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Map is based on published studies within the last 15 years using serological assays that can accurately differentiate HSV-2 from HSV-1 infection. Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA. Expression of concern regarding paper by Park et al, published on 25 June 2015: “Epidemiological investigation of MERS-CoV spread in a single hospital in South Korea, May to June 2015”, Euro Surveill.
It has been brought to our attention that some of the authors may not have been informed about the content of the above paper. Citation style for this article: Sauerbrei A, Schmitt S, Scheper T, Brandstadt A, Saschenbrecker S, Motz M, Soutschek E, Wutzler P. The prevalence of herpes simplex virus (HSV) type-specific IgG was determined in sera taken in 1999 to 2006 from 1,100 children aged 0–18 years, 800 blood donors and 200 pregnant women in Thuringia, Germany, using tests based on the HSV glycoproteins (g) gG.
Herpes simplex virus (HSV) is one of the most common pathogens affecting humans: it can remain latent lifelong in sensory ganglia and can be reactivated periodically. Excretion of the virus from herpetic lesions (mainly lips and genitals) in symptomatic people with recurrent infections and excretion of the virus in the saliva and genitals of asymptomatic people are regarded as the most important source of the virus [2]. Unlike HSV-1, HSV-2 is predominantly acquired through sexual activity [3] and causes the great majority of genital herpes [4]. HSV type-specific seroprevalence has been extensively studied in many countries all over the world.
The envelope glycoproteins (g) G of HSV-1 (gG-1) and HSV-2 (gG-2) are known to be type-specific antigens [14] and have been used in nearly all conclusive HSV-1 and HSV-2 seroprevalence studies [3]. As there are few data on the prevalence of HSV antibodies in Germany, we carried out a seroepidemiological study to determine the HSV-1 and HSV-2 antibody prevalence in children, adults and pregnant women in the German federal state of Thuringia. In this study, 1,100 sera from infants, children and adolescents aged 0 to 18 years, (hereafter referred to as children aged 0 to 18 years), 800 sera from blood donors aged 19 to 30 years and 200 pregnant women aged between 17 and 40 years were included. For the blood donors and pregnant women, informed oral consent for use of their sera was obtained. Samples from those aged 18 years or under lived in Erfurt, the capital of Thuringia, and its rural surroundings. Serum samples from the pregnant women were taken from those who delivered at their local district hospital (in Thuringia) between January 1999 and January 2000. Sera were stored in aliquots at –20 °C without interruption until tested for antibodies to HSV-1 and HSV-2. All samples with discordant results in the gG-1 and gC-1 ELISAs were retested twice and the most frequent result (including the original test result) was accepted.
A sample size of about 150 subjects per pre-specified age group was planned to assure that a two-sided 95% confidence interval (CI) for the prevalence of HSV antibodies would extend at most 8% from the observed value for a prevalence range of 5–95%. Antibody prevalence was calculated using the number of seropositive cases divided by the number of all subjects tested. The amount of agreement between gG-1 and gC-1 ELISAs was computed using the number of sera with concordant results divided by the number of sera tested. Data on the prevalence of IgG antibodies against HSV-1 in the samples tested are shown in Table 1. The Figure shows the age- and sex-specific prevalence of HSV-1 IgG in the children and adults (blood donors) tested.
Of the 2,100 sera tested in this study, 71 showed equivocal results in either of the HSV-1 ELISAs after having been repeated twice and were excluded from the comparison of both ELISAs. Of the 32 sera that gave equivocal results in the HSV-2 gG ELISA, after having been repeated twice, 28 were negative by immunoblot assay (Table 3).
After retesting of sera that were positive in the HSV-2 gG-2 ELISA (n=201), 191 (95%) were also positive in the HSV-2 immunoblot.
Seroprevalence studies of HSV-1 and HSV-2 are vital for a better understanding of the public health importance of disease due to HSV.
As expected, the prevalence of antibodies against HSV-1 and HSV-2 was significantly lower in children and adolescents than in adults; however, for HSV-1, this concerned children only up to the age of 15 years. A considerable delay of HSV-1 infection during childhood has been reported from Finland, where only 17% of children at the age of eight years had antibodies to HSV-1 [21]. In our study, adults (blood donors) aged between 19 and 30 years had an HSV-2 seroprevalence of 13.6%.
Our finding of a higher seroprevalence of HSV-2 among women than among men is in agreement with several other studies [10,30,31].
Disclaimer: The opinions expressed by authors contributing to Eurosurveillance do not necessarily reflect the opinions of the European Centre for Disease Prevention and Control (ECDC) or the editorial team or the institutions with which the authors are affiliated.
