Trends in herpes simplex virus type 1 and type 2 seroprevalence in the United States
Trends in herpes simplex virus type 1 and type 2 seroprevalence in the United States
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DOI：
10.1001/jama.296.8.964
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发表时间：
2006-08-23
影响因子：
120.7
通讯作者：
Markowitz, Lauri E.
中科院分区：
文献类型：
--
作者：
Xu, Fujie;Sternberg, Maya R.;Markowitz, Lauri E.
单纯疱疹病毒1型（HSV-1）和2型是世界范围内常见的感染。单纯疱疹病毒2型（HSV-2）是大多数生殖器疱疹的原因，几乎总是通过性传播。相比之下，HSV-1通常在儿童时期通过非性接触传播。预先存在的HSV-1抗体可以减轻随后获得的HSV-2的临床表现。此外，HSV-1已成为生殖器疱疹的一个重要原因，在一些发达counts. ObjectiveTo检查HSV-1和HSV-2血清阳性率的趋势，在美国1999-2004年与1988- 1994年相比。设计，设置，和参与者横断面，全国代表性调查（美国国家健康和营养检查调查[ NHANES]），用于比较1999-2004年与1988 - 1994年的国家血清阳性率估计值，并对1976-1980年HSV-1、HSV-2血清阳性率的变化进行了回顾。主要结果测量HSV-1和HSV-2抗体的血清阳性率，基于型特异性免疫斑点试验的结果;结果年龄校正后的HSV-2血清阳性率为17.0%（95%置信区间[CI]，15.8%-18.3%）和21.0%（95% CI，19.1%-23.1%），两次调查之间相对下降19.0%（95% CI，-28.6%至9.5%; P <0.001）。1988年至2004年期间，HSV-2血清阳性率的下降尤其集中在14至19岁的人群中。在17至19岁的青少年和年轻人中，即使在调整了性行为的变化后，HSV-2血清阳性率的下降也是显著的。在HSV-2感染者中，报告被诊断患有生殖器疱疹的百分比存在统计学差异（1999-2004年为14.3%，1988-1994年为9.9%; P = 0.02）。HSV-1的血清阳性率从1988-1994年的62.0%（95%CI，59.6%-64.6%）下降到1999-2004年的57.7%（95%CI，55.9%-59.5%），两次调查之间相对下降6.9%（95%CI，-11.6%至-2.3%; P =. 006）。与1988-1994年相比，1999-2004年在感染HSV-1但未感染HSV-2的人中，（分别为1.8%和0.4%;结论这些数据显示HSV-2血清阳性率下降，提示在美国HSV-2血清阳性率增加的轨迹已经逆转。HSV-1的血清阳性率下降，但HSV-1引起的生殖器疱疹的发病率可能增加。
Context Herpes simplex virus type 1 (HSV-1) and type 2 are common infections worldwide. Herpes simplex virus type 2 (HSV-2) is the cause of most genital herpes and is almost always sexually transmitted. In contrast, HSV-1 is usually transmitted during childhood via nonsexual contacts. Preexisting HSV-1 antibodies can alleviate clinical manifestations of subsequently acquired HSV-2. Furthermore, HSV-1 has become an important cause of genital herpes in some developed countries.Objective To examine trends in HSV-1 and HSV-2 seroprevalence in the United States in 1999-2004 compared with 1988-1994.Design, Settings, and Participants Cross-sectional, nationally representative surveys (US National Health and Nutrition Examination Surveys [ NHANES]), were used to compare national seroprevalence estimates from 1999-2004 with those from 19881994, and changes in HSV-1 and HSV-2 seroprevalence since 1976-1980 were reviewed. Persons aged 14 to 49 years were included in these analyses.Main Outcome Measures Seroprevalence of HSV-1 and HSV-2 antibodies based on results from type-specific immunodot assays; diagnosis of genital herpes.Results The overall age-adjusted HSV-2 seroprevalence was 17.0% (95% confidence interval [CI], 15.8%-18.3%) in 1999-2004 and 21.0% (95% CI, 19.1%-23.1%) in 1988-1994, a relative decrease of 19.0% between the 2 surveys (95% CI, -28.6% to -9.5%; P < .001). Decreases in HSV-2 seroprevalence were especially concentrated in persons aged 14 to 19 years between 1988 and 2004. In adolescents aged 17 to 19 years and young adults, the decreases in HSV-2 seroprevalence were significant even after adjusting for changes in sexual behaviors. Among those infected with HSV-2, the percentage who reported having been diagnosed with genital herpes was statistically different (14.3% in 1999-2004 and 9.9% in 1988-1994; P =.02). Seroprevalence of HSV-1 decreased from 62.0% (95% CI, 59.6%-64.6%) in 1988-1994 to 57.7% (95% CI, 55.9%-59.5%) in 1999-2004, a relative decrease of 6.9% between the 2 surveys (95% CI, -11.6% to -2.3%; P =. 006). Among persons infected with HSV-1 but not with HSV-2, a higher percentage reported having been diagnosed with genital herpes in 1999-2004 compared with 1988-1994 (1.8% vs 0.4%, respectively; P < .001).Conclusions These data show declines in HSV-2 seroprevalence, suggesting that the trajectory of increasing HSV-2 seroprevalence in the United States has been reversed. Seroprevalence of HSV-1 decreased but the incidence of genital herpes caused by HSV-1 may be increasing.