Can I Catch Type 1 if I Have Type 2 Herpes
Abstract
Seroprevalence of and coinfection with canker simplex virus type 1 (HSV-1) and type ii (HSV-2) in the United states were analyzed past apply of data from a nationally representative survey (National Health and Nutrition Exam Survey Iii, 1988–1994). Evidence was explored for possible protection by prior HSV-1 infection confronting infection and clinical affliction with HSV-2. Overall, 27.1% of persons aged ≥12 years were seronegative for HSV-1 and HSV-2; 51.0% were seropositive for HSV-1 merely, 5.3% for HSV-two just, and sixteen.6% for both HSV-i and HSV-two. The seroprevalence of HSV-2 was higher in persons with HSV-1 antibody. Approximately 76% of persons who had HSV-two antibody as well had HSV-i antibody. Persons seropositive for HSV-two just reported a history of genital herpes more frequently (16.ii %) than persons seropositive for both HSV-1 and HSV-2 (5.nine %). The seroprevalence of HSV-i and historic period at infection may influence the epidemiology of clinical genital herpes, fifty-fifty if prior HSV-1 infection does not forbid HSV-ii infection.
Herpes simplex virus blazon 1 (HSV-i) and type 2 (HSV-two) are closely related [1]. Infections with HSV-ii typically bear on anogenital sites and are transmitted sexually or from a mother's genital infection to the newborn. By contrast, HSV-one normally causes orolabial infection. Manual most often occurs via nonsexual routes, although sexual and vertical transmissions as well occur. Both viruses are capable of causing either anogenital or orolabial infection and tin produce main and recurrent lesions that are clinically indistinguishable [ii].
In the United states of america, the number of medico visits for the starting time episode of genital herpes has been steadily increasing since 1970 [3]. Data from two national surveys in the Us during 1976–1980 and 1988–1994 show that, whereas the overall ageadjusted seroprevalence of HSV-2 in persons aged ≥12 years increased by xxx% between the ii surveys (from 16.0% to twenty.8%) [iv], the overall seroprevalence of HSV-ane was substantially unchanged [v; and J. Schillinger, personal communication]. These data propose that the United States has experienced an epidemic of herpes due to increasing infection with HSV-2 [6].
There are conflicting information concerning whether prior infections with HSV-ane or HSV-2 confer protection against acquisition of the other type. Some studies have suggested that prior infection with HSV-1 may provide fractional protection against infection with HSV-ii [7–10], whereas others have suggested that prior HSV-ane infection has no effect on acquisition of HSV-two [xi, 12]. Data are consequent, however, concerning the event of prior HSV-i infection on the expression of disease resulting from HSV-2 infection. Stiff bear witness indicates that prior HSV-1 infection increases the likelihood that an infection with HSV-2 will be subclinical [7, 12,13]. Some information likewise suggest that prior infection with HSV-2 can prevent infection with HSV-i [eleven, 14].
In the nowadays commodity, nosotros describe the distribution of HSV-ane and HSV-ii in the United States, using data from a nationally representative serologic sample that were nerveless during the National Health and Nutrition Examination Survey (NHANES) III from 1988 to 1994. Nosotros likewise explore evidence for possible protection by prior HSV-ane infection confronting infection and clinical disease with HSV-2, by comparing the seroprevalence of HSV-two infection and the frequency of self-reported clinical genital canker amongst individuals with and without HSV-1 infection.
Materials and Methods
Detailed descriptions of sampling and data collection procedures for NHANES III can be constitute elsewhere [fifteen]. The laboratory methods used to test NHANES serum samples for HSV antibody have as well been reported [4]. In brief, serum samples from participants aged ≥ 12 years (n = thirteen,904) were tested for antibodies to HSV-1 and HSV-2 by use of a blazon-specific immunodot analysis [16, 17]. Purified glycoproteins gG-1 of HSV-1 and gG-two of HSV-2 were used as antigens for the HSV-one and HSV-ii assays, respectively.