Objectives: The risk factors associated with herpes simplex virus (HSV) seropositivity in pregnant women in Saudi Arabia are not known.
Objective: To describe the prevalence of Herpes Simplex Virus-2 (HSV-2) infection among males in six major cities of Pakistan.
Methods: A cross sectional behavioural and biological survey of urban male population aged 16-45 years was conducted in Rawalpindi, Lahore, Karachi, Faisalabad, Peshawar and Quetta to measure the prevalence of five sexually transmitted infections and assess sexual behaviours.
Conclusion: Empirical evidence from this study suggests that there is city wise variation in the prevalence of HSV-2 infection across the major cities in Pakistan. Globally Herpes Simplex Virus Type-2 (HSV-2) is amongst the most common sexually transmitted infections.1 HSV-2 seroprevalence studies show variation in infection by geographic location. Till recently, we did not have either national or city wise prevalence estimates for HSV infection in Pakistan.
The main component of the study was a cross-sectional behavioural and biological survey of 2400 men carried out in six major cities of Pakistan from June to August 2007. City selection was based on inclusion of the four provincial capitals of the country, Lahore, Peshawar, Quetta and Karachi as well as two other larger cities, Rawalpindi and Faisalabad. The structured survey questionnaire was developed taking into consideration existing questionnaires developed on this topic by previous studies such as Behavioural Surveillance Survey.8 Separate informed consent was obtained from the participants for conducting both the behavioural questionnaire and obtaining biological specimens.
The entire study was approved by the Ethical Review Boards of the Population Council in New York, the London School of Hygiene and Tropical Medicine and HOPE (Health Oriented Preventive Education), a Pakistani research NGO which has its own ethical clearance board. Of a total of 83 respondents, 12 were positive for HSV-2 infection and were also diagnosed with syphilis. In Table, the multivariate analysis shows that HSV-2 infection was significantly associated with age greater than 27 years (27 years was selected as the cut off since it was the median age of the respondents in the overall sample).
According to Corey et al,14 more than 30 epidemiologic studies have demonstrated that prevalent HSV-2 is associated with a two to four fold increased risk of HIV-1 acquisition. The clear linkage between HSV-2 infection and HIV acquisition points to the need for the prompt diagnosis and early management of HSV-2 infections as an important strategy for combating the spread of the HIV infection. An important aspect of HSV infection that raises a major public health challenge is the high proportion of infections that are unrecognized by both patients and clinicians. Many cases of genital herpes are transmitted by persons who are unaware that they are infected.
Based on the growing international evidence policy makers and programme managers should consider the prevalence of HSV-2 infection as a "canary in the mine" in predicting the emergence of a future HIV epidemic and the need to invest in HSV-2 surveillance programmes.
Future prevention intervention must therefore keep in mind targeting this specific group of older men, through focused IEC (Information, Education and Communication) and behaviour change strategies that reduce individual vulnerability by modifying sexual behaviours. To further enhance the effectiveness of prevention programmes, primary care providers should be trained to recognize, counsel and adequately manage STIs. Currently, due to paucity of specific STI clinics in the public sector facilities, most men resort to traditional or private practitioners to manage their sexual health problems. The study of Sexually Transmitted Infections among urban male population in Pakistan: Identifying the Bridging Population was commissioned by the National AIDS Control Program, Government of Pakistan, with funding from the Department for International Development (DFID), United Kingdom.
9.Enzyme-linked immunosorbent assay (ELISA) for the qualitative detection of human IgG class antibodies to HSV-2.
This journal is a member of and subscribes to the principles of the Committee on Publication Ethics.
Citation style for this article: Hill C, McKinney E, Lowndes CM, Munro H, Murphy G, Parry JV, Gill ON, the GUM Anon Network. The objective was to investigate herpes simplex virus (HSV) epidemiology amongst HIV-positive and HIV-negative men who have sex with men (MSM) in England and Wales. Samples were drawn from the National Unlinked Anonymous Survey of Genito-Urinary Medicine Clinic Attendees (GUM Anon) [16] serum archive, which includes unlinked anonymous residual blood specimens collected for routine syphilis serology at representative sentinel sexual health clinics across England and Wales. The study included a randomised age-stratified sample of 3,968 specimens from a total of 8,463 specimens obtained from MSM attending twelve sentinel sexual health clinics (seven in London and five elsewhere across England and Wales) during 2003. The legal and ethical basis for unlinked anonymous HIV testing was established before the programme began and is consistent with the Human Tissue Act 2004 and other guidelines [24]. Sixteen percent (CI: 15%-17%) of the study population were HIV-positive according to unlinked anonymous HIV antibody testing. The prevalence of HSV-2 in this study is similar or lower than those found amongst HIV-positive and HIV-negative MSM in studies elsewhere in Europe, the Americas and Australia [8]. This study also showed that seven in 10 MSM were HSV-1-positive, a rate similar to that found in other high-risk groups in Europe [8]. We thank the clinical and lab staff who collaborate in the GUM Anon survey (institutions listed below). Prevalence and correlates of herpes simplex virus type 2 infection: evaluation of behavioural risk factors.
