A PROSPECTIVE SEROEPIDEMIOLOGICAL SURVEY OF HERPES SIMPLEX (HSV) INFECTIONS IN A COLLEGE POPULATION

Abstract

The true incidence of HSV2 infections in a young, sexually active population and its relationship to prior HSV AB status is unknown. Acquisition of HSV1 AB increases with age, inversely correlates with socioeconomic status, and modifies HSV2 infections. A prospective seroepidemiologic survey of HSV infections in a predominantly upper and middle class college population(658 enrolled mean age 20.2 yrs, 76% sexually active) without a history of genital HSV infection was initiated. Students were followed by active clinical surveillance and by 6 mos serology. After screening for HSV AB by immunofluorescence (IFA),type specific AB responses were studied by western blot analysis (WBA). To date 36.6% of 562 students had previous HAV AB by IFA. Seventy-six % (237/371) of those <age 21 were seronegative. No significant differences of gender, ethnicity, geography, income, type of or frequency of sexual activity between seropositive and seronegative groups were found. Of 226 serological FUps at 12 mos (125 initially seronegative),2 (1.5%) seroconverted asymptomatically by IFA with HSV type 1 AB by WBA. Over 12 mos FU (562 students), 4 confirmed first episode symptomatic genital HSV outbreaks occurred (0.7%). Two had primary genital HSV (1 HSV1, 1 HSV2); 2 had first episode nonprimary (prior HSV1 AB) genital outbreaks; 1 had HSV1 virus isolated. In 29 FU sera (2 with prior HSV2, 27 with prior HSV1 AB), none have seroconverted to the respective HSV type asymptomatically by WBA. In a susceptible, sexually active population in 12 mos FU, the incidence of symptomatic, genital HSV disease, particularly HSV2 disease, appears to be low.

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