Australian Herpes Management Forum

Research Update: Risk of HSV-2 Acquisition Increases Over Early Adulthood

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September 2006

What's known?

Genital herpes is one of the most prevalent sexually transmitted infections in the world.

Accurate assessment of HSV-2 occurrence requires measurement of HSV-2 antibodies, as many infections are asymptomatic or unrecognised.

What’s New?

This study included subjects participating in the Dunedin Multidisciplinary Health and Development Study, a longitudinal study of a cohort born in Dunedin, New Zealand, between 1 April 1972 and 31 March 1973.

The study sample was first followed up at three years of age when 1037 of 1139 eligible children were seen and subsequently, they were seen every two years until 15 years, then at 18, 21, 26, and most recently at 32 years.

At ages 21, 26 and 32, sexual behaviour questions were asked and HSV-2 serology was performed.

The overall prevalence of HSV-2 infection was 18.4%, higher among the women (22.5%) than the men (14.6%) (p=0.003).

The prevalence at age 26 was 15.3% and 7.1%, for women and men respectively.

For the period from first coitus to age 26, the incidence rate for men (6.5 per 1000 person-years) was less than half that for women (14.3 per 1000 person-years) (p=0.001).

In the age period 26 to 32 the rates were similar for men and women: 14.3 and 15.8 per 1000 person-years respectively (p=0.69).

When adjusted for sexual behaviour, the incidence rate ratio, comparing the older to the younger age periods, was 2.9 (95% confidence interval 1.7 to 4.9) for men and 2.0 (95% confidence interval 1.2 to 3.4) for women.

When adjusted for number for sexual partners and same sex contact, the incidence rate ratio for women compared to men was 2.5 (95% CI 1.6 to 4.0) up to age 26, but only to 1.3 (95% CI 0.78 to 2.2) for the age period 26 and 32.

The main findings from this study are that increasing age is independently associated with increasing incidence (or risk of acquiring) of HSV for both men and women and while women are at greater risk than men up to age 26, the risks were similar between ages 26 and 32.

Authors suggest that health promotion and treatment to control HSV-2 infection should be aimed at all ages, not just the young and that this includes availability of suppressive treatment.

Reference

Nigel Dickson, Thea van Roode, Peter Herbison, Janette Taylor, Anthony Cunningham, Charlotte Paul. Risk of HSV-2 acquisition increases over early adulthood: evidence from a cohort study. Sex Transm Infect. 2006 Aug 17; [Epub ahead of print]

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