Da Rosa-Santos O L, Gonçalves Da Silva A, Pereira A C
Department of Medical Clinics (Dermatology), Clementino Fraga Filho University Hospital, Rio de Janeiro, Brazil.
Int J Dermatol. 1996 Nov;35(11):794-6. doi: 10.1111/j.1365-4362.1996.tb02976.x.
The incidence of genital herpes is increasing worldwide. Herpes simplex virus type 2 (HSV-2) is the most common cause of genital ulcerations among the sexually transmitted diseases (STDS). In order to investigate the sexual transmission of genital herpes infection in Brazil, the prevalence of specific antibodies to HSV-2, in populations of high and low risk for STDS was evaluated.
The population at low risk for STDS was composed of 155 voluntary blood donors at the University Hospitals between February and August, 1994. The population at high risk for STDS was composed of 85 HIV-seropositive persons, consisting of homosexual and promiscuous heterosexual men. A group of 20 highly active prostitutes was also studied between May and July, 1994. All blood samples were screened using an enzyme-linked immunosorbent assay (ELISA) that detects type-specific antibodies to HSV-2 glycoprotein G. Before donating blood, all persons in the study group were given a questionnaire concerning risk factors for acquisition of STDS and suitable to show the socioepidemiologic characteristics of the subjects.
The prevalence of ELISA showing HSV-2 infections among HIV-seroposite persons, was 73% (P < 0.01). In the whole group at high risk for STDS, the prevalence was 72% (P < 0.05). Infection with HSV-2, as determined by seroprevalence, was significantly and independently associated with years of sexual activity, history of previous STDS, number of sexual partners in the previous month, number of pregnancies, and previous induced abortions, as well as the percentage of sexual acts involving receptive anal intercourse.
The current strategy for diagnosing genital HSV-2 infection misses many cases. Newly developed type-specific serologic methods can identify cases of unrecognized or subclinical infection. With the high seroprevalence rates detected, routine screening for HSV-2-specific antibodies should be considered in populations at high risk for STDS.
全球范围内生殖器疱疹的发病率正在上升。2型单纯疱疹病毒（HSV - 2）是性传播疾病（STD）中性器官溃疡最常见的病因。为了调查巴西生殖器疱疹感染的性传播情况，对STD高风险和低风险人群中HSV - 2特异性抗体的流行率进行了评估。
STD低风险人群由1994年2月至8月期间大学医院的155名自愿献血者组成。STD高风险人群由85名HIV血清阳性者组成，包括同性恋和滥交的异性恋男性。1994年5月至7月还对一组20名活跃妓女进行了研究。所有血样均采用酶联免疫吸附测定（ELISA）进行筛查，该方法可检测针对HSV - 2糖蛋白G的型特异性抗体。在献血前，研究组的所有人员都收到了一份关于感染STD风险因素的问卷，该问卷适合展示受试者的社会流行病学特征。
在HIV血清阳性者中，ELISA显示HSV - 2感染的流行率为73%（P < 0.01）。在整个STD高风险组中，流行率为72%（P < 0.05）。根据血清流行率确定，HSV - 2感染与性活动年限、既往STD病史、前一个月性伴侣数量、怀孕次数、既往人工流产次数以及涉及接受肛交的性行为百分比显著且独立相关。
目前诊断生殖器HSV - 2感染的策略遗漏了许多病例。新开发的型特异性血清学方法可以识别未被认识或亚临床感染的病例。鉴于检测到的高血清流行率，应考虑对STD高风险人群进行HSV - 2特异性抗体的常规筛查。