The strong association between hsv-2 prevalence and sexual behavior in different this review summarizes and clarifies current knowledge of the prevalence of prevalence and risk factors for herpes simplex virus type 2 infection among. Psychological Stress As A Trigger For Herpes Zoster: Might The Conventional Wisdom Be Wrong? Seroprevalence of herpes simplex virus type 1 and type 2 in Thuringia, Germany, 1999 to 2006. In persons with past primary HSV-1 infection, the risk of acquiring HSV-2 is probably reduced since most antibodies cross-react between HSV-1 and HSV-2 [5].
Seroprevalence rates of HSV-1 of between 50% and 85% or more have been shown in adults from developed countries, such as Germany, Spain and Norway, in the last two decades [3,10]. Recently, gC-1 was shown to be an equivalent antigenic target for type-specific diagnosis of HSV-1 infections [15].
For detection of HSV-1-specific antibodies, results from two enzyme-linked immunosorbent assays (ELISAs) based on the detection of gG-1 or gC-1 were compared for 2,100 serum samples collected during 1999 to 2006. These samples had been taken for routine serological tests, for example, medical check-ups or determination of immune status, during 1999 to 2006.
Those that still gave equivocal results after retesting were analysed using immunoblot recomLine HSV-1 & HSV-2 IgG, as were all sera that were positive, to avoid false-positive results, as results from other studies suggests that HSV-2 ELISAs may results in false-positive results [17]. Adjusted for age, the prevalence of HSV-1 antibodies among girls aged between 0 and 18 years was significantly lower than among boys of the same age (p=0.039).
Adjusted for age, a significantly higher prevalence of HSV-2 IgG in women than in men was detected (p=0.021). In this study, we were particularly interested in determining the HSV seroprevalence of children up to the age of 18 years, since there is little known about this. After the disappearance of maternal antibodies in the first year of life, there was an increase in HSV-1 IgG prevalence to 20% by the age of 2–3 years, to 40% by 4–6 years, to almost 60% by 10–12 years, to 70% by 16–18 years and to about 80% by the age of 28–30 years.
Surprisingly, the prevalence of HSV-1 antibodies among girls was lower than among boys in our study.
In those aged 16–18 years, the prevalence increased to 7.3%, indicating a rising incidence of primary HSV-2 infections, probably due to the start of sexual activity. There was a significantly higher prevalence of HSV-2-specific antibodies among women (16%) than among men (11%) and in pregnant women, the prevalence was 18%. This may result from the differential role of sex on clinical presentation since men appear to have a higher tendency of asymptomatic HSV-2 infection [30].
A recent study revealed that gC-1 and gG-1 may be comparable antigenic targets for the serodiagnosis of HSV-1 infections [15]. Age-specific prevalence of infection with herpes simplex virus types 2 and 1: a global review.
Genital herpes simplex virus type 1 in women: detection in cervicovaginal specimens from gynecological practices in the United States.
Common use of inaccurate antibody assays to identify infection status with herpes simplex virus type 2.
Genital shedding of herpes simplex virus among symptomatic and asymptomatic persons with HSV-2 infection. Herpes simplex and varicella-zoster virus infections during pregnancy: current concepts of prevention, diagnosis and therapy. Herpes simplex virus: incidence of neonatal herpes simplex virus, maternal screening, management during pregnancy, and HIV.


Seroprevalence of herpes simplex virus type 1 and type 2 in selected German populations-relevance for the incidence of genital herpes. Early acquisition of herpes simplex virus type 1 antibodies in children–a longitudinal serological study. Antigenic differences between HSV-1 and HSV-2 glycoproteins and their importance for type-specific serology.
The glycoproteins C and G are equivalent target antigens for the determination of herpes simplex virus type 1-specific antibodies.
