Rise in seroprevalence of herpes simplex virus type 1 among highly sexual active homosexual men and an increasing association between herpes simplex virus type 2 and HIV over time (1984-2003).

OBJECTIVES: Herpes simplex virus type 1 and type 2 (HSV-1 and HSV-2) are both highly prevalent. The rate of genital HSV-1 transmission is reportedly increasing over time. HSV-2 is considered to be an important risk factor for HIV transmission. We therefore studied changes in the HSV-1 and HSV-2 prevalence in a large cohort of men who have sex with men (MSM) over a 20-year time period. METHODS: Among 1847 HIV-infected and HIV-uninfected MSM participating in the Amsterdam Cohort Studies, seroprevalence of HSV-1 and HSV-2 was determined and prevalence rate ratios (PRR) and 95% confidence intervals were calculated. RESULTS: Between 1984 and 2003 the HSV-1 and HSV-2 prevalence decreased among HIV-uninfected MSM (P < 0.001), but remained stable among HIV-infected MSM. HSV-1 prevalence increased among men with at least 200 sexual partners over lifetime (PRR: 1.49, P < 0.001). The association between HIV infection and HSV-2 became stronger over time (PRR: 3.45, P < 0.001). CONCLUSIONS: Seroprevalence of HSV-1 and HSV-2 remained high among HIV infected MSM from 1984 to 2003. The association of HIV and HSV-2 increased during the HIV epidemic. Since the proportion of sexual transmission of HSV-1 is rising, it is important to study the potential role of HSV-1 as risk factor for HIV acquisition.