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Seroprevalence of Herpes Simplex Virus Infections in a Family Medicine Clinic
Lynn Oliver, MD;
Anna Wald, MD, MPH;
Mihee Kim, RN, MPH;
Judith Zeh, PhD;
Stacy Selke, MA;
Rhoda Ashley, PhD;
Lawrence Corey, MD
Arch Fam Med. 1995;4(3):228-232.
Abstract
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Objectives
To determine the prevalence of herpes simplex virus (HSV) antibody in a general medical practice setting and to assess the frequency of subclinical infection.
Design
Prevalence study.
Setting
A family practice clinic at the University of Washington Medical Center, Seattle.
Participants
Five hundred randomly selected patients between the ages of 18 and 45 years.
Main Outcome Measures
Serum samples were tested by Western blot assay to detect the presence of antibody to HSV type 1 (HSV-1) and HSV-2. Demographic information and clinical history of oral and genital herpes were obtained.
Results
One hundred fourteen patients (23%) were seropositive for HSV-2 antibody, 277 patients (56%) were seropositive for HSV-1 antibody, 59 patients (12%) were seropositive for both HSV-2 and HSV-1 antibodies, and 163 patients (33%) were seronegative for both. Women were almost twice as likely as men to be seropositive for HSV-2 antibody (28% vs 15%, P<.001). Blacks had the highest rates of HSV-2 antibody seropositivity (60%) compared with whites (20%) and Asians (6%) (P<.001). Other demographic correlates of seropositivity included being older, having fewer years of education, and having public insurance. The specificity of a clinical history of genital herpes or sores for HSV-2 infection was high (99%), but the sensitivity was low (27%).
Conclusions
Herpes simplex virus infection is common among patients seeking primary care. Women, blacks, and patients of lower socioeconomic status are most likely to be seropositive for HSV-2 antibody. The high frequency of unrecognized HSV infection has implications for primary care physicians in counseling patients regarding HSV infection and transmission.
Author Affiliations
From the Departments of Family Medicine (Dr Oliver), Medicine (Drs Wald and Corey), Laboratory Medicine (Mss Kim and Selke and Drs Ashley and Corey), and Statistics (Dr Zeh), the University of Washington, Seattle.
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