RESUMEN
BACKGROUND: Periodontitis is a common chronic oral disease which seriously affects people's quality of life. Although human herpes simplex virus (HSV) is also found in periodontal lesions, the association between HSV infection and periodontitis is unclear. METHODS: The National Health and Nutrition Examination Survey (NHANES) data for 2009-2010, 2011-2012 and 2013-2014 was combined, and the association between HSV infection and periodontitis in the general population and particular subgroups was investigated through weighted multi-logistic analyses. RESULTS: There were 4,733 participants aged 30-50 years old with clinically assessed periodontitis concurrent with HSV infection. In general analysis, after adjusted for covariates, both HSV-1 (OR = 1.09, P < 0.001) and HSV-2 (OR = 1.06, P = 0.030) infection was significantly associated with periodontitis. In subgroup analyses, compared with patients without HSV infection, patients with HSV-1( +) & HSV-2( +) and HSV-1( +) & HSV-2(-) infection showed higher risk of periodontitis in all subgroups (OR = 1.15, OR = 1.09, P < 0.001), while patients with HSV-1(-) & HSV-2( +) infection showed higher risk of and periodontitis only in the subgroup of people aged 40-50 years (OR = 1.10, P = 0.032) and the Mexican-American subgroup (OR = 1.35, P = 0.042). When only severe periodontitis is considered, HSV infection was associated with periodontitis, no matter the patient was infected with either of the virus or both. CONCLUSIONS: HSV-1 infection was significantly associated with periodontitis and severe periodontitis, while HSV-2 infection was associated with severe periodontitis, and periodontitis in 40-50-year-olds and Mexican-Americans.
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Herpes Simple , Periodontitis , Calidad de Vida , Adulto , Humanos , Persona de Mediana Edad , Americanos Mexicanos , Encuestas Nutricionales , Periodontitis/complicaciones , Periodontitis/epidemiología , Periodontitis/etnología , Periodontitis/virología , Simplexvirus , Herpes Simple/complicaciones , Herpes Simple/epidemiología , Herpes Simple/etnología , Herpes Simple/virología , Factores de EdadRESUMEN
Importance: Approximately 1 in 5 adults in the US had a sexually transmitted infection (STI) in 2018. This review provides an update on the epidemiology, diagnosis, and treatment of gonorrhea, chlamydia, syphilis, Mycoplasma genitalium, trichomoniasis, and genital herpes. Observations: From 2015 to 2019, the rates of gonorrhea, chlamydia, and syphilis increased in the US; from 1999 to 2016, while the rates of herpes simplex virus type 1 (HSV-1) and HSV-2 declined. Populations with higher rates of STIs include people younger than 25 years, sexual and gender minorities such as men and transgender women who have sex with men, and racial and ethnic minorities such as Black and Latinx people. Approximately 70% of infections with HSV and trichomoniasis and 53% to 100% of extragenital gonorrhea and chlamydia infections are asymptomatic or associated with few symptoms. STIs are associated with HIV acquisition and transmission and are the leading cause of tubal factor infertility in women. Nucleic acid amplification tests have high sensitivities (86.1%-100%) and specificities (97.1%-100%) for the diagnosis of gonorrhea, chlamydia, M genitalium, trichomoniasis, and symptomatic HSV-1 and HSV-2. Serology remains the recommended method to diagnose syphilis, typically using sequential testing to detect treponemal and nontreponemal (antiphospholipid) antibodies. Ceftriaxone, doxycycline, penicillin, moxifloxacin, and the nitroimidazoles, such as metronidazole, are effective treatments for gonorrhea, chlamydia, syphilis, M genitalium, and trichomoniasis, respectively, but antimicrobial resistance limits oral treatment options for gonorrhea and M genitalium. No cure is available for genital herpes. Effective STI prevention interventions include screening, contact tracing of sexual partners, and promoting effective barrier contraception. Conclusions and Relevance: Approximately 1 in 5 adults in the US had an STI in 2018. Rates of gonorrhea, chlamydia, and syphilis in the US have increased, while rates of HSV-1 and HSV-2 have declined. Ceftriaxone, doxycycline, penicillin, moxifloxacin, and the nitroimidazoles are effective treatments for gonorrhea, chlamydia, syphilis, Mycoplasma genitalium, and trichomoniasis, respectively, but antimicrobial resistance limits oral therapies for gonorrhea and Mycoplasma genitalium, and no cure is available for genital herpes.
