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Background: Herpes simplex virus type 2 (HSV-2), the main cause of genital herpes, causes lifelong infection and increases the risk of HIV acquisition by at least 2-fold. HSV-2 seroprevalence has been assessed in National Health and Nutrition Examination Surveys (NHANES) since 1976, with seroprevalence decreasing during the past decades (1988-1994 = 21%; 1999-2004= 17%).
Objectives: We sought to determine the U.S. HSV-2 seroprevalence estimates from NHANES 2005-2008.
Methods: We analyzed data from NHANES 2005–2008 to establish the seroprevalence of HSV-2 among persons aged 14–49. Data were weighted to provide national estimates. Logistic regression was used to identify factors associated with HSV-2 seroprevalence. HSV-2 seroprevalence from NHANES 2005–2008 was compared with estimates from NHANES 1999-2004.
Results: In NHANES 2005–2008, the overall HSV-2 seroprevalence was 16.2% (95% confidence interval 14.6%–17.9%). Seroprevalence increased with age, from 1.4% among those aged 14–19 to 26.1% among those aged 40–49, and was higher among women (20.9%) than among men (11.5%, p<0.001). Seroprevalence was higher among non-Hispanic blacks (39.2%) than among non-Hispanic whites (12.3%, p<0.001). HSV-2 seroprevalence did not change between 1999-2004 and 2005-2008 (p=.34)
Conclusions: In the United States, approximately 1 in 6 persons aged 14–49 years has HSV-2 infection; women and African Americans were found to be disproportionately affected.
Implications for Programs, Policy, and/or Research: HSV-2 infection has particular public health importance because it increases the risk of HIV acquisition, and groups with the highest HSV-2 seroprevalence (e.g., non-Hispanic blacks) are at higher risk of acquiring HIV. Primary prevention of HSV-2 infection may be the only method to reduce the excess HIV risk associated with HSV infection in these groups.