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December 20, 2016

A Recommendation Against Serologic Screening for Genital Herpes Infection—What Now?

Author Affiliations
  • 1School of Medicine, Department of Microbiology, The University of Alabama at Birmingham
JAMA. 2016;316(23):2493-2494. doi:10.1001/jama.2016.17139

Genital herpes, one of the most prevalent sexually transmitted infections (STIs) in the United States, is caused either by herpes simplex virus (HSV) type 2 (HSV-2), a virus that almost exclusively causes genital infections, or increasingly by HSV type 1 (HSV-1), a closely related virus that causes both oro-labial herpes (“cold sores”) and genital herpes.1,2 Genital herpes should be prioritized as a public health problem. HSV-2 is estimated to infect more than 45 million individuals (15.3%) living in the United States aged 14 to 49 years, and more than 10% to 20% of new genital herpes infections are now caused by HSV-1.1 Further, genital herpes is an example of the striking health disparities that characterize STIs in the United States; HSV-2 seroprevalence among non-Hispanic blacks (about 39%) is far higher than the seroprevalence among whites (about 12%).1,3 Congenital herpes, which is not a reportable condition, is estimated to be more than twice as common as congenital syphilis (31/100 000 vs 12.4/100 000 live births) and can be devastating for children born to infected mothers.4 In addition, there is a strong association between genital herpes infection and increased risk for acquisition of human immunodeficiency virus type 1.1,5