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Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/tratamiento farmacológico , Infecciones Asintomáticas/epidemiología , Infecciones Asintomáticas/terapia , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/tratamiento farmacológico , Infecciones por Chlamydia/epidemiología , Infecciones por Chlamydia/etnología , Trazado de Contacto , Farmacorresistencia Microbiana , Minorías Étnicas y Raciales/estadística & datos numéricos , Femenino , Gonorrea/diagnóstico , Gonorrea/tratamiento farmacológico , Gonorrea/epidemiología , Gonorrea/etnología , Infecciones por VIH/complicaciones , Infecciones por VIH/transmisión , Herpes Genital/diagnóstico , Herpes Genital/tratamiento farmacológico , Herpes Genital/epidemiología , Herpes Genital/etnología , Herpes Simple/diagnóstico , Herpes Simple/tratamiento farmacológico , Herpes Simple/epidemiología , Herpes Simple/etnología , Humanos , Masculino , Tamizaje Masivo , Infecciones por Mycoplasma/diagnóstico , Infecciones por Mycoplasma/tratamiento farmacológico , Infecciones por Mycoplasma/epidemiología , Infecciones por Mycoplasma/etnología , Mycoplasma genitalium , Técnicas de Amplificación de Ácido Nucleico , Distribución por Sexo , Minorías Sexuales y de Género/estadística & datos numéricos , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/etnología , Sífilis/diagnóstico , Sífilis/tratamiento farmacológico , Sífilis/epidemiología , Sífilis/etnología , Serodiagnóstico de la Sífilis/métodos , Vaginitis por Trichomonas/diagnóstico , Vaginitis por Trichomonas/tratamiento farmacológico , Vaginitis por Trichomonas/epidemiología , Vaginitis por Trichomonas/etnología , Estados Unidos/epidemiologíaRESUMEN
The frequency of central nervous system infections due to herpesvirus have been studied in various populations; however, studies in Mexican mestizo patients are scant. This paper documents the frequency of herpesvirus encephalitis in Mexican mestizo patients from the National Institute of Neurology and Neurosurgery (NINN) of Mexico. To study the frequency of herpetic viral encephalitis at the NINN in the period from 2004 to 2009. We reviewed clinical records from patients with clinically suspected encephalitis; polymerase chain reaction assays were done for detection of herpesviruses in cerebrospinal fluid (CSF) samples. The total number of patients studied was 502; in 59 (12%), the diagnosis of herpetic encephalitis was confirmed by PCR-based testing of CSF. Of them, 21 (36%) were positive for herpes simplex virus type 1, 15 (25%) for Epstein-Barr virus, 10 (17%) for varicella zoster virus, 8 (14%) for cytomegalovirus, 3 (5%) for human herpesvirus 6, and 2 (3%) for herpes simplex virus 2. Our results show a varied frequency of viral encephalitis in mestizo patients due to herpesviruses in a tertiary neurological center and point out the importance of modern molecular technology to reach the etiological diagnosis in cases of encephalitis.
Asunto(s)
Infecciones por Citomegalovirus/diagnóstico , Encefalitis por Varicela Zóster/diagnóstico , Encefalitis Viral/diagnóstico , Infecciones por Virus de Epstein-Barr/diagnóstico , Herpes Genital/diagnóstico , Herpes Simple/diagnóstico , Infecciones por Roseolovirus/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Citomegalovirus/genética , Citomegalovirus/patogenicidad , Infecciones por Citomegalovirus/epidemiología , Infecciones por Citomegalovirus/etnología , Infecciones por Citomegalovirus/virología , Encefalitis por Varicela Zóster/epidemiología , Encefalitis por Varicela Zóster/etnología , Encefalitis por Varicela Zóster/virología , Encefalitis Viral/epidemiología , Encefalitis Viral/etnología , Encefalitis Viral/virología , Infecciones por Virus de Epstein-Barr/epidemiología , Infecciones por Virus de Epstein-Barr/etnología , Infecciones por Virus de Epstein-Barr/virología , Etnicidad , Femenino , Herpes Genital/epidemiología , Herpes Genital/etnología , Herpes Genital/virología , Herpes Simple/epidemiología , Herpes Simple/etnología , Herpes Simple/virología , Herpesvirus Humano 1/genética , Herpesvirus Humano 1/patogenicidad , Herpesvirus Humano 2/genética , Herpesvirus Humano 2/patogenicidad , Herpesvirus Humano 3/genética , Herpesvirus Humano 3/patogenicidad , Herpesvirus Humano 4/genética , Herpesvirus Humano 4/patogenicidad , Herpesvirus Humano 6/genética , Herpesvirus Humano 6/patogenicidad , Humanos , Incidencia , Masculino , México/epidemiología , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa/métodos , Estudios Retrospectivos , Infecciones por Roseolovirus/epidemiología , Infecciones por Roseolovirus/etnología , Infecciones por Roseolovirus/virologíaRESUMEN
BACKGROUND: HIV prevalence varies from 1.7% to 14.8% between ethnic groups in Uganda. Understanding the factors responsible for this heterogeneity in HIV spread may guide prevention efforts. METHODS: We evaluated the relationship between HIV prevalence by ethnic group and a range of risk factors as well as the prevalence of herpes simplex virus-2 (HSV-2), syphilis and symptomatic STIs in the 2004/2005 Uganda HIV/AIDS Sero-Behavioural Survey-a two stage, nationally representative, population based survey of 15-59-year-olds. Spearman's correlation was used to assess the relationship between HIV prevalence and each variable. RESULTS: There was a positive association between HIV prevalence and HSV-2, symptomatic STIs and high-risk sex (sex with a non-cohabiting, non-marital partner) for women. Non-significant positive associations were present between HIV and high-risk sex for men and lifetime number of partners for men and women. CONCLUSION: Variation in sexual behavior may contribute to the variations in HIV, HSV-2 and other STI prevalence by ethnic group in Uganda. Further work is necessary to delineate which combinations of risk factors determine differential STI spread in Uganda.
