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Background: The prevalence of Herpes simplex virus type 2 (HSV-2) in cervical lesions is under-reported, especially in Human immunodeficiency virus (HIV), Epstein-Barr virus (EBV) and Human Papillomavirus (HPV) infected persons. Objectives: This study determined the prevalence of viral mono-infections, co-infections and squamous cell intraepithelial lesions (SIL) in HIV seropositive (HIV+) and HIV seronegative (HIV-) women. Methods: This study included HIV+ and HIV- women (105 each). Cervical smears and viral antibodies were evaluated by Papanicolaou’s technique and ELISA method, respectively. Results: The prevalence of HSV-2, HPV and EBV infections, and SIL were higher in HIV+ women (75.2, 41.9, 41 and 32.4%) than in HIV- women (45.7, 26.7, 26.7 and 13.3%) at p< 0.0001, p= 0.029, 0.041 and 0.002, respectively. Higher prevalence of viral mono-infection and tri-infection was observed in HIV+ women (43.8 and 24.8%) than in HIV- women (27.6 and 8.6%) at p= 0.021, and 0.003, respectively. The prevalence of SIL was also higher in HIV+ women with viral mo- no-infection, bi-infection and tri-infection (15.2, 42.9, and 53.8%) than in HIV- women (6.9, 12.5, and 44.4%) at p= 0.468, 0.041, and 0.711, respectively. Conclusion: This study suggests that the high prevalence of SIL in HIV+ women could be associated with viral co-infec- tions. Keywords: Epstein-Barr virus; human immunodeficiency virus; human papilloma virus; herpes simplex virus type 2; cervi- cal lesion.

Recognition of unusual manifestations such as disseminated HSV or HSV‐related hemophagocytic lymphohistiocytosis among individuals with impaired cellular immunity and prompt treatment initiation are essential for a favorable outcome.

Background Herpes simplex virus type 2 (HSV-2) seroprevalence has been shown to be a potential sign of infection in pregnant women, and it could be applied to check HSV-2 transmission. This study evaluated the anti-HSV-2 IgG prevalence in pregnant women who were referred to health centers in Urmia, Northwest of Iran, during 2014-2015. Methods Serum samples were collected from 86 pregnant women and tested for Anti-HSV-2-specific IgG using a commercial enzyme-linked immunosorbent assays kit. Results Five (5.8%) pregnant women showed the presence of Anti-HSV-2-specific IgG antibodies. Previous abortion was reported in 16 (19.7%) and 2 subjects in the seronegative and seropositive groups, respectively. Conclusion Data from the present study indicate a lower number of HSV-2 seropositives among the pregnant women in Urmia. This reduction would be a result of low number of studied subjects used in the present study; hence, assessing a large sample is recommended.

Graphical abstract, Highlights • Trivalent mRNA and protein vaccines produce robust neutralizing antibodies in dams and pups. • Trivalent mRNA and protein vaccines prevent infection of multiple organs. • Durability of vaccine protection extends into second-generation litters., Neonatal herpes is a dreaded complication of genital herpes infection in pregnancy. We recently compared two vaccine platforms for preventing genital herpes in female mice and guinea pigs and determined that HSV-2 glycoproteins C, D and E expressed using nucleoside-modified mRNA in lipid nanoparticles provided better protection than the same antigens produced as baculovirus proteins and administered with CpG and alum. Here we evaluated mRNA and protein immunization for protection against neonatal herpes. Female mice were immunized prior to mating and newborns were infected intranasally with HSV-2. IgG binding and neutralizing antibody levels in mothers and newborns were comparable using the mRNA or protein vaccines. Both vaccines protected first and second litter newborns against disseminated infection based on virus titers in multiple organs. We conclude that both vaccines are efficacious at preventing neonatal herpes, which leaves the mRNA vaccine as our preferred candidate based on better protection against genital herpes.

Aims: This study investigated the seroprevalence and sexual risk behavior factors associated with syphilis and herpes simplex virus type 2 (HSV-2) among men who have sex with men (MSM), in Manado, Indonesia. Methods: Serum samples and questionnaires regarding their socio-demographic and sexual behaviour were collected from 60 MSM in Manado . Samples were screened for anti-HSV-2 IgG for herpes, the Venereal Disease Research Laboratory (VDRL) and the Treponema Pallidum Haemagglutination (TPHA) test for syphilis. A cross sectional method was used in this study . Results: Of 60 MSM (median age was 20 years), 35% had homosexual orientation and 65% had bisexual orientation. First sexual intercourse of most participants (48.3%) within 16 to 18 years old. In the last 12 months, most participants (55%) had only one male sex partner. There were 63.3% and 16.7% participants performed oral and anal intercourse. About 23.3% participants used condom consistently, but only 35.7% used compatible lubricant. Seropositivity of VDRL and TPHA was detected in 5% participants and anti-HSV-2 IgG in 23.3% participants. The positive serology test for syphilis was associated with sexual intercourse mode (p= 0.001). Significant association was found between anti-HSV-2 IgG seropositivity and condom-use behaviour (p=0,028). Conclusions: The study demonstrated 5% and 23.3% positivity of serology test for syphilis and anti-HSV-2 IgG respectively. Seropositivity of syphilis was correlated with oral and anal intercourse while HSV-2 with no condom-use behaviour among MSM in Manado, Indonesia. Keywords : syphilis, herpes simplex virus type 2, men who have sex with men, sexual behaviou r, Manado

