Persistence in the population: epidemiology, transmission

In: Human Herpesviruses: Biology, Therapy, and Immunoprophylaxis. Cambridge: Cambridge University Press; 2007. Chapter 36.


Herpes simplex viruses are among the most ubiquitous of human infections. The frequency of HSV infection has been measured by testing various populations for the presence of antibody, as both virus and the immune response are thought to persist after infection for the life of the host. Worldwide, ∼90% of people have one or both viruses. HSV-1 is the more prevalent virus, with 65% of persons in the United States having antibodies to HSV-1 (Xu et al., 2002). The epidemiology in Europe is similar, with at least half of the population seropositive for HSV-1. In the developing world, HSV-1 is almost universal, and usually acquired from intimate contact with family in early childhood (Whitley et al., 1998). After childhood, the HSV-1 prevalence rates increase minimally with age. Rates of HSV-1 infection are similar for men and women. In the United States, African-Americans and Asians have higher rates of HSV-1 infection than whites. The majority of infections are oral, although most are asymptomatic. Some data suggest that in developed countries, acquisition of HSV-1 is delayed from early childhood to adolescence or young adulthood (Hashido et al., ; Mertz et al., 2003).

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