Study says 1 in 5 Americans
infected with genital herpes
An estimated 45 million Americans are infected with herpes simplex virus
2 (HSV-2), reports a research team from Emory and the CDC in The New England
Journal of Medicine.
Fewer than 10 percent of those infected are aware they have the virus,
which can be transmitted to sexual partners as well as newborns at delivery.
Also known as genital herpes, HSV-2 is characterized by recurring, active
phases of painful genital blisters. When ulcers are present, one is at higher
risk for contracting and transmitting human immunodeficiency virus (HIV).
Neonates exposed during birth are at high risk for serious illness or death.
"Since the late 1970s, the prevalence of HSV-2 infection has increased
by 30 percent, and HSV-2 is now detectable in roughly one of five persons
12 years of age or older nationwide," wrote team members, including
lead author Michael St. Louis of the CDC and Andre Nahmias professor of
pediatric infectious diseases at the School of Medicine and of epidemiology
at the School of Public Health. "Improvements in the prevention of
HSV-2 infection are needed, particularly since genital ulcers may facilitate
the transmission of [HIV]."
Current study data came from information and serum samples gathered from
two National Health and Nutrition Examination Surveys (NHANES). Data from
NHANES II were gathered from a nationally representative sample of 28,000
Americans between 1976-80, and NHANES III information was collected from
40,000 Americans between 1988-94.
"The age-adjusted overall prevalence of HSV-2 antibody rose from
16 percent in NHANES II to 20.8 percent in NHANES III, a relative increase
of 30 percent," the authors wrote. "The increases in HSV-2 seroprevalence
between [the two groups] were concentrated in the younger age groups."
The team reports that HSV-2 prevalence among white teenagers has quintupled
(from 0.96 to 4.5 percent), and among whites in their 20s it has almost
doubled - from 7.7 to 14.7 percent.
Several factors were identified by the researchers to be independent
predictors of HSV-2 including female sex, African-American or Mexican-American
ethnic background, older age, inferior education, poverty, cocaine use and
a greater lifetime number of sexual partners.
"This objective type of study confirms other reports that young,
white Americans are not heeding public health messages related to the prevention
of sexually transmitted diseases-a grave problem the Institute of Medicine
calls 'the hidden epidemic,'" Nahmias said.
Nahmias led the Emory team in the '80s largely responsible for differentiating
between herpes types 1 and 2 and for showing that type 2 is venereally transmitted
and can cause serious newborn disease. His Emory colleague, Francis Lee,
associate professor of pediatric infectious diseases and a co-author of
the current study, led the team that developed the immunoassay for differentiating
HSV-2 antibodies from those associated with HSV-1, the nongenital form of
the disease. The test has been used in more than 20 countries and made possible
the evaluation of the NHANES serum samples.
Also credited with adding the "H" to the TORCH (toxoplasma,
rubella, cytomegalovirus, herpes) complex of perinatal infections through
his research on neonatal herpes simplex, in September Nahmias received the
Bristol Award from the Infectious Diseases Society of America. The award
recognizes the career contributions he has made over the past 35 years,
which have shaped current knowledge of herpes and other viruses, including
to November 3, 1997 Contents Page