Objectives HIV and herpes simplex virus type 2 (HSV-2) infections are sexually transmitted and propagate in sexual networks. Using mathematical modeling, we aimed to quantify effects of key network statistics on infection transmission, and extent to which HSV-2 prevalence can be a proxy of HIV prevalence. Design/methods An individual-based simulation model was constructed to describe sex partnering and infection transmission, and was parameterized with representative natural history, transmission, and sexual behavior data. Correlations were assessed on model outcomes (HIV/HSV-2 prevalences) and multiple linear regressions were conducted to estimate adjusted associations and effect sizes. Results HIV prevalence was one-third or less of HSV-2 prevalence. HIV and HSV-2 prevalences were associated with a Spearman's rank correlation coefficient of 0.64 (95% confidence interval: 0.58-0.69). Collinearities among network statistics were detected, most notably between concurrency versus mean and variance of number of partners. Controlling for confounding, unmarried mean/variance of number of partners (or alternatively concurrency) were the strongest predictors of HIV prevalence. Meanwhile, unmarried/married mean/variance of number of partners (or alternatively concurrency), and clustering coefficient were the strongest predictors of HSV-2 prevalence. HSV-2 prevalence was a strong predictor of HIV prevalence by proxying effects of network statistics. Conclusion Network statistics produced similar and differential effects on HIV/HSV-2 transmission, and explained most of the variation in HIV and HSV-2 prevalences. HIV prevalence reflected primarily mean and variance of number of partners, but HSV-2 prevalence was affected by a range of network statistics. HSV-2 prevalence (as a proxy) can forecast a population's HIV epidemic potential, thereby informing interventions.

Lei Yin,1–3 Chunhong Zhao,3 Jixia Han,4 Zengjun Li,2 Yanan Zhen,3 Ruixue Xiao,3 Zhongfa Xu,3 Yanlai Sun2 1School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, 2Department of Gastrointestinal Cancer Surgery, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan, 3Department of Gastrointestinal Surgery, The Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan, 4Department of General Surgery, The Sixth People’s Hospital of Jinan, Jinan, People’s Republic of China Background: The incidence of colorectal cancer (CRC) is on the rise. Furthermore, late-stage diagnoses and limited efficacious treatment options make CRC a complex clinical challenge. Therefore, a new therapeutic regimen with a completely novel therapeutic mechanism is necessary for CRC. In the present study, the therapeutic efficacy of oncolytic herpes simplex virus type 2 (oHSV2) in CRC was assessed in vitro and in vivo. oHSV2 is an oncolytic agent derived from herpes simplex virus type 2 that encodes granulocyte-macrophage colony-stimulating factor.Materials and methods: We investigated the cytopathic effects of oHSV2 in CRC cell lines using the MTT assay. Then, cell cycle progression and apoptosis of oHSV2 were examined by flow cytometry. We generated a model of CRC with mouse CRC cell CT26 in BALB/c mice. The antitumor effects and adaptive immune response of oHSV2 were assessed in tumor-bearing mice. The therapeutic efficacy of oHSV2 was compared with the traditional chemotherapeutic agent, 5-fluorouracil.Results: The in vitro data showed that oHSV2 infected the CRC cell lines successfully and that the tumor cells formed a significant number of syncytiae postinfection. The oHSV2 killed cancer cells independent of the cell cycle and mainly caused tumor cells necrosis. The in vivo results showed that oHSV2 significantly inhibited tumor growth and prolonged survival of tumor-bearing mice without weight loss. With virus replication, oHSV2 not only resulted in a reduction of myeloid-derived suppressor cells and regulatory T cells in the spleen, but also increased the number of mature dendritic cells in tumor-draining lymph nodes and the effective CD4+T and CD8+T-cells in the tumor microenvironment.Conclusion: Our study provides the first evidence that oHSV2 induces cell death in CRC in vitro and in vivo. These findings indicate that oHSV2 is an effective therapeutic cancer candidate that causes an oncolytic effect and recruits adaptive immune responses for an enhanced therapeutic impact, thus providing a potential therapeutic tool for treatment of CRC. Keywords: colorectal cancer, oncolytic virus, herpes simplex virus type 2, granulocyte–macrophage colony-stimulating factor, immunotherapy, gene therapy

Familial benign pemphigus, or Hailey-Hailey disease (HHD), is a rare (1 in 50,000), benign, autosomal dominant cutaneous disorder that causes a painful rash and blistering commonly occurring in the intertriginous folds. Despite having a good prognosis, there is no cure for HHD and the disease can be quite debilitating to the quality of life. The complexity of HHD can be compounded by superimposed eczema herpeticum (EH) or Kaposi's varicelliform eruption, which is caused by a viral infection occurring in preexistent cutaneous conditions. We present a unique clinical presentation of HHD with superimposed EH caused by herpes simplex virus type 2 (HSV-2) infection managed in a burn unit. It is highly advised that a recalcitrant HHD with superimposed EH caused by HSV-2 infection should be managed in burn centers that offer multimodalities for prompt, rigorous management. Early diagnosis and treatment are highly suggested for EH to avoid fatal complications.