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Infecciones por VIH/etnología , Herpes Simple/etnología , Herpesvirus Humano 2 , Sexo Inseguro/etnología , Adolescente , Adulto , Circuncisión Masculina/etnología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Factores Sexuales , Sífilis/etnología , Uganda/epidemiología , Adulto JovenRESUMEN
For decades reproductive tract infections (RTIs) have been hypothesized to play a role in uterine fibroid development. The few previous studies conducted used self-reported history of RTIs and had inconsistent findings. We investigated this hypothesis further using serological analysis, an immunological measure of past exposure. We focused on herpes simplex virus type 2 (HSV-2) because prior published data have suggested a possible association with fibroids, and serology for HSV-2 is much more sensitive than self-report. We used cross-sectional enrollment data from African-American women enrolled in a prospective study of fibroid incidence and growth (recruited 2010-2012) in the Detroit, Michigan, area. The women were aged 23-34 years and were screened for fibroids using a standardized ultrasound examination at their enrollment. Age- and multivariable-adjusted logistic regression models were used to estimate odds ratios. Of 1,696 participants, 1,658 had blood samples and HSV-2 serology results; 22% of participants with serology results had fibroids. There was no significant association between HSV-2 seropositivity and the presence of fibroids (multivariable-adjusted odds ratio = 0.94, 95% confidence interval: 0.73, 1.20), nor were there any associations with size of the largest fibroid, number of fibroids, or total fibroid volume. Our data provide no evidence for an influence of HSV-2 exposure on fibroid risk in young African-American women. Further study of other serologically measured RTIs is warranted.
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Negro o Afroamericano , Herpes Simple/etnología , Herpesvirus Humano 2 , Leiomioma/etnología , Adulto , Consumo de Bebidas Alcohólicas/etnología , Anticuerpos Antivirales/sangre , Índice de Masa Corporal , Estudios Transversales , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Leiomioma/diagnóstico por imagen , Michigan/epidemiología , Oportunidad Relativa , Estudios Prospectivos , Reproducibilidad de los Resultados , Estudios Seroepidemiológicos , Conducta Sexual/etnologíaRESUMEN
OBJECTIVE: To identify whether there are ethnic differences in cytomegalovirus (CMV), Epstein-Barr virus (EBV), and herpes simplex virus type 1 (HSV-1) seroprevalence rates in children at 6 years of age, and when present, to evaluate how these differences can be explained by sociodemographic and environmental factors. STUDY DESIGN: This study was embedded within a multi-ethnic population-based prospective cohort study. Serum IgG levels against CMV, EBV, and HSV-1 were measured by enzyme-linked immunosorbent assay in 4464 children (median age 6.0 years). Information on demographics and characteristics were assessed by questionnaires. Herpesvirus seroprevalences between Surinamese-Creole, Surinamese-Hindustani, Turkish, Moroccan, Cape Verdean Antillean, and Native Dutch children were compared. RESULTS: Non-Western ethnicity was an independent risk factor for CMV (aOR, 2.16; 95% CI 1.81-2.57), EBV (1.76; 1.48-2.09), and HSV-1 seropositivity (1.52; 1.39-1.66). Among the ethnic groups, CMV seroprevalences ranged between 29% and 65%, EBV between 43% and 69%, and HSV-1 between 13% and 39%. Low family net household income, low maternal educational level, crowding, and lifestyle factors explained up to 48% of the ethnic differences in HSV-1 seroprevalences, and up to 39% of the ethnic differences in EBV seroprevalences. These factors did not explain ethnic differences in CMV seroprevalences. CONCLUSIONS: Socioeconomic position and factors related to lifestyle explain only a part of the large ethnic differences in EBV and HSV-1 seroprevalences, whereas they do not explain ethnic differences in CMV seroprevalences in childhood.
Asunto(s)
Infecciones por Citomegalovirus/epidemiología , Infecciones por Virus de Epstein-Barr/epidemiología , Etnicidad/estadística & datos numéricos , Herpes Simple/epidemiología , Adulto , Lactancia Materna , Niño , Estudios de Cohortes , Aglomeración , Infecciones por Citomegalovirus/etnología , Escolaridad , Infecciones por Virus de Epstein-Barr/etnología , Femenino , Herpes Simple/etnología , Herpesvirus Humano 1 , Humanos , Renta , Estilo de Vida , Países Bajos/epidemiología , Paridad , Embarazo , Factores de Riesgo , Estudios SeroepidemiológicosRESUMEN
Jewish ritual circumcision rarely but occasionally includes a procedure involving direct oral suction of the wound, which can expose an infant to infection with herpes simplex virus type 1 (HSV-1). This practice has provoked international controversy in recent years, but no systematic review of the clinical literature has previously been published. We designed this review to identify and synthesize all published studies examining the association between circumcision with direct oral suction and HSV-1 infection. Our search strategy identified 6 published case series or case reports, documenting 30 cases between 1988 and 2012. Clinical findings were consistent with transmission of infection during circumcision, although the evidence base is limited by the small number of infections and incomplete case data. Published evidence suggests that circumcision with direct oral suction has resulted in severe neonatal illness and death from HSV-1 transmission, but further research is necessary to clarify the risk of infection.
