Seroprevalence and Risk Factors for Herpes Simplex Virus Infection in a Population of HIV-Infected Patients in Canada

The researchers in the current study set out to determine the seroprevalence of herpes simplex virus (HSV) in a population of HIV-positive patients in Canada. The study participants were HIV patients attending five infectious-disease clinics for follow-up care.

After their informed consent was obtained, the participants completed a questionnaire documenting HIV risk behavior, duration of infection, history of oral and/or genital herpes, and treatment for HIV and/or genital herpes. Clinicians drew blood for HSV type-specific serology; the samples were tested by enzyme-linked immunosorbent assay (Focus Diagnostics HerpeSelect HSV-1,HSV-2 enzyme-linked immunosorbent assay IgG). Equivocal samples were repeated; Western blot was used to resolve any discrepant results.

In all, 629 HIV-positive patients took part. Participants' mean age was 43.9; 74.7 percent were born in Canada; and 72.3 percent were men. Most foreign-born subjects were black (endemic) and women. HSV-1 seroprevalence was 78.1 percent; HSV-2 seroprevalence was 54.6 percent. Females were 2.7 times more likely to be positive for HSV-2. Foreign-born participants were 2.0 times more likely to be positive for HSV-2. Nonwhite subjects were 3.2 times more likely to be seropositive. The lowest seroprevalence of HSV-2 was observed among men who have sex with men. A history of genital herpes was reported by only 30.3 percent of participants positive for HSV-2.

Noting that "a significant proportion of HIV-infected subjects attending five infectious-disease clinics in Canada are co-infected with HSV," the authors concluded that "routine type-specific HSV-2 testing should be introduced to direct education regarding symptoms, signs, and transmission reduction of genital herpes, and perhaps ultimately of HIV-1. Knowledge of HSV serostatus would also provide an opportunity to consider antiviral therapy."