Purpose: To report the unique clinical findings of a case of Herpes Simplex Virus Type 2 herpetic retinitis manifesting as a large elevated subretinal lesion. Observations: A 26-year-old Hispanic male with no significant past medical history presented with a one-week history of right eye pain and endorsement of worsening vision. Ophthalmic examination of the right eye identified a markedly elevated white subretinal lesion with associated findings of vitritis and hypotony. Ultrasound biomicroscopy demonstrated a diffusely thickened choroid and confirmed the observed subretinal mass. Examination of the fellow left eye was largely unremarkable with the exception of lesions suggestive of inactive chorioretinal scars. Diagnostic vitrectomy and vitreous PCR (polymerase chain reaction) was positive only for HSV-2 (herpes simplex virus type 2) and verified by two independent laboratories. The observed subretinal lesion of right eye improved on intravenous acyclovir and intravitreal foscarnet treatment. Conclusions and Importance: Presented here is an unusual, novel clinical presentation of HSV-2 acute retinal necrosis manifesting as an elevated subretinal lesion along with findings of panuveitis. This case suggests that consideration should be given to the diagnosis of HSV ARN (acute retinal necrosis) when a subretinal elevation is concomitantly appreciated in the setting of vitritis and chorioretinal lesions. Keywords: Acute retinal necrosis, Herpes simplex virus type 2, Panuveitis, Polymerase chain reaction

Rationale: Acute respiratory disorders (ARD) have the highest proportion among infectious disease in children. Despite the fact that serological diagnostics of Mycoplasma pneumoniae, Chlamydophila pneumoniae, Pneumocystis jirovecii, herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2), Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpesvirus type 6 (HHV-6) has been available for many years, up to now some objective limitations exist that hinder reliable differentiation between the viral carriage, past or current infection. There are no widely accepted guidelines that would suggest unified strategies for diagnosis and what is of utmost importance, for therapeutic intervention on a case-to-case basis. The rationale for this study was based on underestimation of the burden of these infections in children with prolonged periods of cough and recurrent ARDs, as well as the necessity to further develop diagnostic and management strategies. Aim: To determine causative role of M. pneumoniae, P. jirovecii, C. pneumoniae, HSV-1, -2, EBV, CMV, HHV-6 in children with recurrent ARDs hospitalized to an in-patient unit. Materials and methods: We examined 50 children with recurrent ARDs aged from 1 to 7 years who were hospitalized with an acute respiratory infection. Laboratory assessments included determination of the markers of infections caused by M. pneumoniae, P. jirovecii, C. pneumoniae, HSV- 1, -2, EBV, CMV, HHV-6 by means of polymerase chain reaction, immunoenzyme analysis, and indirect immunofluorescence reaction. Results: Markers of mycoplasma, chlamydial, pneumocystic infection, as well as HSV-1, -2, EBV, CMV, HHV-6 were found in 84% (42 / 50) cases. Active infection (acute or active persistent) was found in 38% (19 / 50) patients. The most prevalent was pneumocystic infection diagnosed in 12 (24%) patients; one fifth of all patients had mycoplasma (in 10 (20%) of cases), whereas herpetic and chlamydial infections were less frequent (4 (8%) and 1 (2%) of cases, respectively). Twelve (24%) patients had a single infection, while the others had mixed infections. Conclusion: We were able to confirm the possibility of combined M. pneumonia / P. jirovecii infection (8%) in children with recurrent ARDs and history of longstanding cough; this is important for an assessment of efficacy of causative treatment. Measurement of serum titers of specific immunoglobulins M and G along with DNA/antigens of potential causative organisms can be sufficient to choose specific antibacterial treatment of obstructive bronchitis and pneumonia in children with the history of longstanding cough and recurrent bronchial obstruction.