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Circuncisión Masculina/efectos adversos , Circuncisión Masculina/etnología , Circuncisión Masculina/métodos , Herpes Simple/etnología , Herpes Simple/transmisión , Judaísmo , Medición de Riesgo , Conducta Ceremonial , Herpes Simple/mortalidad , Herpesvirus Humano 1 , Humanos , Recién Nacido , Judíos , Masculino , Succión/efectos adversosRESUMEN
BACKGROUND: While population-based seroprevalence studies of herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) are widespread, seroincidence studies are largely limited to select or high-risk populations. The US military offers a potential population to derive national seroincidence rate estimates for young adults (ages 18-29). METHODS: We used banked, longitudinal serum specimens collected in a cohort of 1094 military personnel aged 18 to 30 years who served between 1989 and 2005 to estimate national HSV-1 and HSV-2 seroincidence and seroprevalence for the young, adult military population, weighted according to the US Census. Serum was tested with indirect ELISA (enzyme-linked immunosorbent assay). RESULTS: Estimated national seroincidence rates for the US young, adult military population were 9.1 per 100 person-years (95% confidence interval: 4.6-13.5) for HSV-1 and 6.2 (95% confidence interval: 3.1-9.3) for HSV-2. Female sex and black race were associated with significantly higher HSV-2 seroconversion rates. Our estimated HSV1/2 seroprevalences were comparable to US national data provided by National Health and Nutrition Examination Surveys' serosurveys except for non-Hispanic blacks and Hispanics. CONCLUSION: Although these US 2000 Census-weighted estimates of HSV-1 and HSV-2 seroincidence apply only to young, military adults, they nonetheless supply, to our knowledge, the only national figures that might be used to predict US national HSV1/2 seroincidence in young adults. Thus, we believe that our findings in this military population can be used to inform the planning of HSV-1 and 2 prevention measures in the general, young-adult US population.
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Anticuerpos Antivirales/sangre , Herpes Simple/diagnóstico , Herpes Simple/epidemiología , Herpesvirus Humano 1 , Herpesvirus Humano 2 , Personal Militar/estadística & datos numéricos , Adolescente , Adulto , Población Negra , Estudios de Cohortes , Ensayo de Inmunoadsorción Enzimática , Femenino , Herpes Simple/etnología , Herpesvirus Humano 1/inmunología , Herpesvirus Humano 2/inmunología , Hispánicos o Latinos , Humanos , Estudios Longitudinales , Masculino , Factores de Riesgo , Estudios Seroepidemiológicos , Factores Sexuales , Población Blanca , Adulto JovenRESUMEN
Oral squamous cell carcinoma (OSCC) is a major health problem in many parts of the world, and the major causative agents are thought to be the use of alcohol and tobacco. Oncogenic viruses have also been suggested to be involved in OSCC development. This study investigated the prevalence of human papillomaviruses (HPV), herpes simplex virus (HSV) and Epstein-Barr virus (EBV) in 155 OSCC from eight different countries from different ethnic groups, continents and with different socioeconomic backgrounds. 41 A total of OSCCs were diagnosed in the tongue (26%) and 23 in the floor of the mouth (15%); the other 91 OSCCs were diagnosed in other locations (59%). The patients were also investigated regarding the use of alcohol and smoking and smokeless tobacco habits. Tissue samples were obtained from formalin-fixed, paraffin-embedded samples of the OSCC. DNA was extracted and the viral genome was examined by single, nested and semi-nested PCR assays. Sequencing of double-stranded DNA from the PCR product was carried out. Following sequencing of the HPV-, HSV- and EBV-positive PCR products, 100% homology between the sampels was found. Of all the 155 OSCCs examined, 85 (55%) were positive for EBV, 54 (35%) for HPV and 24 (15%) for HSV. The highest prevalence of HPV was seen in Sudan (65%), while HSV (55%) and EBV (80%) were most prevalent in the UK. In 34% (52/155) of all the samples examined, co-infection by two (46/155=30%) or three (6/155=4%) virus specimens was detected. The most frequent double infection was HPV with EBV in 21% (32/155) of all OSCCs. There was a statistically significant higher proportion of samples with HSV (p=0.026) and EBV (p=0.015) in industrialized countries (Sweden, Norway, UK and USA) as compared to developing countries (Sudan, India, Sri Lanka and Yemen). Furthermore, there was a statistically significant higher co-infection of HSV and EBV in samples from industrialized countries (p=0.00031). No firm conclusions could be drawn regarding the relationship between alcohol, tobacco and virus infections. The significance of our findings must be put in relation to other risk factors and these observations warrant further studies to determine the possible role of viral infections and co-infections with HPV, EBV and HSV as risk markers for the development of OSCC.
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Carcinoma de Células Escamosas/epidemiología , Carcinoma de Células Escamosas/virología , Infecciones por Virus de Epstein-Barr/epidemiología , Herpes Simple/epidemiología , Neoplasias de la Boca/epidemiología , Neoplasias de la Boca/virología , Infecciones por Papillomavirus/epidemiología , Adulto , África/epidemiología , Anciano , Anciano de 80 o más Años , Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/etnología , Animales , Asia/epidemiología , Secuencia de Bases , Carcinoma de Células Escamosas/etnología , Chlorocebus aethiops , ADN Viral/química , ADN Viral/genética , Infecciones por Virus de Epstein-Barr/etnología , Europa (Continente)/epidemiología , Herpes Simple/etnología , Herpesvirus Humano 4/genética , Herpesvirus Humano 4/aislamiento & purificación , Humanos , Persona de Mediana Edad , Datos de Secuencia Molecular , Neoplasias de la Boca/etnología , América del Norte/epidemiología , Papillomaviridae/genética , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/etnología , Prevalencia , Simplexvirus/genética , Simplexvirus/aislamiento & purificación , Fumar/epidemiología , Fumar/etnología , Tabaco sin HumoRESUMEN
Herpes simplex virus type 2 (HSV-2) is a common sexually transmitted infection (STI) worldwide that causes genital infection. Among several factors responsible, host genetic factors may play an important role in susceptibility to HSV-2 infection. Apoptosis is a vital mechanism in eliminating virus-infected cells and controlling viral infections. Apoptosis can be regulated and triggered by the interaction between Fas and Fas Ligand (FasL). Polymorphisms in genes encoding Fas and FasL might result in altered apoptosis and contribute in susceptibility to viral infections. Two polymorphisms in Fas gene (FasR-1377G > A, FasR-670A > G) and one in FasL gene (FasL-844T > C) have been well studied and associated with different diseases. These polymorphisms were investigated in 407 South African women of black African and mixed-ancestry origin to determine if they were associated with HSV-2 seropositivity. Two hundred sixty-five women were HSV-2 infected and 142 were non-infected. HSV-2 was detected using HerpeSelect ELISA test and genotyping was performed using TaqMan assay. FasR-1377A allele showed a statistically significant association (P = 0.008) with reduced risk of HSV-2 infection. Analyzing the FasR haplotypes also showed a statistically significant association (P = 0.0001) with FasR-1377/FasR-670 AG haplotype and reduced risk of HSV-2 infection. There was no significant association found with FasR-670A > G and FasL-844T > C polymorphisms and risk of HSV-2 infection. This is, to our knowledge, the first time a non-HLA genetic link with HSV-2 infection has been reported.
