       Document 0257
 DOCN  M9440257
 TI    Epidemiology of genital herpes infections.
 DT    9404
 AU    Mertz GJ; Department of Medicine, University of New Mexico, Albuquerque.
 SO    Infect Dis Clin North Am. 1993 Dec;7(4):825-39. Unique Identifier :
       AIDSLINE MED/94149265
 AB    Much has been learned in the last decade about the epidemiology of
       genital herpes infections, including new information about
       seroprevalence and the risk of transmission of genital herpes to sex
       partners and at delivery. Unfortunately, the type-specific serologic
       assays now routinely used in these studies are not widely available, and
       commercially available assays that claim to be type-specific are not.
       Thus, most clinicians still do not have access to reliable type-specific
       assays. In cross-sectional seroprevalence studies, detection of HSV-2
       antibody is positively associated with increasing age, lower levels of
       income or education, increased numbers of sexual partners, black or
       Hispanic race, female gender, male homosexual activity, and HIV
       infection. In addition, studies cited in this review have clarified the
       clinical spectrum of genital herpes infection in persons who have
       transmitted genital herpes to a sex partner, have shed virus
       asymptomatically, or are found to have HSV-2 antibody. Ten percent to
       40% of these individuals are aware that they have genital herpes,
       whereas the remaining 60% to 90% are not. Among the latter, at least
       half have a history of recurrent genital lesions typical of genital
       herpes or can be taught to recognize typical, symptomatic episodes
       within 6 months if examined promptly after the onset of any unexplained
       genital symptoms. The remainder, about a third of the total, have no
       history of genital herpes and remain asymptomatic despite a careful
       history and follow-up examinations; in women in this group, asymptomatic
       shedding of HSV can be identified. Atypical lesions appear to play an
       important but as yet incompletely defined role. Most persons who
       transmit genital herpes to a sex partner or at delivery do not have a
       history of lesions at the time of transmission of HSV infection,
       suggesting that asymptomatic shedding or atypical, unrecognized lesions
       are responsible for most cases of transmission. In heterosexual couples,
       the risk of acquisition of HSV-2 infection from a sex partner with
       genital herpes is lowest in men (less than 5%), higher in HSV-1
       seropositive women (less than 10%), and highest (about 30%) in women
       without antibody to HSV-1 or HSV-2. The risk of transmission to infants
       exposed to asymptomatic shedding at delivery is low (about 3%) in women
       with or without a history of genital herpes if HSV antibody of the same
       type is present in cord blood.(ABSTRACT TRUNCATED AT 400 WORDS)
 DE    Ethnic Groups  Female  Herpes
       Genitalis/COMPLICATIONS/DIAGNOSIS/*EPIDEMIOLOGY/  TRANSMISSION
       Herpesvirus 1, Human  Herpesvirus 2, Human  Human  HIV
       Infections/COMPLICATIONS  Infant, Newborn  Male  Pregnancy  Risk Factors
       Sex Behavior  Sexual Partners  United States/EPIDEMIOLOGY  JOURNAL
       ARTICLE  REVIEW  REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