IntroductionHerpes simplex virus (HSV) infection can cause painful, recurrent genital ulcer disease (GUD), which can have a substantial impact on sexual and reproductive health. HSV-related GUD is most often due to HSV type 2 (HSV-2), but may also be due to genital HSV type 1 (HSV-1), which has less frequent recurrent episodes than HSV-2. The global burden of GUD has never been quantified. Here we present the first global and regional estimates of GUD due to HSV-1 and HSV-2 among women and men aged 15–49 years old.MethodsWe developed a natural history model reflecting the clinical course of GUD following HSV-2 and genital HSV-1 infection, informed by a literature search for data on model parameters. We considered both diagnosed and undiagnosed symptomatic infection. This model was then applied to existing infection estimates and population sizes for 2016. A sensitivity analysis was carried out varying the assumptions made.ResultsWe estimated that 187 million people aged 15–49 years had at least one episode of HSV-related GUD globally in 2016: 5.0% of the world’s population. Of these, 178 million (95% of those with HSV-related GUD) had HSV-2 compared with 9 million (5%) with HSV-1. GUD burden was highest in Africa, and approximately double in women compared with men. Altogether there were an estimated 8 billion person-days spent with HSV-related GUD globally in 2016, with 99% of days due to HSV-2. Taking into account parameter uncertainty, the percentage with at least one episode of HSV-related GUD ranged from 3.2% to 7.9% (120–296 million). However, the estimates were sensitive to the model assumptions.ConclusionOur study represents a first attempt to quantify the global burden of HSV-related GUD, which is large. New interventions such as HSV vaccines, antivirals or microbicides have the potential to improve the quality of life of millions of people worldwide.

Background Herpes simplex virus (HSV) has various presentations, depending on the patient’s immune status, age, and the route of transmission. In adults, HSV type 1 is found predominantly in the oral area, and HSV type 2 (HSV-2) is commonly found in the genital area. HSV-2 infection without genital lesions is uncommon. Herein we report a unique case of pharyngotonsillitis as an initial manifestation of disseminated HSV-2 infection without genital involvement. Case presentation A 46-year-old male was admitted to our hospital with a 1-week history of fever and sore throat. His past medical history included hypereosinophilic syndrome diagnosed at age 45 years. Physical examination revealed throat congestion, bilaterally enlarged tonsils with exudates, tender cervical lymphadenopathy in the left posterior triangle, and mild epigastric tenderness. The laboratory data demonstrated bicytopenia, elevated liver enzyme levels, and hyperferritinemia. A bone marrow smear showed hypocellular marrow with histiocytes and hemophagocytosis. The diagnosis of HLH was confirmed, and the patient was treated with methylprednisolone pulse therapy on days 1–3. On day 5, despite initial improvement of the fever and sore throat, multiple, new, small bullae developed on the patient’s face, trunk, and extremities. Additional testing showed that he was positive for HSV-specific immunoglobulin M and immunoglobulin G. Disseminated HSV infection was suspected, and intravenous acyclovir (10 mg/kg every 8 h) was begun. A subsequent direct antigen test of a bulla sample was positive for HSV-2. Moreover, tonsillar and esophageal biopsies revealed viral inclusion bodies. Immunohistochemical staining and a quantitative real-time polymerase chain reaction (PCR) assay confirmed the presence of HSV-2. Disseminated HSV-2 infection with multiple bullae, tonsillitis, esophagitis, and suspected hepatic involvement was diagnosed. After a 2-week course of intravenous acyclovir, his hematological status and liver function normalized, and his cutaneous skin lesions resolved. He was discharged on day 22 in good general health and continued taking oral valacyclovir for viral suppression due to his immunosuppressed status. Conclusion Disseminated HSV-2 infection should be considered as one of the differential diagnoses in patients with pharyngotonsillitis and impaired liver function of unknown etiology even if there are no genital lesions.