Asunto(s)
Población Negra/genética , Herpes Simple/etnología , Herpesvirus Humano 2/patogenicidad , Polimorfismo de Nucleótido Simple , Receptor fas/genética , Adulto , Apoptosis , Estudios de Casos y Controles , Proteína Ligando Fas/genética , Femenino , Predisposición Genética a la Enfermedad , Genotipo , Herpes Simple/genética , Herpes Simple/fisiopatología , Humanos , SudáfricaRESUMEN
BACKGROUND: Elevated antibodies to latent herpesviruses have been demonstrated to be a reliable marker of diminished cellular immunity and recently have been associated with low socioeconomic position (SEP) in older adults. Extending these observations in a community-based study over a wide age range would provide an important new direction for investigating mechanisms underlying poor health outcomes in individuals with low SEP. METHODS: Anti-herpes simplex virus (HSV)-1 and anti-Epstein-Barr virus (EBV) antibodies were measured in blood samples from 1457 adults aged 25-90. Regression models were then used to determine the relationships between viral reactivation, age, gender, ethnicity and SEP. RESULTS: Individuals were significantly more likely to have higher antiviral antibodies (ie, reactivation) to both EBV and HSV-1 than one virus alone. Individuals in the lowest age group had less reactivation, whereas greater reactivation was observed in women and those with the least education. Compared to white non-Hispanics, Hispanics and black non-Hispanics experienced more viral reactivation. These relationships remained strong after controlling for sociodemographic factors as well as smoking status, body mass index and physical activity. CONCLUSIONS: These results demonstrate that herpesvirus reactivation is associated with variables such as age, gender, ethnicity and education, and may play a role in poorer health outcomes in both younger and older adults.
Asunto(s)
Anticuerpos Antivirales/análisis , Infecciones por Virus de Epstein-Barr/inmunología , Accesibilidad a los Servicios de Salud/economía , Herpes Simple/inmunología , Herpesvirus Humano 1/inmunología , Latencia del Virus , Adulto , Anciano , Anciano de 80 o más Años , Formación de Anticuerpos , Población Negra/estadística & datos numéricos , Escolaridad , Infecciones por Virus de Epstein-Barr/etnología , Femenino , Herpes Simple/etnología , Hispánicos o Latinos/estadística & datos numéricos , Humanos , Inmunidad Celular , Masculino , Persona de Mediana Edad , Factores Socioeconómicos , Texas , Población Blanca/estadística & datos numéricosRESUMEN
There is a strong relation between socioeconomic position and health outcomes, although the mechanisms are poorly understood. The authors used data from 1,503 California participants in the 1998-1999 Sacramento Area Latino Study on Aging aged 60-100 years to ask whether socioeconomic position is related to immune function as measured by the body's ability to keep latent herpesvirus antibody levels in a quiescent state. Individuals with lower educational levels had significantly higher levels of immunoglobulin G antibodies to cytomegalovirus and herpes simplex virus type 1. The odds ratio for being in a higher tertile of cytomegalovirus antibodies was 1.54 (95% confidence interval: 1.18, 2.01) for those in the lowest educational group, and the odds ratio for being in a higher tertile of herpes simplex virus type 1 was 1.63 (95% confidence interval: 1.25, 2.13). The relation between education and cytomegalovirus and herpes simplex virus type 1 antibody levels remained strong after controlling for baseline health conditions, smoking status, and body mass index. This is the first study known to show a relation between socioeconomic position and immune response to latent infection. It provides suggestive evidence that modulation of the immune system via latent infections may play a role in the observed associations between socioeconomic position and disease.