Die (Weiter-) Verwendung von menschlichen Korpermaterialien fur Zwecke der medizinischen Forschung (2003) [The (further) use of human body samples for the purpose of medical research (2003) English translation of the title]. Prevalence of herpes simplex virus types 1 and 2 among children and adolescents attending a sexual abuse clinic.
Development of antibodies against cytomegalovirus, varicella-zoster virus and herpes simplex virus in Finland during the first eight years of life: a prospective study.
National seroprevalence and trends in herpes simplex virus type 1 in the United States, 1976-1994.
Prevalence of antibodies against herpes simplex virus types 1 and 2 in children and young people in an urban region in Tanzania. Herpes simplex virus infection in pregnancy and in neonate: status of art of epidemiology, diagnosis, therapy and prevention. Seroprevalence study of herpes simplex virus type 2 among pregnant women in Germany using a type-specific enzyme immunoassay. The burden of infection with HSV-1 and HSV-2 in England and Wales: implications for the changing epidemiology of genital herpes.
Premarket evaluation of a commercial glycoprotein G-based enzyme immunoassay for herpes simplex virus type-specific antibodies.
Comparison of four enzyme immunoassays with a western blot assay for the determination of type-specific antibodies to herpes simplex virus. Novel recombinant ELISA assays for determination of type-specific IgG antibodies against HSV-1 and HSV-2. Neither ECDC nor any person acting on behalf of ECDC is responsible for the use that might be made of the information in this journal. This study was aimed at identifying the sociodemographic variables associated with seroprevalence of HSV-1 and HSV-2 in pregnant women in a Saudi hospital. Prevalence of herpes simplex virus types 1 and 2 and associated sociodemographic variables in pregnant women attending King Fahd Hospital of the university. Seroprevalence, incidence of prenatal infections and reliability of maternal history of varicella zoster virus, cytomegalovirus, herpes simplex virus and parvovirus B19 infection in South-Western Finland. The burden of infection with herpes simplex virus type 1 and type 2: seroprevalence study in Estonia. Seroprevalence of herpes simplex virus types 1 and 2, Epstein-Barr virus, and cytomegalovirus in children with acute lymphoblastic leukemia in Egypt. Prevalence and risk factors for herpes simplex virus type 2 infection among pregnant women in Israel.
Genomic variation among herpes simplex virus type 1 strains: virus DNA analysis of isolates from Saudi patients. Hearing impairment among children in Saudi Arabia: familial incidence and potential risk factors.
Herpes simplex virus type 1 (HSV-1) and varicella-zoster virus (VZV) infections in Saudi Arabia. Genital herpes simplex virus infections: laboratory confirmation in diverse patient groups. Seroepidemiological prevalence of IgG antibodies to Herpesviruses in the human population of Makkah. Analysis of Herpes Simplex 1 and 2 IgG and IgM Antibodies in Pregnant Women and their Neonates. Premarket evalu­ation of a commercial glycoprotein G-based enzyme immunoassay for herpes simplex virus type-specific an­tibodies.
In 2007 the Ministry of Health and the National Aids Control Program (NACP) commissioned a behavioural and biological study of urban male population that was implemented by the Population Council.
Only male population were selected as they constitute the bridging population that is a conduit for the spread of sexually transmitted infections from high to low risk general population.
A multistage sampling design was employed to select a total of 400 men aged 16-45 years in each city.
Two data collection teams, each comprising a doctor, phlebotomist, lab technician and two social interviewers remained in the field for 45 days in each city. Proportion of unmarried respondents was 47 percent of which 80 percent were employed and 14 percent were illiterate.
Nine respondents who tested positive for HSV-2 reported as never having had sexual intercourse in their life times. The presence of a concentrated epidemic in the high risk groups suggests the need for more targeted interventions at mitigating high risk behaviours including the acquisition of sexually transmitted infections. Up to 70 percent of genital HSV infections are unrecognized.3 Asymptomatic infection plays a major role in maintaining viral circulation in society.
Results from this study also show the relationship between educational level and infection prevalence to be city specific.
Counseling will play an important role in preventing transmission to the partner and subsequent neonatal mortality. These practitioners mostly prescribe antibiotics which may cover bacterial infections, but they do not treat viral infections. Appropriate strategies for preventing acquisition and management of Sexually Transmitted Infections should be amongst the priorities for curtailing the future spread of an HIV epidemic in Pakistan. Human immunodeficiency virus infection and genital ulcer disease in South Africa: the herpetic connection.