In this article deals with a typical clinical example of a severe form of acute neuroinfectious lesion of the spinal cord HSV2‑etiology in a patient with minor cellular immunodeficiency, who suffered from often recurrent genital herpes without adequate prophylactic antiviral treatment for the prevention of CNS damage. The patient, M., 54 years old, had acute lumbosacral myelitis, caused by herpes virus type 2, with a picture of the lower deep paraparesis, paragypesthesia, impaired pelvic organs functions. The diagnosis is confirmed on the basis of a PCR of the cerebrospinal fluid. Immunological examination revealed a selective deficiency of natural killers (CD3–CD1+CD56+ lymphocytes) — cells that are important in controlling the latent virus in the saçral sensory ganglia. A genetic survey identified a deficiency of the folate cycle that caused the minor cellular immune deficiency (MTHFR 677 С > Т homo, MTHFR 1298 А > С hetero, MTRR 66 A > G hetero). Therefore, the patient received dual treatment — acyclic analogues of guanosine to suppress viral reproduction and interferone therapy to compensate cellular immunodeficiency. This case demonstrates the feasibility of close interaction between neurologists and clinical immunologists in immunocompromised patients with neuroinfectional lesions caused by opportunistic pathogens., Приведен типичный клинический пример тяжелой формы острого нейроинфекционного поражения спинного мозга HSV2‑этиологии у пациента с минорным клеточным иммунодефицитом, который длительно страдал частыми рецидивами генитального герпеса, не получая надлежащего профилактического противовирусного лечения для предотвращения поражения ЦНС. У пациента в возрасте 54 года развился острый пояснично‑крестцовый миелит, вызванный вирусом герпеса 2 типа, с картиной нижнего глубокого парапареза, парагипестезии, нарушения функции тазовых органов. Диагноз подтвержден по результатам полимеразной цепной реакции спинномозговой жидкости. При иммунологическом обследовании выявлен выборочный дефицит естественных киллеров (CD3–CD1+CD56+‑лимфоцитов) — клеток, которые имеют важное значение для контроля над латентным вирусом в сакральных сенсорных ганглиях. При генетическом обследовании идентифицирован дефицит энзимов фолатного цикла, который был причиной минорного клеточного иммунодефицита (MTHFR 677 С > Т гомо, MTHFR 1298 А > С гетеро, MTRR 66 A > G гетеро). Поэтому пациент получал двойное лечение — ациклическими аналогами гуанозина для угнетения вирусной репродукции и интерферонотерапию для компенсации клеточного иммунодефицита. Этот случай демонстрирует необходимость тесного взаимодействия неврологов и клинических иммунологов при ведении иммуноскомпрометированных пациентов с нейроинфекционными поражениями, вызванными оппортунистическими возбудителями., Наведено типовий клінічний приклад тяжкої форми гострого нейроінфекційного ураження спинного мозку HSV2‑етіологїі у пацієнта з мінорним клітинним імунодефіцитом, який тривало страждав на часті рецидиви генітального герпесу, не отримуючи належного профілактичного противірусного лікування для запобігання ураженню ЦНС. У пацієнта віком 54 роки розвинувся гострий попереково‑крижовий мієліт, спричинений вірусом герпесу 2 типу, з картиною нижнього глибокого парапарезу, парагіпестезії, порушення функції тазових органів. Діагноз підтверджено за результатами полімеразної ланцюгової реакції спинномозкової рідини. При імунологічному обстеженні виявлено вибірковий дефіцит природних кілерів (CD3–CD16+CD56+‑лімфоцитів) — клітин, які мають важливе значення для контролю над латентним вірусом у сакральних сенсорних гангліях. При генетичному обстеженні ідентифіковано дефіцит ензимів фолатного циклу, що був причиною мінорного клітинного імунодефіциту (MTHFR 677 С > Т гомо, MTHFR 1298 А > С гетеро, MTRR 66 A > G гетеро). Тому пацієнт отримував подвійне лікування — ациклічними аналогами гуанозину для пригнічення вірусної репродукції та інтерферонотерапію для компенсації клітинного імунодефіциту. Цей випадок демонструє необхідність тісної взаємодії неврологів та клінічних імунологів при веденні імуноскомпрометованих пацієнтів з нейроінфекційними ураженнями, спричиненими опортуністичними збудниками.

Liver metastasis represents the most prominent metastasis of colorectal cancer (CRC) and is the leading cause of CRC mortality, making the early prevention of this event very important. While current CRC therapies include surgery, radiotherapy and chemotherapy, no effective treatment option for CRC liver metastasis (CRLM) exists. Furthermore, the effects of currently available metastatic CRC drugs are frequently limited by their toxicity and side effects. Oncolytic herpes simplex virus type 2 (oHSV2) selectively infects tumor cells and also induces an antitumor immune response. The present study investigated the cytopathic effects of oHSV2 on CT-26 cells in vitro and tested its inhibitory effect on CRLM. In vitro experimental data demonstrated that oHSV2 effectively inhibited the growth of CT-26 cells. In vivo study data demonstrated that treatment with oHSV2 alone slowed the growth of subcutaneous xenograft tumors without inducing weight loss and also inhibited CRLM by increasing the numbers of cluster of differentiation (CD)4+ T, CD8+ T and natural killer cells. In summary, oHSV2 shows potential as a safe and effective therapeutic agent for inhibiting the metastasis of CT-26 CRC cells to the liver.

Non-traumatic myelopathies can result from a wide spectrum of conditions including inflammatory, ischemic, and metabolic disorders. Here, we describe the case of a 60-year old immunocompetent woman who developed acute back pain followed by rapidly ascending flaccid tetraparesis, a C6 sensory level, and sphincter dysfunction within 8 h. Acyclovir and steroids were started on day 2 and herpes simplex virus type 2 (HSV-2) was confirmed by polymerase chain reaction in cerebrospinal fluid. Magnetic resonance imaging revealed a bilateral anterior horn tractopathy expanding from C2 to T2 and cervicothoracic cord swelling. Screening for paraneoplastic antibodies and cancer was negative. Neurophysiology aided in the work-up by corroborating root involvement. Recovery was poor despite early initiation of antiviral treatment, adjuvant anti-inflammatory therapy, and neurorehabilitation efforts. The clinical course, bilateral affection of the anterior horns, and early focal atrophy on follow-up magnetic resonance imaging take a necrotizing myelitis potentially caused by intraneuronal spread of the virus into consideration. Further, we summarize the literature on classical and rare presentations of HSV-2 myeloradiculitis in non-immunocompromised patients and raise awareness for the limited treatment options for a condition with frequent devastating outcome.