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Envejecimiento/inmunología , Anticuerpos Antivirales/inmunología , Infecciones por Citomegalovirus/etnología , Citomegalovirus/inmunología , Herpes Simple/etnología , Herpesvirus Humano 1/inmunología , Inmunidad/inmunología , Anciano , Anciano de 80 o más Años , Proteína C-Reactiva/metabolismo , California/epidemiología , Infecciones por Citomegalovirus/inmunología , Infecciones por Citomegalovirus/metabolismo , Femenino , Estudios de Seguimiento , Herpes Simple/inmunología , Herpes Simple/metabolismo , Humanos , Incidencia , Masculino , Americanos Mexicanos , Persona de Mediana Edad , Estudios Prospectivos , Factores Socioeconómicos , Factores de TiempoRESUMEN
BACKGROUND: Young women receiving family planning services are at risk for both unintended pregnancy and herpes simplex virus type 2 (HSV-2) infection. METHODS: We performed a secondary analysis using data from a previously published randomized controlled trial evaluating access to emergency contraception on reproductive health outcomes. Women aged 15 to 24 years were recruited from two Planned Parenthood clinics and two community health clinics in San Francisco. Demographic information and sexual history were obtained by interview. HSV-2 seropositivity was determined by fingerstick blood test. New pregnancies were measured by self-report, urine testing and medical chart review. Subjects were evaluated for incident HSV-2 infection and pregnancy at a 6-month follow-up appointment. Women who were pregnant or intending to become pregnant at enrolment were excluded. RESULTS: At enrolment 2,104 women were screened for HSV-2 and 170 (8.1%) were seropositive. Eighty-seven percent of initially seronegative women completed the study (n = 1,672) and 73 (4.4%) became HSV-2 seropositive. HSV-2 seroincidence was 7.8 cases per 100 person-years. One hundred and seventeen women (7%) became pregnant and 7 (6%) of these had a seroincident HSV-2 infection during the study. After adjustment for confounders, predictors of incident HSV-2 infection were African American race and having multiple partners in the last six months. Condom use at last sexual encounter was protective. CONCLUSION: HSV-2 seroincidence and the unintended pregnancy rate in young women were high. Providers who counsel women on contraceptive services and sexually transmitted infection prevention could play an expanded role in counselling women about HSV-2 prevention given the potential sequelae in pregnancy. The potential benefit of targeted screening and future vaccination against HSV-2 needs to be assessed in this population.
Asunto(s)
Negro o Afroamericano , Herpes Simple/epidemiología , Herpesvirus Humano 2/aislamiento & purificación , Complicaciones Infecciosas del Embarazo/epidemiología , Embarazo no Planeado , Conducta Sexual , Adolescente , Adulto , Anticuerpos Antivirales/sangre , Estudios de Cohortes , Centros Comunitarios de Salud , Servicios de Planificación Familiar , Femenino , Herpes Simple/etnología , Herpes Simple/inmunología , Herpesvirus Humano 2/inmunología , Humanos , Embarazo , Complicaciones Infecciosas del Embarazo/virología , Embarazo no Planeado/etnología , Análisis de Regresión , Factores de Riesgo , San Francisco/epidemiología , Estudios Seroepidemiológicos , Enfermedades de Transmisión Sexual/epidemiologíaRESUMEN
OBJECTIVES: To describe HSV-1 seroprevalence in children in the United States and to examine factors associated with herpes simplex virus type 1 (HSV-1) infection in children. STUDY DESIGN: Sera samples available from 2989 children age 6 to 13 years who participated in the National Health and Nutrition Examination Surveys (NHANES) 1999-2002 were tested for HSV-1 antibodies using a type-specific immunodot assay. HSV-1 seroprevalence in children age 12 to 13 years was compared with that reported in an earlier survey (NHANES 1988-1994). RESULTS: Overall, HSV-1 seroprevalence in children age 6 to 13 years was 31.1% (95% confidence interval [CI], 28.6% to 33.9%). Seroprevalence increased with age, from 26.3% in 6- to 7-year-olds to 36.1% in 12-to 13-year-olds, and varied by race/ethnicity, birthplace, and poverty level. Among US-born children age 12 to 13 years, the point estimate of HSV-1 seroprevalence was lower in NHANES 1999-2002 than in NHANES 1988-1994 (34.3% vs 38.1%), but the differences were not statistically significant. CONCLUSIONS: HSV-1 is a common infection in US children, with more than 25% infected by age 7. Race/ethnicity, birthplace, and poverty level are predictors for HSV-1 infection in children.
Asunto(s)
Herpes Simple/epidemiología , Herpesvirus Humano 1 , Adolescente , Negro o Afroamericano/estadística & datos numéricos , Distribución por Edad , Niño , Estudios Transversales , Herpes Simple/etnología , Humanos , Americanos Mexicanos/estadística & datos numéricos , Pobreza , Estudios Seroepidemiológicos , Distribución por Sexo , Estados Unidos/epidemiología , Población Blanca/estadística & datos numéricosRESUMEN
OBJECTIVES: The objectives of this study were to estimate national seroprevalence of herpes simplex virus type 1 (HSV-1), describe trends in seroprevalence, and examine correlates of infection. GOAL: The goal of this study was to measure the burden of HSV-1 infection in the U.S. population. STUDY: We tested serum samples for HSV-1 antibody and analyzed questionnaire data collected for the second and third National Health and Nutrition Surveys (NHANES II, 1976-80; NHANES III, 1988-94). Seroprevalence estimates were weighted to represent the total U.S. population. RESULTS: At the time of NHANES III, two thirds (68%) of the U.S. population 12 years and older had HSV-1 antibody. Prevalence increased with age and varied by race/ethnicity; the majority of persons in all race/ethnic groups were HSV-1-seropositive by age 30. Overall, the national seroprevalence of HSV-1 decreased nonsignificantly by 2% in the years between NHANES II and III; decreases in HSV-1 seroprevalence in some population subgroups were balanced by increases in other groups. CONCLUSIONS: There was no overall change in the seroprevalence of HSV-1 in the U.S. population between NHANES II and III.
