Seroprevalence of herpes simplex virus-2 infection among women seeking medical care for signs and symptoms of vaginitis.

Two identically designed studies were conducted to determine the prevalence of herpes simplex virus type 2 (HSV-2) infection and viral shedding among women with no known history of genital herpes or HSV-2 seropositivity, who sought care at a US-based obstetrics/gynaecology clinic because of recurrent signs and symptoms of vaginitis. Samples comprised 50 women of any race (All-Comers Sample; Study 1) and 49 black women (Black Sample; Study 2) diagnosed at the clinic visit with vaginitis on the basis of standard work-up and medical history. In the All-Comers Sample, 15 (30%) women were HSV-2 seropositive and two (4%) were positive for HSV-2 by polymerase chain reaction (PCR); these two patients were also HSV-2 seropositive. Therefore, among patients seropositive for HSV-2, two (13%) were shedding virus at the time of the clinic visit. In the Black Sample, 25 (51%) were HSV-2 seropositive and two (4%) were PCR positive for HSV-2. Factors associated with HSV-2 seropositivity included age >30 years, erythema on pelvic examination, age < or = 15 years at first intercourse and having more than four lifetime sexual partners. The high prevalence of HSV-2 infection in these samples underscores the need to test for HSV-2 infection in women consulting with signs and symptoms of vaginitis.