Background Herpes Simplex Virus Type 2 (HSV-2) is one of the most common sexually transmitted diseases. Although there is still no licensed vaccine for HSV-2, a theoretical investigation of the potential effects of a vaccine is considered important and has recently been conducted by several researchers. Although compartmental mathematical models were considered for each special case in the previous studies, as yet there are few global stability results. Results In this paper, we formulate a multi-group SVIRI epidemic model for HSV-2, which enables us to consider the effects of vaccination, of waning vaccine immunity, and of infection relapse. Since the number of groups is arbitrary, our model can be applied to various structures such as risk, sex, and age group structures. For our model, we define the basic reproduction number ℜ0 and prove that if ℜ0≤1, then the disease-free equilibrium is globally asymptotically stable, whereas if ℜ0>1, then the endemic equilibrium is so. Based on this global stability result, we estimate ℜ0 for HSV-2 by applying our model to the risk group structure and using US data from 2001 to 2014. Through sensitivity analysis, we find that ℜ0 is approximately in the range of 2-3. Moreover, using the estimated parameters, we discuss the optimal vaccination strategy for the eradication of HSV-2. Conclusions Through discussion of the optimal vaccination strategy, we come to the following conclusions. (1) Improving vaccine efficacy is more effective than increasing the number of vaccines. (2) Although the transmission risk in female individuals is higher than that in male individuals, distributing the available vaccines almost equally between female and male individuals is more effective than concentrating them within the female population.

Summary Objectives This study sought to assess if there is a meaningful way in which variations in sexually transmitted infection (STI) prevalence can be classified at the level of world regions. Methods Linear regression was performed to assess if the incidence and prevalence of six STIs (HIV, herpes simplex virus type 2, chlamydia, gonorrhea, syphilis, and trichomoniasis) by world region was positively correlated. Partitioning around medoids (PAM) was then used to assess if the regions of the world can be classified according to the incidence and prevalence of these STIs. Results We found evidence that STI incidence/prevalence varies considerably in different regions around the world. Linear regression revealed that the incidence and prevalence of certain STIs by world region was positively correlated (Pearson's correlation coefficient varied from 0.664 to 0.985). PAM provided support for dividing the world regions into two, three, or four STI incidence/prevalence categories, but it provided most support for the two-category system. In each of these systems the East Asia/Pacific and North Africa/Middle East regions were in the lowest STI category and Sub-Saharan Africa was the only region in the high STI category. Conclusions The incidence and prevalence of certain STIs by world region are positively correlated. The world regions can be meaningfully classified according to STI incidence/prevalence.

This study evaluated the performance of the Kalon Biological HSV2 IgG enzyme-linked immunosorbent assay (Kalon Biological Ltd, Surrey, United Kingdom) on dried blood spots (DBS) of various dilutions compared with plasma from young women aged 18–24 years in Uganda. We estimated the sensitivity and specificity of three DBS dilutions using plasma as the reference. All three evaluated DBS dilutions yielded low sensitivities and specificities, with DBS 1:2 yielding the highest concurrence. Other herpes simplex virus type 2 assays should be examined with regard to their utility for testing DBS.

Numerous studies suggest that herpes simplex virus type 2 (HSV-2) increases the risk of HIV-1 infection but recent clinical trials of HSV-2 suppressive therapy failed to show an effect. We assessed the putative association between HSV-2 and HIV-1 in a population of HIV-concordant-negative, HIV-1-discordant and HIV-1-concordant-positive married couples from Dakar, Senegal. In agreement with previous studies, we observed a strong overall association between HSV-2 and HIV-1 (odds ratio 4.61; P < 0.001). However, this association was mainly determined by a low HSV-2 prevalence in HIV-concordant-negative couples compared with HIV-1-discordant and HIV-1-concordant-positive couples (23% versus 59% and 66%, respectively; P < 0.001). We observed no further differences in HSV-2 prevalence between HIV-1-discordant and HIV-1-concordant-positive couples (59% and 66%, respectively; P = 0.483). Neither the index (59% versus 62%, P = 1.000) nor recipient partners (41% versus 63%, P = 0.131) in HIV-1-discordant and HIV-1-concordant-positive couples showed significant differences in HSV-2 prevalence. HSV-2 does not constitute a clear risk factor for HIV-1 infection in this population.

A surprising result of the groundbreaking CAPRISA-004 trial, which demonstrated the efficacy of vaginal tenofovir 1% gel in reducing the risk of human immunodeficiency virus (HIV)-1 infection by 39% in heterosexual women, was the added benefit of this microbicide in reducing acquisition of herpes simplex virus type 2 (HSV-2) by 51%. HSV-2 is the most common cause of genital ulcer disease worldwide, and is responsible for considerable morbidity among women and neonates. The virus is further implicated in increasing the risk of both HIV acquisition and transmission, and may have additional adverse consequences in HIV-coinfected persons, making HSV-2 prevention an important clinical and public health objective. While tenofovir had not previously been widely considered to be an anti-herpes drug, in vitro activity against HSV is well documented, raising interest in potential future applications of tenofovir and its prodrugs in HSV-2 control. This article reviews the currently available data for tenofovir as an anti-herpes agent, as well as unanswered questions about delivery systems, drug formulation, rectal administration, drug resistance, and clinical applications.