In this analysis, demographic variables were divers according to the recommendations of the National Center for Wellness Statistics (NCHS) for analysis of NHANES III data [18]. Of note, in NHANES III, race was defined by self-written report equally "not-Hispanic blackness," "nonHispanic white (referred to as "black" and "white" in this newspaper), "Mexican American," or "other." Persons who reported their race in other than the 3 specific categories were classified as "other." On the basis of HSV serology, we classified persons into iv serostatus groups: seronegative (HSV-1 and HSV-ii negative), HSV-1 but (HSV-1 positive and HSV-ii negative), HSV-2 only (HSV-ane negative and HSV-2 positive), and coinfected (HSV-1 and HSV-2 positive).
SUDAAN software (Release vii.5.2, Inquiry Triangle Constitute) was used for statistical analyses because of the circuitous survey pattern used in NHANES Iii. All prevalence estimates were weighted to represent the noninstitutionalized civilian U.s. population past use of weights calculated with an additional poststratification step past NCHS. Nosotros considered an estimate of seroprevalence to be unreliable if the SE was ≥ 30% of the seroprevalence estimate, and we did not present such estimates. A logistic regression procedure in SUDAAN (PROC MULTILOG) was used to study the contained association between a given serostatus category and specific demographic or behavioral variables.
Results
Prevalence of HSV infections. Overall, 27.i % of persons anile 12 years in the U.s.a. were HSV seronegative (table one), 51.0% were positive for HSV-1 but, and 5.3% were positive for HSV-2 only; 16.6% of persons were coinfected with HSV-1 and HSV-two.
Table 1.
The distribution of canker simplex virus (HSV) serostatus in persons ≥12 years of historic period by demographic and behavioral factors, National Health and Nutrition Exam Survey III (1988–1994).
Tabular array 1.
The distribution of herpes simplex virus (HSV) serostatus in persons ≥12 years of age past demographic and behavioral factors, National Wellness and Nutrition Test Survey Three (1988–1994).
Significantly more than male person (31.4%) than female person (23.2%) subjects were seronegative for HSV infection (table ane). Although the seroprevalence of HSV-i only was similar in male and female subjects, the seroprevalence of coinfection was significantly higher in female than in male subjects. The seroprevalence of HSV-one only increased with historic period from xl.0% in 12–19-year-olds to 64.5% in ≥lxx-year-olds. The seroprevalence of HSV-2 only increased from 1.2% in 12–19-year-olds to a pinnacle of 8.five% in xxx–39-yearolds. The seroprevalence of coinfection increased with increasing age and then plateaued after historic period 40 years. HSV seroprevalence also varied by race/ethnicity. Whites were significantly more likely to be seronegative than persons of other race/ethnicity. Mexican Americans had the highest seroprevalence of HSV-ane just. The seroprevalence of both HSV-2 only and coinfection was highest among blacks. Persons who were at or above the poverty index were significantly more likely to be seronegative and less likely to be coinfected than those whose incomes were below the poverty index.
The seroprevalence of coinfection was significantly higher in persons who get-go had sexual intercourse at a younger age and increased with the total number of lifetime sex partners. The seroprevalence of HSV-2 only showed a similar trend with these 2 behavioral factors. In dissimilarity, the seroprevalence of HSV-1 just did not vary past the age at first sexual intercourse and did not increase with the total number of lifetime sex activity partners (table 1).
Effects of HSV-i on HSV-ii infection. We compared the seroprevalence of HSV-two in persons with and without HSV-1 antibody. Overall, the seroprevalence of HSV-2 was significantly college in persons who were seropositive for HSV-1 than in those who were seronegative for HSV-one (P < .001). The seroprevalence of HSV-2 by HSV-1 serostatus, stratified by age and sex, is shown in effigy one. In both male and female subjects, HSV-2 seroprevalence appears to be higher in persons seropositive for HSV-ane. However, subsequently farther adjustment for race/ethnicity using logistic regression models, HSV-ii serostatus was non significantly associated with HSV-1 serostatus (P = .1).
Figure one.
