Prevalence of Herpes Simplex Decreasing in the U.S.

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Summary and Comment

Prevalence of Herpes Simplex Decreasing in the U.S.

Comparison of national seroprevalence estimates for 1988–1994 and 1999–2004 showed a decreasing prevalence of both HSV-1 and HSV-2 during the 1990s.

Infection with type 2 herpes simplex virus (HSV-2) is associated not only with HSV disease but also with increased risk for HIV transmission. Comparison of data from the National Health and Nutrition Examination Surveys (NHANES) for 1976–1980 and 1988–1994 showed a worrisome increase in HSV-2 seroprevalence during this interval. Now, investigators have compared the data for 1988–1994 with those for 1999–2004. Respondents aged 14 through 49 were included in the analyses.

The NHANES for 1999–2004 showed an overall seroprevalence of 57.7% for HSV-1 and 17.2% for HSV-2. The seroprevalence of HSV-1 declined by 6.9% between the 1988–1994 and 1999–2004 survey periods; decreases were noted in all racial/ethnic, sex, and age subgroups except for males aged 20–39. The seroprevalence of HSV-2 showed an overall decline of 19.0%, with the decrease greatest in younger age groups. The percentage of participants who reported sexual activity also decreased between surveys among 15- to 29-year-olds, although the reported number of lifetime sexual partners did not. Among individuals who were infected with HSV-1 but not also with HSV-2, the prevalence of reported genital herpes was higher in 1999–2004 than in 1988–1994 (1.8% vs. 0.4%).

Comment: These results provide reassurance that recent changes in sexual practices have reversed the rising prevalence of HSV-2 infection in the U.S. Potential factors not addressed in the NHANES questionnaires include increased condom usage, choosing oral sex over vaginal sex, and better partner selection. Defining the key factors would allow development of more-effective strategies to reduce sexually transmitted diseases.

— Richard T. Ellison III, MD

Published in Journal Watch Infectious Diseases September 20, 2006