Introduction: Genital infection with herpes simplex virus type 2 (HSV-2) facilitates the acquisition of HIV, both mutually reinforcing infection. Lifelong latent HSV-2 infection raises concerns among women of reproductive age, considering the risk of neonatal transmission. In Nigeria, screening for HSV-2 and co-infection with HIV in antenatal clinics is not routine. This study was undertaken to determine the seroprevalence and co-infection of HSV-2 and HIV among pregnant women. Methods: This was a cross-sectional study conducted at the antenatal clinic of the University College Hospital, Ibadan, between March and August 2013. A total of 270 consenting pregnant women were enrolled. The study involved collecting socio-demographic data and laboratory determination of HSV-2 immunoglobulin G (IgG) and HIV seroprevalence using type-specific third-generation enzyme-linked immunosorbent assay (DIAPRO Diagnostic Bioprobes, Milan, Italy) and Uni-Gold Recombigen/ALERE determine, respectively. Data analyses were done using SPSS version 20 (SPSS Inc., IL, USA). Results: The seroprevalence for HSV-2 type-specific IgG was 33.3% (90/270), and HIV antibodies were identified in 19.63% (53/270) of the women. The HIV co-infection was 38.8% (35/90) among HSV-2-positive women and 10% (18/180) among HSV-2-negative women. Majority of the HSV-2 positive women (62.2%, 56/90) presented in their 2nd trimester while 18.9% (17/90) in their 3rd trimester. Conclusion: The seroprevalence of HSV-2 in this pregnant population is lower than what is observed in some other Sub-Saharan African countries; however, HSV-2/HIV co-infection is high. The HSV-2-seronegative women are still susceptible to primary HSV-2 infection in pregnancy with increased risk for HIV co-infection and neonatal transmission.

We found the prevalence of recurrent lymphocytic meningitis associated with herpes simplex virus type 2 (HSV-2) was 2.2/100,000 population in Finland during 1996–2006, higher than previous estimates. PCR was most sensitive in detecting HSV-2 DNA from cerebrospinal fluid if the sample was taken 2–5 days after symptom onset.

Purpose: To determine the seroprevalence of herpes simplex virus type 2 (HSV-2) in two urban communities in Delhi and to correlate the presence of HSV-2 seroprevalence with sociodemographic profile, risk factors and presence of other reproductive tract infections (RTIs). Methods: Men and women aged between 15-49 years from an urban slum and an urban middle class colony were invited to participate in the study. They provided interview information; blood for HSV-2, HIV and syphilis serology; first void urine specimens for diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis infection; and genital specimens for diagnosis of bacterial vaginosis, vaginal candidiasis and trichomoniasis. Results: The prevalence of HSV-2 seropositivity was found to be 7 and 8.6% in men and women, respectively. HSV-2 seropositivity was found to be significantly associated with urban middle class community and older age. No statistically significant correlation was found between HSV-2 seropositivity and other laboratory-confirmed RTIs. Conclusions: The findings of our study indicate a relatively low prevalence of HSV-2 seropositivity and other sexually transmitted infections in the two communities that were studied.

Objective: To understand the changing impact of herpes simplex 2 (HSV-2) and other sexually transmitted infections (STIs) on HIV incidence over time in four sub-Saharan African cities, using simulation models. Methods: An individual-based stochastic model was fitted to demographic, behavioural and epidemiological data from cross-sectional population-based surveys in four African cities (Kisumu, Kenya; Ndola, Zambia; Yaounde, Cameroon; and Cotonou, Benin) in 1997. To estimate the proportion of new HIV infections attributable to HSV-2 and other STIs over time, HIV incidence in the fitted model was compared with that in model scenarios in which the cofactor effect of the STIs on HIV susceptibility and infectivity were removed 5, 10, 15, 20 and 25 years into the simulated HIV epidemics. Results: The proportion of incident HIV attributable to HSV-2 infection (the model estimated population attributable fraction (PAF M )) increased with maturity of the HIV epidemic. In the different cities, the PAF M was 8–31% 5 years into the epidemic, but rose to 35–48% 15 years after the introduction of HIV. In contrast, the proportion of incident HIV attributable to chancroid decreased over time with strongest effects five years after HIV introduction, falling to no effect 15 years after. Sensitivity analyses showed that, in the model, recurrent HSV-2 ulcers had more of an impact on HIV incidence than did primary HSV-2 ulcers, and that the effect of HSV-2 on HIV infectivity may be more important for HIV spread than the effect on HIV susceptibility, assuming that HSV-2 has similar cofactor effects on HIV susceptibility and infectivity. The overall impact of other curable STIs on HIV spread (syphilis, gonorrhoea and chlamydia) remained relatively constant over time. Conclusions: Although HSV-2 appears to have a limited impact on HIV incidence in the early stages of sub-Saharan African HIV epidemics when the epidemic is concentrated in core groups, it has an increasingly large impact as the epidemic progresses. In generalised HIV epidemics where control programmes for curable STIs are already in place, interventions against HSV-2 may have a key role in HIV prevention.

