The epidemiology of genital infection with herpes simplex virus types 1 and 2 in genitourinary medicine attendees in inner London. Issue 4 (1st August 2005)

• Record Type: Journal Article
• Authors: Ramaswamy, M; McDonald, C; Sabin, C; Tenant-Flowers, M; Smith, M; Geretti, A M
• Is Part Of: Sexually transmitted infections. Volume 81:Issue 4(2005)
• Page Start: 306
• Page End: 308
• Publication Date: 2005-08-01
• Subjects: GUM, genitourinary medicine -- ELISA, enzyme linked immunoassay -- HSV, herpes simplex virus -- PCR, polymerase chain reaction; genitourinary medicine clinics -- herpes simplex virus -- ethnicity; Sexually transmitted diseases -- Periodicals; HIV infections -- Periodicals; 616.951005
• DOI: 10.1136/sti.2004.011643
• Languages: English
• ISSNs: 1368-4973

Abstract

Abstract : Objective: To characterise the epidemiological and clinical features of genital herpes and the diagnostic role of HSV-2 specific serology in an ethnically diverse cohort of genitourinary medicine (GUM) attendees in inner London. Methods: Genital swabs (n = 186) were tested by real time polymerase chain reaction (PCR) and serum samples (n = 70) by HSV-2 specific enzyme linked immunoassay (ELISA). Results: Among 186 patients (median age 29 years), 104/186 (56%) were male and 176/186 (95%) heterosexual; ethnicity was predominantly black Caribbean (76/186, 41%), white (65/186, 35%), or black-African (41/186, 22%). The most common lesion sites were penis (85/104 men, 82%) and vulva (63/82 women, 77%); 114/186 (61%) patients were diagnosed clinically with first episode disease. Women were more likely to present <5 days of onset (p = 0.008). Black Caribbean patients were more likely to present ⩾5 days (p = 0.04) and decline HIV testing (p = 0.03). By PCR, 108/186 (58%) swabs tested positive for HSV-1 (7/108, 6.5%) or HSV-2 (101/108, 93.5%). Independent predictors of a positive PCR were heterosexual group, <5 days of onset, and visible genital ulceration on examination. HSV-2 was associated with black Caribbean and black African ethnicity; HSV-1 with white ethnicity (p = 0.006). By HSV-2 specific serology, 16/42 (38%) first episodes caused by HSV-2 were recurrent infections, and 7/19 (37%) patients with recurrent genital disease but negative PCR had genital herpes. Conclusions: Epidemiological trends in genital HSV-1 and HSV-2 infection appear to vary between ethnic groups in the United Kingdom. HSV-2 specific serology improves diagnostic accuracy in GUM populations where most genital infections are caused by HSV-2.