Comparison of the seroprevalence of herpes simplex virus blazon ii (HSV-2) among HSV type 1 (HSV-one)-seronegative and HSV1-seropositive persons, by sex and age group, National Health and Nutrition Test Survey 111, 1988–1994 (estimates of HSV-2 seroprevalence by HSV-i infection status and sexual activity in the age group 12–19 years were considered to be unreliable and are non presented).
Figure 1.
Comparison of the seroprevalence of herpes simplex virus type 2 (HSV-ii) amongst HSV type one (HSV-1)-seronegative and HSV1-seropositive persons, by sex and age group, National Health and Nutrition Test Survey 111, 1988–1994 (estimates of HSV-2 seroprevalence past HSV-1 infection status and sex activity in the historic period group 12–19 years were considered to be unreliable and are not presented).
To further evaluate the effect of HSV-1 antibody on HSV-ii infection, we examined the proportion of persons with HSV-2 antibody who were coinfected with HSV-1. Because infections with HSV-1 are more mutual than infections with HSV-2 at younger ages, persons who are coinfected with HSV-1 and HSV2 are likely to accept acquired HSV-1 infection before HSV-2 infection. In persons who had HSV-two antibody (full n = 671+2861 = 3532; come across table 1), 75.9% too had HSV-one antibody. This per centum was similar in male and female subjects (74.five% in males and 76.8% in females; P > .two).
Reported history of clinical genital canker. To describe factors associated with clinical genital herpes, we analyzed responses of participants (aged 17–59 years) to the question, "Has a doctor always told you that you had genital herpes?" Overall, 2.8% of participants reported a history of doctor-diagnosed genital canker (table ii). The frequency of genital herpes was similar in men and women. Persons infected with HSV-2 only reported a history of genital herpes with significantly higher frequency (sixteen.ii%) than persons who were coinfected with HSV-1 and HSV-2 (5.9%). Later on adjustment for historic period, sexual practice, and race/ethnicity, persons seropositive for HSV-two but were ∼3 times more likely to written report a history of genital canker than those who had antibodies to both HSV-ane and HSV-ii (odds ratio [OR], two.9; 95% confidence interval [CI], 1.7–v.i).
Table ii.
Factors associated with reported history of clinical genital herpes among persons 17–59 years of age in National Health and Nutrition Examination Survev (NHANES) 3 (1988–1994).
Tabular array 2.
Factors associated with reported history of clinical genital canker among persons 17–59 years of historic period in National Wellness and Nutrition Examination Survev (NHANES) III (1988–1994).
Predictors for serostatus of HSV-2 only. Compared with persons coinfected with HSV-i and HSV-2 (due north = 2861), persons who were seropositive for HSV-ii merely (northward = 671) were significantly younger (mean historic period, 39 vs. 47 years), were more likely to be white (66% vs. 59%), had college levels of pedagogy (45% vs. 27% had an educational activity of > 12 years' duration), had more lifetime sex partners (median, seven vs. 5), and had an income that placed them above the poverty index (84% vs. 79%; P < .04 for all predictors). All the same, a person's sexual activity and age at showtime sexual intercourse were non associated with a serostatus of HSV-2 merely or coinfected (P > .three for both). Using a logistic regression model, nosotros establish that persons seropositive for HSV-ii merely were more likely to written report an historic period ≤39 years (OR, 1.8; 95% CI, 1.4–2.5), white race/ethnicity (OR, 1.6; 95% CI, 1.0–2.5), and teaching > 12 years (OR, 1.8; 95% CI, 1.iii–2.4), when compared with persons coinfected with HSV-1 and HSV-ii. The number of lifetime sex partners and income below or higher up the poverty index were not significantly associated with being seropositive for HSV-two only, after aligning for other variables in the model (P > .ane).
Discussion
This assay, which used nationally representative data, shows that ∼73% of the population aged ≥12 years in the United States had antibodies to 1 or both types of HSV. These data as well advise that prior HSV-1 infection reduces the likelihood that an infection with HSV-2 is symptomatic, merely it may not protect against conquering of HSV-2 infection.
