What is the prevalence of herpes simplex virus (HSV) infection in the US?

Updated: Mar 17, 2020
  • Author: Sean P McGregor, DO, PharmD; Chief Editor: William D James, MD  more...
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Herpes simplex virus (HSV) type 1 infection is typically acquired by early childhood. The seroprevalence of HSV-1 in persons aged 14-49 years in the United States is 53.9%, based on data from the 2005-2010 National Health and Nutrition Examination Survey (NHANES). [7] Only about 30% of these individuals have clinically apparent outbreaks. The seroprevalence of HSV-2 in the United States is 15.7%, and more than 80% of these infections are either asymptomatic or unrecognized. [7, 8] Regardless, these individuals still have episodes of viral shedding and can transmit the virus. The seroprevalence of HSV-1 has declined approximately 7% from prior NHANES data. However, the seroprevalence of HSV-2 has remained stable after increasing between 1976 and 1980 and subsequently declining between 1988 and 2004. [8] Independent predictors of HSV-2 seropositivity include female sex, older age, non-Hispanic black race, and increased lifetime sex partners. [8, 9] Additionally, patients with prior sexually transmitted infections, such as chlamydia, gonorrhea, and syphilis, have higher rates of HSV-2 seroprevalence. [10] Newer data indicate that HSV-1 infections may account for more genital infections than previously thought. A retrospective review of genital HSV infection in college-age students revealed that HSV-1 accounted for 78% of isolates, suggesting a reversal in prior etiologic notions. [11]

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