patients. T he correlation between HSV-2 antibody and current gonorrhoea was more marked than that between HSV-2 and other STDs. Conclusion: Asymptomati c infection with HSV-2 is quite common in Australian antenatal patient s and more common in patients with STDs, who have higher rates of sexu al exposure.