Because of the cantankerous-exclusive nature of NHANES III, we cannot separate a accomplice effect from the effect of age. The seroprevalence of HSV-ii only and that of coinfection peaked earlier historic period forty years. Possible explanations for this include worsening of the HSV-2 epidemic in the United States in recent decades and a decreased likelihood for a person to acquire new HSV-ii infection afterwards age 40 years. The seroprevalence of HSV-1 increased with increasing age, which suggests that many persons may learn HSV-ane in adulthood or that earlier birth cohorts had a higher incidence of HSV-one infection than did afterward cohorts.
These data from NHANES Iii support other studies indicating that prior HSV-1 infection may not protect against acquisition of HSV-2. Absolutely, NHANES III is not platonic to study the interaction between HSV-1 and HSV-2, because the information are cross-sectional. However, because mostpeople probably learn HSV-1 earlier in life than HSV-2, we reason that, if prior HSV-1 infection had strongly protected against acquisition of HSV-two, HSV-two seroprevalence would be lower in persons with HSV-1 antibody than in those without HSV-1 antibody, and coinfection with both HSV-1 and HSV-ii would be uncommon. To the contrary, we found that the seroprevalence of HSV-two was college among persons who had HSV-1 antibody than amongst those without HSV-1 antibody, and ∼76% of persons who had HSV-two antibody as well had HSV-1 antibiotic.
Our study as well found that neither the patterns of HSV-two seroprevalence by HSV-1 serostatus nor the relative percentage of persons with HSV-2 antibody who were coinfected with HSV-ane differs past sexual practice. Several studies, however, take suggested that prior HSV-1 infection may provide partial protection against acquisition of HSV-ii infection, although the protective effect may be limited to women. A prospective report by Mertz et al. [8] establish that preexisting HSV-i antibody was associated with a reduced risk of acquisition of HSV-2 infection in women, but that was a relatively small written report based on a total of 11 HSV-2 seroconversions in women. In men, there were but 3 HSV-2 seroconversions, and no conclusions could be made. A protective effect conferred by prior HSV-ane infection in women was also suggested in a smaller prospective study by Bryson et al. [9] and in a cantankerous-exclusive report [7]. In contrast, a prospective study by Brown et al. [11] found that the conquering rate of HSV-2 was similar in pregnant women with and without prior HSV-1 infection. To engagement, the best information concerning the possible protective upshot of HSV-i antibiotic on acquisition of HSV-2 infection are from a clinical trial [12] in which 1508 persons seropositive for HSV-1 and 885 persons seronegative for HSV-one were followed prospectively. Similar to what we found in this analysis, the researchers of that clinical trial concluded that HSV-ane antibody had no effect on the charge per unit of acquiring HSV-2 infection (the HSV-2 seroconversion rate was v.1 vs. v.ii per 100 person-years in those who did and did not have preexisting HSV-1 antibody).
In a cantankerous-sectional study such as ours, the ability to detect potential protection of HSV-1 infection against HSV-2 may exist limited; persons with HSV-1 infection may be more than probable to exist exposed to HSV-2, considering the 2 viruses share some mutual social and behavioral risk factors and a common style of sexual transmission. Although the NHANES III data are not ideal to evaluate the possibility that prior HSV-1 infection may be partially protective against HSV-2, findings from our analysis advise that such protection, if any exists, may not be strong enough to exist evident in either men or women at the population level.
Our data support observations that prior HSV-1 infection alters the clinical manifestations of HSV-ii infection. Persons seropositive for HSV-ii just were ∼3 times more likely to have a history of clinical genital herpes than those coinfected with HSV-1 and HSV-two. This finding is consistent with several previous studies. Langenberg et al. [12] found that, when HSV-2 infection was newly acquired, persons who had no HSV-1 antibody were more than probable to exist symptomatic than those who were seropositive for HSV-1. Similarly, Koutsky et al. [13] constitute that persons with HSV-2 only were ii.4 times more than likely to have recognized prior episodes of genital infection than those who had both HSV-ane and HSV-2 antibodies. Taken together with our population-based data, these studies bespeak that persons infected with HSV-2 but, although accounting for but nearly i-fourth of those infected with HSV-2 in the United States, may have a disproportionate amount of the morbidity from HSV and may contribute substantially to the medical cost associated with genital herpes.