Trends in HIV-1 and HIV-2 prevalence and risk factors in pregnant women in Harare, Zimbabwe. HIV testing in national population-based surveys: experience from the Demographic and Health Surveys. Etiology of genital ulcers and prevalence of human immunodeficiency virus coinfection in 10 US cities. Sero-epidemiological and sociological patterns of herpes simplex virus infection in the world.
The epidemiology of herpes simplex virus type-2 infection among married women in Mysore, India.
The effects of herpes simplex virus-2 on HIV-1 acquisition and transmission: a review of two overlapping epidemics.
Seroepidemiological study of herpes simplex virus types 1 and 2 in Brazil, Estonia, India, Morocco, and Sri Lanka. Antibody to herpes simplex virus type 2 as a marker of sexual risk behavior in rural Tanzania. High seroprevalence of HSV-1 and HSV-2 in STD clinic attendees and non-high risk controls: A case control study at a referral hospital in South India. Unlinked anonymous sera from 3,968 MSM attending 12 sexual health clinics in 2003 were tested for HIV, HSV-2 and HSV-1 antibodies. In the UK as elsewhere in Western Europe, there are high rates of sexually transmitted infections (STI) (other than HSV) amongst MSM, particularly HIV-positive MSM [12,13], and there have been increasing diagnoses of anogenital herpes reported by sexual health clinics [9]. For each serum limited information was available, including prevention group, prior knowledge of HIV status and diagnoses received at the visit. All sera were tested for HSV-2 and HSV-1 antibodies using a pair of enzyme immunoassays that distinguish the type-specific antibody response against HSV-2 and HSV-1 [20]. Approval was received from local ethics committees covering each site where the GUM Anon survey was underway. This is of concern, given the increasing evidence for the role of HSV-2 in HIV progression, onward transmission and acquisition [1-3]. This is consistent with the global epidemiology: whilst there is considerable variation in HSV-2 prevalence worldwide, in general, HSV-2 prevalence is lower in Europe than in Africa and the Americas [8,11]. The role of anti-HSV therapeutics in the HIV-infected host and in controlling the HIV epidemic.
Herpes simplex virus 2 infection increases HIV acquisition in men and women: systematic review and meta-analysis of longitudinal studies. Sexually transmitted infections in Western Europe among HIV-positive men who have sex with men. Genital herpes serotesting: a study of the epidemiology and patients' knowledge and attitude among STD clinic attenders in Coventry, UK. Antibody to herpes simplex virus type 2 as serological marker of sexual lifestyle in populations.
The public health applications of unlinked anonymous seroprevalence monitoring for HIV in the United Kingdom. GACPAT HIV 1 + 2: a simple, inexpensive assay to screen for, and discriminate between, anti-HIV 1 and anti-HIV 2. HIV incidence appears constant in men who have sex with men despite widespread use of effective antiretroviral therapy. Monoclonal antibody blocking tests for the detection of HSV-1- and HSV-2-specific humoral responses: comparison with western blot assay.
Performance of Commercially Available Enzyme Immunoassays for Detection of Antibodies against Herpes Simplex Virus Type 2 in African Populations.
A monoclonal blocking EIA for herpes simplex virus type 2 antibody: validation for seroepidemiological studies in Africa. Human tissue and biological samples for use in research: Operational and ethical guidelines.
Clinical efficacy of high-dose acyclovir in patients with human immunodeficiency virus infection: a meta-analysis of randomized individual patient data. The seroprevalence of herpes simplex virus type 2 (hsv-2) infection was population to be at risk of both hsv-2 and hiv infection, hsv-2 prevalence data are. Herpes simplex virus type 2 (hsv-2) is the leading cause of genital hsv-2 infection represents a risk factor for the acquisition and from the behavioral factors evaluated, those that. Herpes simplex virus type 2 (hsv-2) is similarly for hsv-2 with elisa and surveyed for sexual risk behavior and prevalence of hsv-2 antibodies was 3. Herpes simplex virus type 2 seroprevalence among three female population of type 2 herpes simplex virus (hsv-2) infection and risk factors in three female significant differences in the prevalence of viral infection by population groups. There are two types, HSV-1 and HSV-2, which differ not only genetically but also in the principal route of transmission, the body site predominantly affected, seroprevalence and rate of reactivation [1]. Although no clinical signs can be recognised in many people with HSV-2 infections, as is also the case for HSV-1 infections, asymptomatic people can shed the virus, and thus there is a substantial risk of viral transmission to their sexual partners [6].
For HSV-2, seroprevalence varied as a function of age, sex, number of lifetime sexual partners and socio-economic status [3,10].
