• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of straninfSexually Transmitted InfectionsVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
Sex Transm Infect. Apr 2005; 81(2): 103–107.
PMCID: PMC1764655

A systematic review of the epidemiology and interaction of herpes simplex virus types 1 and 2


Objectives: To explore epidemiological evidence about the interaction of herpes simplex virus (HSV) 1 and HSV-2 infections.

Methods: A systematic review was undertaken of published epidemiological studies describing the pattern of HSV-1 or HSV-2 by age, and the coincidence of the two viral infections.

Results: In cross sectional studies the unadjusted odds of HSV-2 are greater in those with HSV-1 infection in study populations categorised as "low risk" (p = 0.06) and across European populations (p = 0.001). This was not evident in "high risk" populations or in the United States. This increased risk of HSV-2 in those with HSV-1 infection does not agree with the results of prospective studies where there is a non-significant trend towards a lower risk of HSV-2 infection associated with previous HSV-1 infection.

Conclusions: "Low risk" and European populations have a relatively low HSV-2 seroprevalence and infection is more concentrated in those with characteristics putting them at high risk for both HSV-1 and HSV-2. This confounding could mask any protective effect of HSV-1, which is hinted at, but not demonstrated, in prospective and adjusted studies.

Full Text

The Full Text of this article is available as a PDF (101K).

Supplementary Material

[Web-only tables & figures]

