Rates of Genital Herpes Infections Rise in Scotland

Genital infections with herpes simplex virus type 1 (HSV-1) have risen in western Scotland over the last 15 years, particularly among young women, according to a study in the British Medical Journal ("Longitudinal Study of Genital Infection by Herpes Simplex Virus Type 1 in Western Scotland over 15 Years," 2002;324;1366-1367).

Researchers reviewed all genital samples of herpes simplex processed between 1986 and 2000 at the West of Scotland Specialist Virology Center. Of the 3,181 swabs testing positive for the virus, 63 percent were from women and 37 percent were from men. Twenty-nine percent of patients were ages 21 to 25. In 1986-1988, 33 percent of all positive swabs were due to HSV-1, rising progressively to 56 percent in 1998-2000.

Both the number and percentage of HSV-1 infections have risen, said the authors. Genital infection with HSV-1 is also strongly associated with being young (<25 years) and being female. Most new cases of genital HSV-1 infection are likely to be due to orogenital transmission, but there is no evidence suggesting that oral sex practices have changed substantially, said the authors. The occurrence of HSV-1 infection in women is unexplained.

These results suggest that counseling and clinical management strategies may need to be revised. Preventive strategies for genital herpes should focus on the risk of unprotected orogenital intercourse, which is frequently perceived as "safe" in the context of STD transmission, the authors noted.

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