Department of Mathematics, Statistics, and Physics, Qatar University, P.O. Box 2713, Doha, Qatar.
Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, P.O. Box 24144, Doha, Qatar.
BMC Med. 2019 Mar 11;17(1):57. doi: 10.1186/s12916-019-1285-x.
Herpes simplex virus type 1 (HSV-1) is a prevalent lifelong infection that appears to be undergoing an epidemiologic transition in the United States (US). Using an analytical approach, this study aimed to characterize HSV-1 transitioning epidemiology and estimate its epidemiologic indicators, past, present, and future.
An age-structured mathematical model was developed to describe HSV-1 transmission through oral and sexual modes of transmission. The model was fitted to the National Health and Nutrition Examination Surveys, 1976-2016 data series.
HSV-1 seroprevalence was projected to decline from 61.5% in 1970 to 54.8% in 2018, 48.5% in 2050, and 42.0% in 2100. In < 3 decades, seroprevalence declined by > 30% for those aged 0-19 years, but < 5% for those aged > 60. Meanwhile, the number of new infections per year (oral and genital) was persistent at 2,762,000 in 1970, 2,941,000 in 2018, 2,933,000 in 2050, and 2,960,000 in 2100. Of this total, genital acquisitions contributed 252,000 infections in 1970, 410,000 in 2018, 478,000 in 2050, and 440,000 in 2100-a quarter of which are symptomatic with clinical manifestations. For those aged 15-49 years, nearly 25% of incident infections are genital. Most genital acquisitions (> 85%) were due to oral-to-genital transmission through oral sex, as opposed to genital-to-genital transmission through sexual intercourse.
HSV-1 epidemiology is undergoing a remarkable transition in the US, with less exposure in childhood and more in adulthood, and less oral but more genital acquisition. HSV-1 will persist as a widely prevalent infection, with ever-increasing genital disease burden.
单纯疱疹病毒 1 型（HSV-1）是一种普遍存在的终身感染，在美国（US）似乎正在经历一种流行病学转变。本研究采用分析方法，旨在描述 HSV-1 流行转变的流行病学特征，并估计其过去、现在和未来的流行病学指标。
建立了一个年龄结构的数学模型来描述 HSV-1 通过口腔和性传播途径的传播。该模型拟合了 1976 年至 2016 年全国健康和营养检查调查的数据系列。
HSV-1 血清阳性率预计将从 1970 年的 61.5%下降到 2018 年的 48.5%，到 2050 年的 42.0%，到 2100 年的 42.0%。在不到 30 年的时间里，0-19 岁年龄组的血清阳性率下降了>30%，但>60 岁年龄组的血清阳性率下降了<5%。与此同时，每年（口腔和生殖器）的新感染人数保持在 1970 年的 276.2 万，2018 年的 294.1 万，2050 年的 293.3 万和 2100 年的 296.0 万。其中，生殖器感染在 1970 年贡献了 25.2 万例感染，2018 年贡献了 41.0 万例感染，2050 年贡献了 47.8 万例感染，2100 年贡献了 44.0 万例感染-其中四分之一有临床症状。对于 15-49 岁年龄组，近 25%的新感染是生殖器感染。大多数生殖器感染（>85%）是由于口对口性传播引起的，而不是由于性传播引起的生殖器对生殖器传播。
HSV-1 在美国的流行病学正在发生显著转变，儿童时期的暴露减少，成年时期的暴露增加，口腔感染减少，生殖器感染增加。HSV-1 将作为一种广泛流行的感染持续存在，并导致生殖器疾病负担不断增加。
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