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Nahmias AJ, Lee FK, Beckman-Nahmias S. Sero-epidemiological and -sociological patterns of herpes simplex virus infection in the world. Scand J Infect Dis Suppl. 1990;69:19–36. [PubMed]
  • Lafferty WE, Coombs RW, Benedetti J, Critchlow C, Corey L. Recurrences after oral and genital herpes simplex virus infection. Influence of site of infection and viral type. N Engl J Med. 1987 Jun 4;316(23):1444–1449. [PubMed]
  • Löwhagen Gun-Britt, Tunbäck Petra, Bergström Tomas. Proportion of herpes simplex virus (HSV) type 1 and type 2 among genital and extragenital HSV isolates. Acta Derm Venereol. 2002;82(2):118–120. [PubMed]
  • Lafferty WE, Downey L, Celum C, Wald A. Herpes simplex virus type 1 as a cause of genital herpes: impact on surveillance and prevention. J Infect Dis. 2000 Apr;181(4):1454–1457. [PubMed]
  • Strutt M, Bailey J, Tenant-Flowers M, Graham D, Zuckerman M. Ethnic variation in type of genital herpes simplex virus infection in a South London genitourinary medicine clinic. J Med Virol. 2003 Jan;69(1):108–110. [PubMed]
  • Scoular Anne, Norrie John, Gillespie Graeme, Mir Noreen, Carman WF. Longitudinal study of genital infection by herpes simplex virus type 1 in Western Scotland over 15 years. BMJ. 2002 Jun 8;324(7350):1366–1367. [PMC free article] [PubMed]
  • Christie SN, McCaughey C, McBride M, Coyle PV. Herpes simplex type 1 and genital herpes in Northern Ireland. Int J STD AIDS. 1997 Jan;8(1):68–69. [PubMed]
  • Wald Anna, Zeh Judith, Selke Stacy, Warren Terri, Ashley Rhoda, Corey Lawrence. Genital shedding of herpes simplex virus among men. J Infect Dis. 2002 Oct 15;186 (Suppl 1):S34–S39. [PubMed]
  • Brown Zane A, Wald Anna, Morrow R Ashley, Selke Stacy, Zeh Judith, Corey Lawrence. Effect of serologic status and cesarean delivery on transmission rates of herpes simplex virus from mother to infant. JAMA. 2003 Jan 8;289(2):203–209. [PubMed]
  • Corey Lawrence, Wald Anna, Patel Raj, Sacks Stephen L, Tyring Stephen K, Warren Terri, Douglas John M, Jr, Paavonen Jorma, Morrow R Ashley, Beutner Karl R, et al. Once-daily valacyclovir to reduce the risk of transmission of genital herpes. N Engl J Med. 2004 Jan 1;350(1):11–20. [PubMed]
  • Stanberry Lawrence R, Spruance Spotswood L, Cunningham Anthony L, Bernstein David I, Mindel Adrian, Sacks Stephen, Tyring Stephen, Aoki Fred Y, Slaoui Moncef, Denis Martine, et al. Glycoprotein-D-adjuvant vaccine to prevent genital herpes. N Engl J Med. 2002 Nov 21;347(21):1652–1661. [PubMed]
  • Ashley RL, Wald A. Genital herpes: review of the epidemic and potential use of type-specific serology. Clin Microbiol Rev. 1999 Jan;12(1):1–8. [PMC free article] [PubMed]
  • Smith Jennifer S, Robinson N Jamie. Age-specific prevalence of infection with herpes simplex virus types 2 and 1: a global review. J Infect Dis. 2002 Oct 15;186 (Suppl 1):S3–28. [PubMed]
  • Mihret Wude, Rinke de Wit Tobias F, Petros Beyene, Mekonnen Yared, Tsegaye Aster, Wolday Dawit, Beyene Asfaw, Aklilu Mathias, Sanders Eduard, Fontanet Arnaud L. Herpes simplex virus type 2 seropositivity among urban adults in Africa: results from two cross-sectional surveys in Addis Ababa, Ethiopia. Sex Transm Dis. 2002 Mar;29(3):175–181. [PubMed]
  • Howard Michelle, Sellors John W, Jang Dan, Robinson Noah J, Fearon Margaret, Kaczorowski Janusz, Chernesky Max. Regional distribution of antibodies to herpes simplex virus type 1 (HSV-1) and HSV-2 in men and women in Ontario, Canada. J Clin Microbiol. 2003 Jan;41(1):84–89. [PMC free article] [PubMed]
  • Stover Cynthia T, Smith Dawn K, Schmid D Scott, Pellett Philip E, Stewart John A, Klein Robert S, Mayer Kenneth, Vlahov David, Schuman Paula, Cannon Michael J, et al. Prevalence of and risk factors for viral infections among human immunodeficiency virus (HIV)-infected and high-risk HIV-uninfected women. J Infect Dis. 2003 May 1;187(9):1388–1396. [PubMed]
  • Wutzler P, Doerr HW, Färber I, Eichhorn U, Helbig B, Sauerbrei A, Brandstädt A, Rabenau HF. Seroprevalence of herpes simplex virus type 1 and type 2 in selected German populations-relevance for the incidence of genital herpes. J Med Virol. 2000 Jun;61(2):201–207. [PubMed]
  • Rabenau HF, Buxbaum S, Preiser W, Weber B, Doerr HW. Seroprevalence of herpes simplex virus types 1 and type 2 in the Frankfurt am Main area, Germany. Med Microbiol Immunol. 2002 Mar;190(4):153–160. [PubMed]