Our finding that persons seropositive for HSV-ii only were significantly younger than those coinfected has several possible explanations. One is that prior HSV-1 infection is partially protective and delays conquering of HSV-two. A second caption is that, if prior HSV-ii infection prevents HSV-1 infection, as was suggested past some early on studies [11, fourteen], the higher per centum of HSV-ii only in young persons could indicate that the after birth cohorts caused HSV-two infection at younger ages, before acquiring HSV-ane infection. In NHANES III, the percent of persons who had their first sexual intercourse at age ≤17 years was 64% in 20–29-yr-olds, in comparison with merely 44% in l–59-year-olds.
The age at which a person acquires HSV-1 and HSV-2 infections has important implications for the epidemiology of genital canker. Commencement, because persons who lack HSV-ane antibody are more than likely to have symptomatic HSV-2 infection, acquisition of HSV-two before HSV-1 would lead to an increment in clinical genital canker. Second, if fewer persons larn HSV-1 infection in childhood, genital herpes due to HSV-one infection may increase, especially if oral sexual practice becomes more common [19, twenty]. A prospective written report during the 1990s reported that, amidst sexually active adults, new symptomatic genital HSV-1 infections are as common as new symptomatic oropharyngeal HSV-1 infections, at a rate of 0.v cases per 100 person-years [12]. Recently, a big study of the etiology of genital herpes found that the proportion of primary genital herpes infections due to HSV-1 was 15% amid heterosexual men, 21% among heterosexual women, and 47% among homosexual men [21].
Because genital herpes tin facilitate man immunodeficiency virus transmission [22], agreement the epidemiology of HSV infections and the factors that affect their clinical manifestations is of critical importance. The seroprevalence of HSV1 and the age at its acquisition may influence the epidemiology of clinical genital canker in the U.s.. Furthermore, if the efficacy of HSV-2 vaccines that are currently nether development [23] differs by HSV-1 serostatus, monitoring the seroprevalence of both HSV-1 and HSV-2 volition exist important for development of preventive and vaccination strategies.
Acknowledgments
The authors give thanks Drs. Geraldine M. McQuillan, National Center for Health Statistics; Gregory L. Armstrong, Division of Viral and Rickettsial Diseases, and Katherine Grand. Stone, Division of Sexually Transmitted Disease Prevention, Centers for Disease Command and Prevention; and Douglas T. Fleming, Robert Forest Johnson Medical School, Academy of Medicine and Dentistry of New Jersey, for their technical assistance and valuable comments.
References
i.
, .
Antigenic and biologic differences in herpesvirus hominis
,
Prog Med Virol
,
1968
, vol.
10
(pg.
110
-
59
)
2.
, . , , , et al.
Biology of herpesviruses
,
Sexually transmitted diseases
,
1999
3d ed
New York
McGraw-Hill
(pg.
269
-
83
)
3.
Usa Department of Health and Human Services, Public Health Services, Division of STD Prevention
,
Sexually transmitted disease surveillance, 1999
,
2000
Atlanta
Centers for Illness Control and Prevention
pg.
36
four.
, , , et al.
Herpes simplex virus blazon ii in the U.s.a., 1976–1994
,
Northward Engl J Med
,
1997
, vol.
337
(pg.
1105
-
11
)
5.
, , , , , .
National prevalence of canker virus type 1 infection [abstruse 79]
,
1998
Abstracts of the 38th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC). Session 130-L
San Diego, CA
American Society for Microbiology
pg.
571
6.
, , , et al.
Incidence of herpes simplex virus blazon ii infection in the United States
,
Am J Epidemiol
,
2001
, vol.
153
(pg.
912
-
20
)
seven.