Asunto(s)
Herpes Simple/epidemiología , Herpesvirus Humano 1/aislamiento & purificación , Adolescente , Adulto , Distribución por Edad , Anciano , Anticuerpos Antivirales/análisis , Población Negra/estadística & datos numéricos , Niño , Preescolar , Estudios Transversales , Femenino , Herpes Simple/sangre , Herpes Simple/etnología , Herpes Simple/etiología , Herpesvirus Humano 1/inmunología , Humanos , Lactante , Masculino , Persona de Mediana Edad , Encuestas Nutricionales , Estudios Seroepidemiológicos , Estados Unidos/epidemiología , Población Blanca/estadística & datos numéricosRESUMEN
OBJECTIVES: We examined racial/ethnic differences in the seroprevalence of selected infectious agents in analyses stratified according to risk categories to identify patterns and to determine whether demographic, socioeconomic, and behavioral characteristics explain these differences. METHODS: We analyzed data from the third National Health and Nutrition Examination Survey, comparing differences among groups in regard to the prevalence of infection with hepatitis A, B, and C viruses, Toxoplasma gondii, Helicobacter pylori, and herpes simplex virus type 2. RESULTS: Racial/ethnic differences were greater among those in the low-risk category. In the case of most infectious agents, odds associated with race/ethnicity were almost 2 times greater in that category than in the high-risk category. CONCLUSIONS: Stratification and adjustment for socioeconomic factors reduced or eliminated racial/ethnic differences in the prevalence of infection in the high-risk but not the low-risk group, wherein race/ethnicity remained significant and might have been a surrogate for unmeasured risk factors.
Asunto(s)
Enfermedades Transmisibles/etnología , Etnicidad , Encuestas Nutricionales , Adulto , Enfermedades Transmisibles/epidemiología , Femenino , Infecciones por Helicobacter/epidemiología , Infecciones por Helicobacter/etnología , Helicobacter pylori , Hepatitis A/epidemiología , Hepatitis A/etnología , Hepatitis B/epidemiología , Hepatitis B/etnología , Hepatitis C/epidemiología , Hepatitis C/etnología , Herpes Simple/epidemiología , Herpes Simple/etnología , Humanos , Masculino , Modelos Estadísticos , Prevalencia , Estudios Seroepidemiológicos , Toxoplasmosis/epidemiología , Toxoplasmosis/etnología , Estados Unidos/epidemiologíaRESUMEN
A longitudinal cohort study of sexually active women 18-30 years of age was conducted to identify variables associated with the acquisition of herpes simplex virus type 2 (HSV-2) infections. Six hundred seventy HSV-2-seronegative women were followed up at 4-month intervals for 1 year; acquisition of HSV-2 antibodies was detected in 32 of these women. Black race, < or =12 years of education, having a new sex partner, and bacterial vaginosis (BV) were associated with HSV-2 seroconversion on univariate analysis. Antecedent HSV-1 infection was not protective against HSV-2 acquisition. After controlling for other identified risk factors in multivariable models, the diagnosis of BV remained associated with an increased risk of acquiring HSV-2 infection (hazard ratio, 2.1; 95% confidence interval, 1.0-4.5; P=.05). In this study, the population attributable risk of BV for HSV-2 seroconversion was 21%. Additional studies are needed to determine whether screening and treatment of BV could reduce susceptibility to the acquisition of HSV-2 in women.
Asunto(s)
Herpes Simple/complicaciones , Herpesvirus Humano 2 , Vaginosis Bacteriana/complicaciones , Adulto , Estudios de Cohortes , Estudios Transversales , Ensayo de Inmunoadsorción Enzimática , Femenino , Herpes Simple/epidemiología , Herpes Simple/etnología , Humanos , Estudios Longitudinales , Reacción en Cadena de la Polimerasa , Embarazo , Factores de Riesgo , Vaginosis Bacteriana/epidemiología , Vaginosis Bacteriana/etnologíaRESUMEN
BACKGROUND: Voluntary HIV testing sites provide an opportunity to identify and counsel persons with herpes simplex virus type 2 (HSV-2) infection, thereby enhancing the prevention of HSV-2 and HIV infections. GOAL AND STUDY DESIGN: Using serologic specimens left over from HIV testing, we measured HSV-2 prevalence and incidence among persons who had repeatedly tested for HIV at anonymous counseling and testing sites in San Francisco during the period October 1997 through March 2000. RESULTS: The prevalence of HSV-2 infection was 23.5% (n = 987) overall, 28.7% among women, and 24.1% among men who have sex with men (MSM). In relation to race/ethnicity, HSV-2 prevalence was highest among African Americans (34.4%). The incidence of HSV-2 infection (n = 457 person-years [PY] of follow-up) was 2.6 per 100 PY overall and 3.1 per 100 PY among MSM. All but one of the HSV-2 seroconversions occurred among MSM. In multivariate subanalysis of MSM, a self-reported sexually transmitted disease (hazards ratio [HR], 4.3; 95% CI, 1.2-16.1) and HIV seroconversion (HR, 19.4; 95% CI 3.8-99.9) during the interval between tests were correlated with HSV-2 incident infection. CONCLUSION: Offering HSV-2 serologic counseling and testing at HIV counseling and testing sites might help prevent the spread of both infectious diseases.
