Type-Specific Seroprevalence of Herpes Simplex Virus Type 2 and Associated Risk Factors in Middle-Aged Women From 6 Countries: The IARC Multicentric Study

PATNAIK, PADMAJA PhD*†; HERRERO, ROLANDO MD, PhD‡; MORROW, R ASHLEY PhD§; MUÑOZ, NUBIA MD|¶; BOSCH, F XAVIER MD#; BAYO, SINÉ MD**; EL GUEDDARI, BRAHIM MD††; CACERES, EDUARDO MD‡‡; CHICHAREON, SAIBUA B. MD§§; CASTELLSAGUÉ, XAVIER MD, MPH, PhD#; MEIJER, CHRIS J. L. M. MD||; SNIJDERS, PETER J. F. PhD||; SMITH, JENNIFER S. MPH, PhD*

Sexually Transmitted Diseases:
doi: 10.1097/OLQ.0b013e31811f4118
Article
Abstract

Goal: To determine type-specific seroprevalence of herpes simplex viruses (HSV-1 and HSV-2) and HSV-2 risk factors.

Study Design: Six-hundred fifty eight middle-aged control women (hospital-based in 4 of 6 countries) from a multicenter cervical cancer case–control study participated from 1985 to 1997. Type-specific serum IgG antibodies against HSV-1 and HSV-2 were detected with Western Blot.

Results: HSV-1 seroprevalence was 89% to 100% everywhere except Thailand (51%). HSV-2 seroprevalence ranged from 9% (Spain) to 57% (Colombia), and was independently associated with having ≥2 lifetime sexual partners overall [Odds ratio (OR), 2.1; 95% confidence interval (CI) 2.5–3.1], and in Morocco (OR, 2.7; 95% CI, 1.2–6.1) and Thailand (OR, 4.4; 95% CI, 1.3–15.4), and with being unmarried in Colombia, Peru, Spain, but not significantly in Mali. Women whose male partner’s sexual debut was ≤17 years had a higher HSV-2 risk (OR, 4.3 95% CI, 1.3–13.7).

Conclusions: HSV-2 seroprevalence in middle-aged women varied over 4-fold and was associated with riskier sexual behaviors in women and their male partners.

In Brief

Type-specific Western blot HSV-2 prevalence in middle-aged women from 6 countries varied widely (9%, Spain–57%, Colombia). HSV-2 risk factors included sexual behavior of women and their male partners.

Author Information

From the *Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; †Worldwide Epidemiology, GlaxoSmithKline, Research Triangle Park, North Carolina; ‡Proyecto Epidemiológico Guanacaste, Fundacion, INCIENSA, Costa Rica; §Laboratory Medicine, University of Washington, Seattle, Washington; |International Agency for Research on Cancer (IARC), Lyon, France; ¶Institut Catala d’Oncologia (ICO), 24, Quai Fulchiron, Lyon, France; #IDIBELL, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain; **Institut National de Recherche en Santé Publique, Bamako, Mali; ††Institut National d’Oncologie, Sidi Mohamed Ben Abdellah, BP 6213 Ri Agdal Rabat, Morocco; ‡‡Maes-Heller Cancer Research Centre, Lima, Peru; §§Department of Obstetrics-Gynecology, Faculty of Medicine, Prince of Songkla University, Hat-Yai, Songkla, Thailand; ||Department of Pathology, VU University Medical Center, Amsterdam, Netherlands

The authors thank Dr. Silvia Franceschi, International Agency for Research on Cancer (IARC), Lyon, France, and Dr. Cristina Bosetti, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy, for their assistance in conducting this study; Dr. Jamie Robinson for his support through the Worldwide Development Post-Doctoral Fellowship; and Dr. Julius Atashili for his assistance.

The study was supported by the European Community CI 1-0371-F(CD); The Fondo de Investigaciones Sanitarias (FIS), Spain 86/753, 87/1513, 88/2049, 90/0901, 95/0955, 01/1237, 01/1236, PI051308 and BAE 01/5013; The International Agency for Research on Cancer, Lyon, France FI/92/3-2 PAR; Preventiefonds, The Netherlands 28-1502·1; Programa Interministerial de Investigación y Desarrollo, Spain SAF 96/0323, The Conselho Nacional de Desenvolvimiento Cientifico e Tecnologico, Brazil (CNPq) JEN-204453/88·7 and the Department of Reproductive Health and Research at the World Health Organization, Grant No. 98·101; and the National Institutes of Health, USA Grant AI30731.

The Worldwide Development Post-Doctoral Fellowship sponsored by the University of North Carolina at Chapel Hill and GlaxoSmithKline supported Dr. Padmaja Patnaik in analyzing the data and preparing the manuscript. Dr. Jennifer Smith was supported through the Centers for AIDS Research, National Institute of Allergy and Infectious Diseases (grant 5 P30 AI050410-07).

Current affiliation for Padmaja Patnaik is Family Health International, Durham, North Carolina.

Correspondence: Dr. Jennifer Smith, Department of Epidemiology, CB# 7435, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7435. E-mail: JenniferS@unc.edu.

Received for publication March 13, 2007, and accepted May 17, 2007.

© Copyright 2007 American Sexually Transmitted Diseases Association