Session: Poster Session: Herpes Viruses
Monday, October 27, 2008: 12:00 AM
Room: Hall C
Background: Population-based studies suggest that acquisition of herpes simplex virus 2 (HSV 2) is most common in the decade between ages 20 and 29, especially in minority women. Most acquisitions seem to occur without symptoms. We tested a cohort of prospectively followed young women for HSV 2 antibody and correlated acquisition with sexual behavior and genital symptoms. Methods: Women, age 18-24, who were part of a cohort that was enrolled between the ages of 14-17, had blood obtained for HSV 2 antibody testing. These women had extensive data collected on sexual behavior, genital symptoms, and incident sexually transmitted infections since enrollment based on intensive diary collections and weekly vaginal swabs at various times during the study. Blood was tested for HSV 2 antibody using the HerpeSelect 2 ELISA (Focus Diagnostics). Results: There were 118 subjects available for enrollment. The median age was 21 years. Although only 3 subjects (2.5%) had a history of genital herpes, 37 (31.4%) had HSV 2 antibodies detected. Factors associated with a positive test included age (OR 1.32, 95% CI 1.05, 1.66), years of sexual activity (OR 1.16, 95% CI 1.00, 1.36), and number of lifetime partners (OR 1.09, 95% CI 1.01, 1.17). There was no association between a positive HSV 2 antibody test and days of genital symptoms (pain or discharge). Fourteen of the HSV 2 positive subjects had a previous negative HSV 2 antibody test a mean of 5.6 years earlier. Among these subjects with incident HSV 2 infection there was no significant association with behavioral factors such as number of sexual partners or number of unprotected sexual contacts between the two tests, compared to those who did not seroconvert. Conclusions: HSV 2 infection is very common among young adult women, but symptomatic genital herpes is not. Even daily recording of symptoms in a diary failed to identify subjects who were HSV 2 positive. These findings suggest that identifying HSV 2 positive young women may require screening.