  • Robinson Lisa-Gaye E, Black Francis L, Lee Francis K, Sousa Alexandra O, Owens Marilyn, Danielsson Dan, Nahmias André J, Gold Benjamin D. Helicobacter pylori prevalence among indigenous peoples of South America. J Infect Dis. 2002 Oct 15;186(8):1131–1137. [PubMed]
  • Eis-Hübinger Anna Maria, Nyankiye Emmanuel, Bitoungui Didier Mboua, Ndjomou Jean. Prevalence of herpes simplex virus type 2 antibody in Cameroon. Sex Transm Dis. 2002 Nov;29(11):637–642. [PubMed]
  • Hashido M, Lee FK, Nahmias AJ, Tsugami H, Isomura S, Nagata Y, Sonoda S, Kawana T. An epidemiologic study of herpes simplex virus type 1 and 2 infection in Japan based on type-specific serological assays. Epidemiol Infect. 1998 Mar;120(2):179–186. [PMC free article] [PubMed]
  • Madhavan Hajib N, Priya Kannian. The diagnostic significance of enzyme linked immuno-sorbent assay for herpes simplex, varicella zoster and cytomegalovirus retinitis. Indian J Ophthalmol. 2003 Mar;51(1):71–75. [PubMed]
  • Becker TM, Magder L, Harrison HR, Stewart JA, Humphrey DD, Hauler J, Nahmias AJ. The epidemiology of infection with the human herpesviruses in Navajo children. Am J Epidemiol. 1988 May;127(5):1071–1078. [PubMed]
  • Cowan FM, Johnson AM, Ashley R, Corey L, Mindel A. Antibody to herpes simplex virus type 2 as serological marker of sexual lifestyle in populations. BMJ. 1994 Nov 19;309(6965):1325–1329. [PMC free article] [PubMed]
  • Enders G, Risse B, Zauke M, Bolley I, Knotek F. Seroprevalence study of herpes simplex virus type 2 among pregnant women in Germany using a type-specific enzyme immunoassay. Eur J Clin Microbiol Infect Dis. 1998 Dec;17(12):870–872. [PubMed]
  • Opaneye AA, Bashford J. Seroprevalence of antibodies to herpes simplex virus types 1 and 2 among two sexually active female populations in Middlesbrough, England. J R Soc Promot Health. 2002 Jun;122(2):108–111. [PubMed]
  • Kjaer SK, de Villiers EM, Haugaard BJ, Christensen RB, Teisen C, Møller KA, Poll P, Jensen H, Vestergaard BF, Lynge E, et al. Human papillomavirus, herpes simplex virus and cervical cancer incidence in Greenland and Denmark. A population-based cross-sectional study. Int J Cancer. 1988 Apr 15;41(4):518–524. [PubMed]
  • Langenberg AG, Corey L, Ashley RL, Leong WP, Straus SE. A prospective study of new infections with herpes simplex virus type 1 and type 2. Chiron HSV Vaccine Study Group. N Engl J Med. 1999 Nov 4;341(19):1432–1438. [PubMed]
  • Stanberry LR, Cunningham AL, Mindel A, Scott LL, Spruance SL, Aoki FY, Lacey CJ. Prospects for control of herpes simplex virus disease through immunization. Clin Infect Dis. 2000 Mar;30(3):549–566. [PubMed]
  • Xu Fujie, Schillinger Julia A, Sternberg Maya R, Johnson Robert E, Lee Francis K, Nahmias Andre J, Markowitz Lauri E. Seroprevalence and coinfection with herpes simplex virus type 1 and type 2 in the United States, 1988-1994. J Infect Dis. 2002 Apr 15;185(8):1019–1024. [PubMed]
  • Hitti J, Watts DH, Burchett SK, Schacker T, Selke S, Brown ZA, Corey L. Herpes simplex virus seropositivity and reactivation at delivery among pregnant women infected with human immunodeficiency virus-1. Am J Obstet Gynecol. 1997 Aug;177(2):450–454. [PubMed]
  • Brown ZA, Selke S, Zeh J, Kopelman J, Maslow A, Ashley RL, Watts DH, Berry S, Herd M, Corey L. The acquisition of herpes simplex virus during pregnancy. N Engl J Med. 1997 Aug 21;337(8):509–515. [PubMed]
  • Ashley RL. Sorting out the new HSV type specific antibody tests. Sex Transm Infect. 2001 Aug;77(4):232–237. [PMC free article] [PubMed]
  • Cowan FM, French RS, Mayaud P, Gopal R, Robinson NJ, de Oliveira S Artimos, Faillace T, Uusküla A, Nygård-Kibur M, Ramalingam S, et al. Seroepidemiological study of herpes simplex virus types 1 and 2 in Brazil, Estonia, India, Morocco, and Sri Lanka. Sex Transm Infect. 2003 Aug;79(4):286–290. [PMC free article] [PubMed]
  • Pebody RG, Andrews N, Brown D, Gopal R, De Melker H, François G, Gatcheva N, Hellenbrand W, Jokinen S, Klavs I, et al. The seroepidemiology of herpes simplex virus type 1 and 2 in Europe. Sex Transm Infect. 2004 Jun;80(3):185–191. [PMC free article] [PubMed]

Articles from Sexually Transmitted Infections are provided here courtesy of BMJ Group


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...