在澳大利亚墨尔本，一项为期 14 年的回顾性观察研究显示，女性和男性初发性生殖器疱疹患者中单纯疱疹病毒 1 型的比例不断增加。

Increasing proportion of herpes simplex virus type 1 among women and men diagnosed with first-episode anogenital herpes: a retrospective observational study over 14 years in Melbourne, Australia.

机构信息

Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia

Central Clinical School, Monash University, Melbourne, Victoria, Australia.

出版信息

Sex Transm Infect. 2019 Jun;95(4):307-313. doi: 10.1136/sextrans-2018-053830. Epub 2018 Dec 15.

DOI:10.1136/sextrans-2018-053830

PMID:30554143

Abstract

OBJECTIVES

Reports of rising herpes simplex virus type 1 (HSV-1) genital infections relative to HSV-2 have been published up to 2006 in Australia. These changes have been attributed to declining childhood immunity to HSV-1. We described the temporal trends of HSV-1 and HSV-2 up to 2017 in Melbourne, Australia, to determine if the earlier trend is continuing.

METHODS

We conducted a retrospective review of the medical records of 4517 patients who were diagnosed with first episode of anogenital HSV infection at the Melbourne Sexual Health Centre, Australia, between January 2004 and December 2017. HSV-1 and HSV-2 were calculated as a proportion of all first episode of anogenital HSV infections. The change in the proportions of HSV-1 and HSV-2 over time was assessed by a χ trend test. Risk factors associated with HSV-1 were examined using a multivariable logistic regression model.

RESULTS

The proportion of first episode of anogenital herpes due to HSV-1 increased significantly over time in women (from 45% to 61%; p<0.001) and heterosexual men (from 38% to 41%; p=0.01) but not in men who have sex with men (MSM) (p=0.21). After adjusting for condom use, partner number and age, the annual increase remained significant only in women (OR 1.08, 95% CI 1.03 to 1.13, p<0.001). In MSM, HSV-1 caused up to two-thirds of anogenital herpes in most years and HSV-1 was more likely to be diagnosed at an anal site than genital site (OR 1.69, 95% CI 1.23 to 2.32, p<0.001). Younger age (<28 years) was an independent risk factor for HSV-1 in all groups.

CONCLUSIONS

The proportion of first-episode anogenital herpes due to HSV-1 has been rising in women since 2004. HSV-1 has become the leading cause of anogenital herpes in younger populations, women and MSM.

摘要

目的

截至 2006 年，澳大利亚已有报道称单纯疱疹病毒 1 型（HSV-1）生殖器感染的比例呈上升趋势，而单纯疱疹病毒 2 型（HSV-2）的感染比例呈下降趋势。这些变化归因于儿童对 HSV-1 的免疫力下降。本研究旨在描述 2004 年 1 月至 2017 年 12 月期间在澳大利亚墨尔本性健康中心就诊的 4517 例初发性生殖器 HSV 感染患者的时间趋势，以确定这一早期趋势是否仍在继续。

方法

我们对在澳大利亚墨尔本性健康中心就诊的 4517 例初发性生殖器 HSV 感染患者的病历进行了回顾性分析。这些患者的诊断时间为 2004 年 1 月至 2017 年 12 月。计算 HSV-1 和 HSV-2 在所有初发性生殖器 HSV 感染中的比例。通过 χ 趋势检验评估 HSV-1 和 HSV-2 随时间变化的比例。使用多变量逻辑回归模型分析与 HSV-1 相关的危险因素。

结果

女性（从 45%升至 61%；p<0.001）和异性恋男性（从 38%升至 41%；p=0.01）中由 HSV-1 引起的初发性生殖器疱疹比例显著增加，但男男性行为者（MSM）（p=0.21）中没有显著增加。在调整了 condom 使用、伴侣数量和年龄后，仅在女性中，HSV-1 的年增长率仍有显著意义（OR 1.08，95%CI 1.03 至 1.13，p<0.001）。在 MSM 中，HSV-1 在大多数年份引起了多达三分之二的生殖器疱疹，并且 HSV-1 更可能在肛门部位而不是生殖器部位被诊断（OR 1.69，95%CI 1.23 至 2.32，p<0.001）。年轻（<28 岁）是所有人群中 HSV-1 的独立危险因素。