Asunto(s)
Infecciones por VIH/prevención & control , Herpes Simple/epidemiología , Herpes Simple/prevención & control , Herpesvirus Humano 2 , Aceptación de la Atención de Salud/estadística & datos numéricos , Adolescente , Adulto , Negro o Afroamericano/estadística & datos numéricos , Anciano , Etnicidad/estadística & datos numéricos , Femenino , Infecciones por VIH/complicaciones , Herpes Simple/complicaciones , Herpes Simple/etnología , Homosexualidad Masculina , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , San Francisco/epidemiología , Estudios Seroepidemiológicos , Consejo Sexual , Sexualidad/estadística & datos numéricosRESUMEN
OBJECTIVE: To determine the prevalence of antibody to herpes simplex virus type 2 (HSV-2) in patients attending a general public antenatal clinic and three public sexually transmitted disease (STD) clinics in Sydney. BACKGROUND: Highly specific tests for herpes simplex type 2 antibody, using the glycoprotein G2, have been recently introduced, allowing determination of past asymptomatic infection. Overseas studies have confirmed the long held suspicion that asymptomatic infection is more common than clinical genital herpes. The seroprevalence of HSV-2 in antenatal and STD clinic patients varies markedly in different countries. These are the first data available for Australia by means of this highly specific test. DESIGN: Cross-sectional study of seroprevalence in these two patient groups. Sera used in the antenatal study were those submitted for routine antenatal screening for viral markers. PARTICIPANTS: Two hundred and twenty-nine consecutive patients attending the Westmead Hospital antenatal clinics, and 107 consecutive patients attending three public STD clinics. HYPOTHESES: That Australian populations show a relatively high prevalence of past asymptomatic infection with HSV-2; and that higher rates of infection will be found in patients attending STD clinics and with past or current histories of STDs. MAIN OUTCOME MEASURES: Comparison of HSV-2 seroprevalence between antenatal clinic patients and STD clinic patients; and associations of HSV-2 antibody with age, sex, occupation, country of birth, a history of current or past STDs and antibody to HSV-1. RESULTS: Antibody to HSV-2 was found in 14.5% of antenatal clinic patients and 40% of STD clinic patients. None of the antenatal patients and less than half of the seropositive STD clinic patients reported clinical genital herpes. Associations with age, socioeconomic status and previous HSV-1 infection were less marked than in studies from the United States. Female STD clinic patients had a significantly higher seroprevalence than males and three times the seroprevalence of age-matched antenatal clinic patients. The correlation between HSV-2 antibody and current gonorrhoea was more marked than that between HSV-2 and other STDs. CONCLUSION: Asymptomatic infection with HSV-2 is quite common in Australian antenatal patients and more common in patients with STDs, who have higher rates of sexual exposure.
Asunto(s)
Herpes Simple/epidemiología , Complicaciones Infecciosas del Embarazo/epidemiología , Adulto , Instituciones de Atención Ambulatoria , Anticuerpos Antivirales/análisis , Australia/epidemiología , Estudios Transversales , Femenino , Herpes Simple/etnología , Herpes Simple/inmunología , Humanos , Inmunoensayo , Masculino , Embarazo , Complicaciones Infecciosas del Embarazo/etnología , Complicaciones Infecciosas del Embarazo/inmunología , Atención Prenatal , Prevalencia , Enfermedades de Transmisión Sexual/complicaciones , Simplexvirus/inmunología , Factores SocioeconómicosRESUMEN
OBJECTIVE: To examine the extent and correlates of infection with herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) in an inner-city community, we studied the prevalence of antibodies to these viruses and their association with risk behaviors in a representative sample of unmarried white, black, and Hispanic adults living in San Francisco, Calif. DESIGN: Cross-sectional, community-based, random household survey. PARTICIPANTS: In 1988 and 1989, we surveyed 1770 unmarried men and women aged 20 to 44 years from three San Francisco neighborhoods of varying geographic and cultural characteristics. MAIN OUTCOME MEASURES: HSV-1 and HSV-2 antibodies based on an immunodot assay using type-specific glycoproteins gG-1 and gG-2. RESULTS: Of blood samples from 1212 participants available for testing, 750 (62%) had HSV-1 antibodies and 400 (33%) had HSV-2 antibodies. After controlling for other variables, HSV-1 antibody was significantly correlated (P less than .05) with older age (in heterosexual men, women, and homosexually active men), less education (in heterosexual men and women), and Hispanic (especially those not born in the United States) or black race. HSV-2 antibody was significantly correlated (P less than .05) with female gender, number of lifetime sexual partners and older age (in heterosexual men and women), and low levels of education and black or Hispanic race (in women). Among those with antibody to HSV-2, only 28 (19%) of 149 men and 32 (13%) of 251 women reported a history of genital herpes. However, most men (62%) and women (84%) who reported a history of genital herpes had HSV-2 antibodies. We observed a similar pattern (low sensitivity and moderate specificity) for a history of facial herpes and the presence of HSV-1 antibodies. After controlling for other variables, HSV-2 antibodies were associated with a lower frequency of HSV-1 antibodies among homosexual men infected with the human immunodeficiency virus. CONCLUSIONS: HSV-1 antibodies were found in nearly two thirds of single urban adults and were most common among Hispanics not born in the United States. HSV-2 antibodies were found in one third of this population and were associated with risk behaviors for sexually transmitted diseases. For both facial and genital herpes infections, self-reporting of infection was very insensitive and moderately specific.