, , , , .
Epidemiology of genital herpes in Pittsburgh: serologic, sexual, and racial correlates of apparent and inapparent canker simplex infections
,
J Infect Dis
,
1990
, vol.
162
(pg.
299
-
305
)
eight.
, , , , .
Run a risk factors for the sexual transmission of genital canker
,
Ann Intern Med
,
1992
, vol.
116
(pg.
197
-
202
)
nine.
, , , , , .
Risk of conquering of genital herpes simplex virus blazon 2 in sex activity partners of persons with genital canker: a prospective couple written report
,
J Infect Dis
,
1993
, vol.
167
(pg.
946
-
50
)
ten.
, for the Canker Vaccine Efficacy Study Group
Gender-specific efficacy of a condom SBAS4-adjuvanted gD2 subunit vaccine confronting genital herpes disease (GUD): results of two clinical efficacy trials [late breaker abstract L-half dozen]
,
2000
Plan and abstracts of the 40th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC; Toronto): final program, abstracts, and exhibition addendum
Washington, DC
American Lodge of Microbiology
pg.
18
11.
, , , et al.
The acquisition of herpes simplex virus during pregnancy
,
N Engl J Med
,
1997
, vol.
337
(pg.
509
-
15
)
12.
, , , , .
A prospective report of new infections with canker simplex virus type 1 and blazon ii. Chiron HSV Vaccine Written report Grouping
,
Due north Engl J Med
,
1999
, vol.
341
(pg.
1432
-
8
)
thirteen.
, , , et al.
The frequency of unrecognized blazon ii herpes simplex virus infection among women: implications for the control of genital herpes
,
Sex Transm Dis
,
1990
, vol.
17
(pg.
90
-
4
)
14.
, , .
Sero-epidemiological and -sociological patterns of herpes simplex virus infection in the world
,
Scand J Infect Dis
,
1990
Suppl 69
(pg.
19
-
36
)
xv.
Plan and performance of the Third National Health and Nutrition Examination Survey, 1988–94. National Center for Health Statistics
,
Vital Health Star
,
1994
, vol.
i
32
16.
, , , , , .
Detection of herpes simplex virus blazon-ii-specific antibody with glycoprotein G
,
J Clin Microbiol
,
1985
, vol.
22
(pg.
641
-
four
)
17.
, , , , .
A novel glycoprotein (gG-ane) for detection of herpes simplex virus specific antibodies
,
J Virol Methods
,
1986
, vol.
14
(pg.
111
-
eight
)
18.
NHANES 3 reference manuals and reports. National Heart for Health Statistics (CD-ROM). DHHS publication no. (PHS) 96–0178
,
1996
nineteen.
.
The current trend in genital canker: progress in prevention
,
Sex Transm Dis
,
1994
, vol.
21
Suppl 2
(pg.
S38
-
44
)
xx.
.
Oral sexual activity amid adolescents: is information technology sex activity or is information technology abstinence?
,
Fam Plann Perspect
,
2000
, vol.
32
(pg.
298
-
304
)
21.
, , , .
Herpes simplex virus type ane as a cause of genital herpes: impact on surveillance and prevention
,
J Infect Dis
,
2000
, vol.
181
(pg.
1454
-
7
)
22.
, , .
HSV-2 and HIV: consequences of an endemic opportunistic infection
,
Step Perspect
,
1997
, vol.
9
(pg.
2
-
4
)
23.
, , , et al.
Prospects of control of herpes simplex virus disease through immunization
,
J Infect Dis
,
2000
, vol.
30
(pg.
549
-
66
)
Writer notes
This research was supported in part by an appointment to the Research Participation Program at the Centers for Illness Control and Prevention (CDC), National Center for HIV, STD, and TB Prevention, Partition of STD Prevention, administered by the Oak Ridge Constitute for Science and Teaching through an interagency agreement between the United states of america Department of Energy and the CDC.
© 2002 by the Infectious Diseases Society of America
Source: https://academic.oup.com/jid/article/185/8/1019/814003
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