Fleming D T, McQuillan G M, Johnson R E, Nahmias A J, Aral S O, Lee F K, St Louis M E
National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
N Engl J Med. 1997 Oct 16;337(16):1105-11. doi: 10.1056/NEJM199710163371601.
Herpes simplex virus type 2 (HSV-2) infection is usually transmitted sexually and can cause recurrent, painful genital ulcers. In neonates the infection is potentially lethal. We investigated the seroprevalence and correlates of HSV-2 infection in the United States and identified changes in HSV-2 seroprevalence since the late 1970s.
Serum samples and questionnaire data were collected during the National Health and Nutrition Examination Surveys (NHANES) II (1976 to 1980) and III (1988 to 1994). HSV-2 antibody was assessed with an immunodot assay specific for glycoprotein gG-2 of HSV-2.
From 1988 to 1994, the seroprevalence of HSV-2 in persons 12 years of age or older in the United States was 21.9 percent (95 percent confidence interval, 20.2 to 23.6 percent), corresponding to 45 million infected people in the noninstitutionalized civilian population. The seroprevalence was higher among women (25.6 percent) than men (17.8 percent) and higher among blacks (45.9 percent) than whites (17.6 percent). Less than 10 percent of all those who were seropositive reported a history of genital herpes infection. In a multivariate model, the independent predictors of HSV-2 seropositivity were female sex, black race or Mexican-American ethnic background, older age, less education, poverty, cocaine use, and a greater lifetime number of sexual partners. As compared with the period from 1976 to 1980, the age-adjusted seroprevalence of HSV-2 rose 30 percent (95 percent confidence interval, 15.8 to 45.8 percent). The seroprevalence quintupled among white teenagers and doubled among whites in their twenties. Among blacks and older whites, the increases were smaller.
Since the late 1970s, the prevalence of HSV-2 infection has increased by 30 percent, and HSV-2 is now detectable in roughly one of five persons 12 years of age or older nationwide. Improvements in the prevention of HSV-2 infection are needed, particularly since genital ulcers may facilitate the transmission of the human immunodeficiency virus.
2型单纯疱疹病毒（HSV-2）感染通常通过性传播，可导致复发性疼痛性生殖器溃疡。在新生儿中，这种感染可能是致命的。我们调查了美国HSV-2感染的血清流行率及其相关因素，并确定了自20世纪70年代末以来HSV-2血清流行率的变化。
在第二次（1976年至1980年）和第三次（1988年至1994年）国家健康和营养检查调查（NHANES）期间收集血清样本和问卷数据。使用针对HSV-2糖蛋白gG-2的免疫斑点试验评估HSV-2抗体。
1988年至1994年，美国12岁及以上人群中HSV-2的血清流行率为21.9%（95%置信区间为20.2%至23.6%），相当于非机构化平民人口中有4500万人感染。女性的血清流行率（25.6%）高于男性（17.8%），黑人（45.9%）高于白人（17.6%）。在所有血清呈阳性的人中，不到10%报告有生殖器疱疹感染史。在多变量模型中，HSV-2血清阳性的独立预测因素为女性、黑人种族或墨西哥裔美国人种族背景、年龄较大、教育程度较低、贫困、使用可卡因以及一生中有更多性伴侣。与1976年至1980年期间相比，经年龄调整的HSV-2血清流行率上升了30%（95%置信区间为15.8%至45.8%）。白人青少年中的血清流行率增长了四倍，20多岁白人中的血清流行率增长了一倍。在黑人和老年白人中，增长幅度较小。
自20世纪70年代末以来，HSV-2感染率增加了30%，现在在全国12岁及以上的人群中，大约五分之一的人可检测到HSV-2。需要改进HSV-2感染的预防措施，特别是因为生殖器溃疡可能会促进人类免疫缺陷病毒的传播。
