Catàleg general Salut sexual
Epidemiology of genital herpes simplex virus infection in Bilbao, Spain, between 2004 and 2014
ResumBackground: Herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) are the most commonly causes of genital ulceration. The aim of this study was to analyze and compare characteristics of patients infected with genital HSV-1 and HSV-2 from 2004 to 2014 in a sexually transmitted disease (STD) clinic population, in Bilbao, Spain. Material/methods: Data were collected from our STD clinic patients with genital herpes. The proportions of HSV-1 and HSV-2 detected in these individuals were analyzed by different characteristics. Results: A total of 225 of HSV positive genital samples of 135 patients were studied. HSV-2 was typed in 62.2% (84/135), HSV-1 in 34.8% (47/135) and both types in 2.9% (4/135) of the patients. HSV-1 was detected in 61.7% (29/47) of patients aged less than 34 years and HSV-2 in 72.6% (61/84) between 25 and 44 years. The mean time of the appearance of symptoms was 10 days and the most frequent symptom was painful ulcerations or blisters 66.6% (90/135). Famciclovir was the more common treatment in these patients 48.5% (51/105). More female than male patients had HSV-1 infection (76.5% vs. 23.4%). Genital HSV-1 may often be acquired through contact with a partner’s oral-labial herpes 78.5% (11/14) and genital HSV-2 through contact with a partner’s genital herpes 78.2% (18/23). The proportion of first episode was higher among HSV-1 infections 51.4% (36/70) and 4.2% (3/70) of them was primary infection confirmed serologically. These first episodes among HSV-1 infections were higher among women 76.5% (36/47), heterosexual men and women 91.6 % (33/36), single sexual partner the last 12 months 61.1% (22/36) and genital and oral sex 91.6% and 83.3% (33/36 and 30/36), respectively. Recurrences were higher among HSV-2 infections 80% (52/65). Sexual behaviors which had been associated with HSV-2 infection include single sexual partner 59% (65/110), sporadic sexual contact 68.5% (24/35), sex-worker 100% (5/5), HIV sexual partner 83.3% (5/6) and ex-IDUs 80% (4/5). Most of the patients with HSV-2 infection had history of a STD 84.9% (62/73) and a concomitant STD diagnosis 62.5% (30/48). HIV was the majority prior STD 28.7% (21/73) and syphilis, C. trachomatis infection and condylomas were the most prevalent concomitant diagnosis 10.4% (5/48). 48.8% (64/131) of patients did not use any contraceptive method. Conclusions: HSV-2 was still the most common causative agent of genital herpes in this study, but the proportion of HSV-1 was high. Risk factors for genital HSV-1 first episode include younger age, female gender, heterosexual men and women, single sexual partner the last 12 months and genital and oral sex, include a prior contact with a partner’s oral-labial herpes. Sexual behaviors associated with HSV-2 infection were older age, female gender, low level of education, single sexual partner and prior and concomitant STD.
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