For all people whose samples were included, the clinical or laboratory data did not indicate the presence of infectious diseases. According to the Central Ethical Committee of Germany [16], when residual samples are used for research studies, patient consent is not required in exceptional cases and the effort needed to obtain the consent is not justifiable. A standard curve based on the extinction values of three calibration sera containing 2, 20 or 200 relative units (RU) per mL was used to the calculate results. However, a limitation of the study is that the collection of sera over a seven-year period may mask changes in seroepidemiology. These data add to previous findings from the German population, using a relatively small number of sera from infants, children and adolescents [10]. However, the difference in prevalence between pregnant women and female blood donors was statistically not significant. To our knowledge, the study presented here is the first comprehensive serosurvey that includes both gG-1- and gC-1-based ELISAs. Materials and Methods: This is a hospital-based cross-sectional study that included all pregnant mothers who delivered at King Fahd Hospital of the University (KFHU) over a period of two years (November 2002 to October 2004). In each city 10 blocks demarcated by the Population Census Organization were selected based on probability proportional to socio-economic status. The two main objectives of this DFID-funded study were to estimate the prevalence of five commonly occurring STIs, including HIV, in six major cities of the country and to document sexual behaviours amongst urban male population. In the first stage 10 blocks demarcated by the Population Census Organization (that comprise 200-250 households) were selected in each city based on probability proportionate to socio-economic status using male and female literacy as a proxy indicator for economic status.


Data analysis included descriptive statistics measuring frequencies, bi and multivariate analysis based on logistic regression models. In total 106 individual respondents were diagnosed with one of the five STIs, out of which 83 cases were diagnosed with HSV-2 infection. Association was also observed between presence of HSV-2 infection and respondents having four or more non-marital sexual partners (either male or female) in the last 12 months [adjusted O.R.
Having multiple partners is statistically significantly associated with disease occurrence. For instance, Rawalpindi with a high male literacy rate (82 percent) had the lowest prevalence of HSV-2. To ensure adequate treatment, antibody specific tests for HSV-2 detection should be made available on an incremental basis at all tertiary level care facilities, at least at the district headquarter hospitals where functional laboratories are already present. Mass awareness must be created in the general population to access services from trained providers who have the facilities to provide information, counseling, testing, and appropriate treatment.
Rana Muzaffar, Head of Molecular Biology at Sindh Institute of Urology and Transplantation (SIUT), and her team, Dr.
For HIV-negative individuals, HSV-2 infection increases the risk of HIV acquisition more than two-fold [1,3,5,6], although trials to date have failed to show an impact of HSV medication on HIV acquisition [1-3].
However, information on the prevalence of HSV amongst HIV-positive and HIV-negative MSM in the UK is not available: the infection is primarily asymptomatic or unrecognised and serological screening is not routinely performed [3,5]. They utilise type-specific murine monoclonal antibodies whose binding to the homologous HSV antigen is blocked when the specimen under test also contains the homologous antibody type.
Among HIV-positive individuals, the association of HSV-2 and HSV-1 serostatus with knowledge of HIV serostatus, recently acquired HIV infection (derived through STARHS) and other characteristics was investigated.
The prevalence rates may be an underestimate of current rates amongst MSM attending sexual health clinics, as the annual number of ano-genital herpes diagnoses in sexual health clinics and the prevalence of HIV and other STI have increased since 2003 [9].
In our study, the prevalence of HSV-2 amongst MSM born in sub-Saharan Africa was not different to that amongst UK-born MSM, even after adjusting for age and other factors. Unfortunately, no culture or PCR result was available from the genital ulcers to determine the type causing the presenting ano-genital disease. Prevalence rate ratios described the association between hsv infection and its risk factors, using log binomial. The prevalence of HSV-1 antibodies among girls was significantly lower than among boys and a significantly higher prevalence of HSV-2 IgG in women than in men was detected. Even though the risk of vertical viral transmission is lower than that for acquiring primary infection, recurrent genital herpes must be regarded as the most common cause of neonatal infections [7]: up to 85% of neonatal herpes infections are caused by HSV-2 [8], which are associated with a poor prognosis [9].
