Seroprevalence of herpes simplex virus infections in a family medicine clinic
L. Oliver, A. Wald, M. Kim, J. Zeh, S. Selke, R. Ashley and L. Corey
Department of Family Medicine, University of Washington, Seattle.
OBJECTIVES: To determine the prevalence of herpes simplex virus (HSV)
antibody in a general medical practice setting and to assess the frequency
of subclinical infection. DESIGN: Prevalence study. SETTING: A family
practice clinic at the University of Washington Medical Center, Seattle.
PARTICIPANTS: Five hundred randomly selected patients between the ages of
18 and 45 years. MAIN OUTCOME MEASURES: Serum samples were tested by
Western blot assay to detect the presence of antibody to HSV type 1 (HSV-1)
and HSV-2. Demographic information and clinical history of oral and genital
herpes were obtained. RESULTS: One hundred fourteen patients (23%) were
seropositive for HSV-2 antibody, 277 patients (56%) were seropositive for
HSV-1 antibody, 59 patients (12%) were seropositive for both HSV-2 and
HSV-1 antibodies, and 163 patients (33%) were seronegative for both. Women
were almost twice as likely as men to be seropositive for HSV-2 antibody
(28% vs 15%, P < .001). Blacks had the highest rates of HSV-2 antibody
seropositivity (60%) compared with whites (20%) and Asians (6%) (P <
.001). Other demographic correlates of seropositivity included being older,
having fewer years of education, and having public insurance. The
specificity of a clinical history of genital herpes or sores for HSV-2
infection was high (99%), but the sensitivity was low (27%). CONCLUSIONS:
Herpes simplex virus infection is common among patients seeking primary
care. Women, blacks, and patients of lower socioeconomic status are most
likely to be seropositive for HSV-2 antibody. The high frequency of
unrecognized HSV infection has implications for primary care physicians in
counseling patients regarding HSV infection and transmission.
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