In Germany, the prevalence of HSV-1 IgG antibodies reached levels of more than 90% in adults during 1996 to 1998, whereas about 15% of adults possessed IgG antibodies to HSV-2 [10]. Our findings are in contrast to the study from Davidovici et al., which demonstrated significantly higher HSV-1 seroprevalence in females aged 10–19 years in Israel [22]. The seroprevalence data of HSV-2 in blood donors in this study are comparable with findings from other parts of Germany [10]. Saschenbrecker are employed by the Institute of Experimental Immunology (affiliated to Euroimmun AG), and M. Anti-HSV-1 and anti-HSV-2 IgG and IgM antibodies were determined using type-specific ELISA. This paper discusses results related to the prevalence of HSV-2 infection amongst males in the six major cities of Pakistan. Within each block 40 individuals were selected from each household through systematic sampling with a random start. All specimens were transported to the laboratory of the Sindh Institute of Urology and Transplantation at Karachi. In this paper the multivariate analysis has looked at the association of the independent factors age, education, marital status, sex in the last three months and number of partners with the presence of HSV-2 infection. The results related to the prevalence of Genital Herpes (HSV-2) in the six major urban centres of the country are presented in Figure. With a concentrated HIV epidemic already manifest in the high risk groups, genital herpes may serve as a conduit for the spread of subsequent HIV infections into the general low risk population of women. On the other hand Karachi which is a metropolitan city with a large migrant population of unskilled workers and a lower male literacy level (72 percent) had the highest prevalence of all six cities. Furthermore health educational campaigns launched through health facilities should educate men about risk factors and the need for periodic testing in order to avoid complications that can occur in case they remain asymptomatic for long.
The impact of HSV-1 on HIV is less researched, possibly as it causes genital herpes with less severe symptoms and less frequent recurrences [7] and because it is primarily acquired orally early on in childhood in most countries with a high HIV incidence [7,8]. Specimens that inhibit the binding of the monoclonal antibody by ≥50% are considered to be positive for that HSV type-specific antibody. Additional information such as ethnicity and sexual behaviour would be needed to understand how MSM born in sub-Saharan Africa attending sexual health clinics in England and Wales differ from the overall population in their region of birth. Most of those diagnosed with a first attack of ano-genital herpes who were HSV-1 seropositive only may have been infected with HSV-2 as well but had not yet seroconverted. The reduced incidence of HSV-1 infections during childhood, especially in girls, has to be followed up since a higher number of primary HSV-2 infections may result.
In HSV-1 infection, the body above the waist is predominantly affected; in HSV-2, it is mainly below the waist.
Further studies revealed that the prevalence of antibodies to both HSV types has not changed over the last two to three decades in Germany [11]. In keeping with the findings from Israel, our study suggests that HSV-1 infection is being acquired later in life. It should not be forgotten, however, that the low HSV-2 IgG prevalence might also be caused, at least partially, by false-positive test results because of the limited specificity of HSV-2 antibody tests [17]. The considerably lower seroprevalence rate of 8.9% among pregnant women from Stuttgart (Germany) [28] can only be interpreted in the context of the different serological methods used and differences between the populations tested. Except where otherwise stated, all manuscripts published after 1 January 2016 will be published under the Creative Commons Attribution (CC BY) licence. Although HSV-2 has a predilection for the genital mucosae, genital herpes can be caused by either HSV-1 or 2.
In total 2400 men were administered a behavioural questionnaire and 2396 provided biological specimens for laboratory testing. Informed consent was obtained for both the interview and the sampling of biological specimens. Specimens were airlifted to Karachi taking special precautions during transportation that included maintaining the cold chain and avoidance of spillage and contamination of the specimens. On the other hand, occupation, income and marital status were not found to be significantly associated. Future prevention programmes must, therefore, be cognizant of and adapt as needed, to city differentials.
Encouraging a healthy lifestyle by providing youth with life skills education within schools can be an effective approach in reaching out to young men.
It is of concern that one in two HIV-positive MSM and one in six HIV-negative MSM may be infected with HSV-2, given increasing evidence of its impact on HIV progression, onward transmission and acquisition.
However, 50% of diagnoses of first attacks of ano-genital herpes amongst MSM in the United Kingdom (UK) are now caused by HSV-1 [5,7,9,10].
Sera from individuals with a previously undiagnosed HIV infection were further examined by the Serological Testing Algorithm for Recent HIV Seroconversion (STARHS) using the ‘detuned’ Vironostika HIV-1 microelisa test (bioMerieux). For HSV-1, primary infections occur mostly during infancy and childhood, after maternal antibodies have disappeared in the first year of life. However, only a few studies have analysed the time of HSV seroconversion during infancy, childhood and adolescence.
Seroprevalence was calculated only on the basis of the ELISAs using gG-1 and gG-2 and the retest results using an immunoblot assay, where appropriate.
The age- and sex-specific prevalence of HSV-2 IgG in the children and adults (blood donors) tested is shown in the Figure. This is in contrast to data from the data from the United States, where 68% of the population aged over 12 years had HSV-1 antibodies [23], The overall age-specific HSV seroprevalence rates in childhood obtained from Brazil are 1.5 times higher [24] and the figures from Tanzania are two to three times higher [25] than in this study, from one part of Germany. A review of the literature suggests that the incidence of neonatal diseases caused by both types of HSV ranges widely, from 5 to 31 per 100,000 live births [27]. These factors have also to be considered for the interpretation of data from several countries, where HSV-2 seroprevalence ranged from 4% (in England and Wales) to 24% (in Bulgaria) [29]. You are free to share and adapt the material, but you must give appropriate credit, provide a link to the licence, and indicate if changes were made.
Special containers were provided by Sind Institute of Urology and Transplantation for this purpose.
Without treatment 70 percent of neonates with disseminated infections are unable to survive19 and half of the survivors develop neurological conditions. The empirical evidence from the literature has shown a higher seroprevalence of HSV-2 among females as compared to males.21-23 This argues for the inclusion of women in the overall STI prevention strategy. The information must include messages that conform to our religious and societal norms and emphasize behaviours such as abstinence and marital fidelity along with explanations of the modes of transmission and associated morbidities of sexually transmitted infections. To date results have been disappointing from trials aimed at reducing HIV onward transmission and HIV acquisition using HSV antiviral medication. The mean time since seroconversion for sera testing positive for recently acquired HIV infection by the detuned test is six months [19]. In particular, little is known about the seroprevalence of HSV-2 in children: seroprevalence in childhood is often used to estimate the incidence of intrauterine and neonatal HSV-2 infections. Relatively high prevalence rates of HSV-2 infection in Tanzanian children suggest that non-sexual transmission of HSV-2 (e.g. The overall refusal rate was 37 percent well within the range of other surveys comprising male population.7,8 The sample size calculations were based on a conservative expected 7 percent prevalence of any tested STI (chlamydia, gonorrhea, or syphilis).
However, recent research in an African context demonstrates the efficacy of HSV antivirals in delaying HIV progression. Coping strategies and behavioural changes following a genital herpes diagnosis herpes simplex virus type 2 incidence and associated risk factors among female sex. Recent studies have shown that nearly one third of children in Sweden [12] have been infected with HSV-1 and there is a gradual development of antibodies throughout childhood [3,12].
Since previous infection with HSV-1 may protect against HSV-2 infection or attenuate the severity of disease, lower antibody prevalence among girls may result in a higher number of primary HSV-2 infections that are mostly localised in the genital tract in sexually active individuals. Expected compliance for the biological data collection was 70 percent, based on the pretest results. The high prevalence of HSV-2 amongst HIV-positive MSM suggests that an increased focus on HSV control in the management of HIV amongst MSM in the United Kingdom (UK) may be warranted. In contrast, HSV-2 antibodies have been reported to appear generally after sexual debut [3,13]. Hence, a reduced incidence of HSV-1 infections during childhood and adolescence, especially in girls, has to be followed up in further HSV-1 seroprevalence studies.
In the USA, there is more than 45 million people currently infected with HSV, with <1 million cases diagnosed yearly. The design effect (which takes into account the increase in standard errors due to clustering) was set at 2.0.
This test qualitatively detects the presence or absence of human lgG class antibodies to HSV-2 in human sera. Given this and existing research on the high prevalence of genitally acquired HSV-1 amongst MSM in the UK, further research is also warranted into the role of HSV-1 in the HIV epidemic in this context.
Bmc infectious diseases herpes simplex virus type 2 (hsv-2) is the leading cause of genital associations between risk factors and hsv-2 seropositivity. Using multiple regression analysis, the prevalence of HSV-2 IgG was found to increase in older mothers (p = 0.037).
The focus diagnostics ELISA uses purified recombinant type specific IgG-2 antigen immobilized on polystyrene microwells. No statistically significant association was found between HSV seroprevalence and other socio demographic variables. Risk factors for infection with herpes simplex virus type 2: role of smoking, douching, uncircumcised males, and vaginal.
The proposed sample size was also justified in terms of its power to detect behavioural change with statistical confidence.



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Comments
  1. Agamirze 23.03.2014 at 19:12:38
    Minerals and several other trace minerals.
  2. TM_087 23.03.2014 at 19:30:34
    Alone, herpes infects greater than three-quarters of one million new central nervous system infections, whereas HSV-2.