This study was designed to determine the seroprevalence of herpes simplex virus type 2 (HSV-2) and to evaluate its association with age, sex as well as other demographic and behavioural factors in 150 human immunodeficiency virus (HIV) positive adults patients attending the general medical outpatient ward for routine care of Niterói, state of Rio de Janeiro, Brazil. Serum samples were screened for HSV-2 antibodies using an indirect ELISA. Eighty-three patients were men (mean age: 38.8) and 67 were women (mean age: 35.4). The estimated prevalence of HSV-2 was 52% (95% CI: 44-60%) and it was higher among men (53%) than among women (50.7%). Overall, the age of first sexual intercourse and past history of genital herpes were associated with HSV-2 seropositivity. Analysis by gender disclosed significant association of number of lifetime sex partners only among men. Although HSV-2 antibodies were frequent in the study group, genital herpes was reported by 21.8% of the HSV-2 positive subjects, indicating low awareness of the HSV-2 infection. These results may have public health importance for Brazil as the high rate of HSV-2 infection may act as a cofactor of HIV transmission.

A systematic review of studies conducted in Africa found high herpes simplex virus (HSV)-2 acquisition rates in both general and high-risk cohorts; thereby identifying an efficient setting for preventative HSV-2 vaccine trials., The burden of HSV type 2 varies substantially by region, with the highest incidence and prevalence in sub-Saharan Africa. We undertook a systematic review to identify studies reporting prospective data on incidence rates in men and women in Africa. Of 18 eligible studies, 7 were conducted in high-risk populations. Among women, incidence rates appeared to be higher in those with high-risk sexual behavior, with rates ranging from 3 to 23 per 100 person-years. In contrast, incidence rates in men appeared to be lower, ranging from 1 to 12 per 100 person-years. Risk factors for HSV-2 in women included prevalent human immunodeficiency virus (HIV) infection, younger age at sexual initiation, and sexual activity. Among men, condom use and circumcision had a protective effect, whereas prevalent HIV increased the risk of HSV-2 acquisition. This review draws attention to the high HSV-2 acquisition rates reported in Africa, thereby identifying an efficient setting for preventative HSV-2 vaccine trials.

This study aimed to examine the influence of human herpesvirus type 8 (HHV-8) and herpes simplex virus type 2 (HSV-2) co-infections on apoptosis serum markers in human immunodeficiency virus (HIV)-infected patients. Sera from 110 HIV-infected and 59 HIV-uninfected individuals were analyzed for soluble Fas (sFas), sFas ligand (sFasL), caspase-8, and Bcl-2. The findings of HIV-infected patients with no co-infection (n = 37), HIV-infected patients with HHV-8 co-infection (n = 22), HIV-infected patients with HSV-2 co-infection (n = 51), and patients with HSV-2 co-infection and no HIV infection (n = 20) were compared to controls (reference group) with no HIV, HSV-2, and HHV-8 co-infections (n = 39). Soluble Fas and sFasL concentrations were the highest in HIV and HHV-8 co-infected patients (medians, 912.7 pg/ml and 74.3 pg/mL, respectively). No difference in caspase-8 concentrations was found, whereas Bcl-2 concentrations were the highest in HIV and HHV-8 co-infected individuals. Older age was associated with higher sFas (p < 0.001) and lower sFasL (p = 0.04) concentrations. In a robust regression model adjusted for age, the log-transformed sFas concentrations were significantly lower in HIV-infected patients with no co-infections (β = -0.244 ; p < 0.001) and higher in HIV and HHV-8 co-infected patients (β = 0.216 ; p = 0.012) compared to the reference group. Soluble FasL was significantly lower in HIV-infected patients with no co-infections (β = -0.284 ; p = 0.005) and in HIV-infected patients with HSV-2 co-infection (β = -0.381 ; p < 0.001) compared to the reference group. Soluble FasL was also higher in HIV and HHV-8 co-infected patients compared to controls (β = 0.248 ; p = 0.036). Our results suggest that HHV-8 and HSV-2 may have a significant effect on Fas-FasL-mediated apoptosis in HIV-1 patients. HHV-8 upregulates while HSV-2 downregulates sFas and sFasL.

BACKGROUND: : In the absence of prospectively collected transmission data, the transmission potential of a sexually transmissible infection (STI) can be estimated by its proxy of concordance in sexual partners. Here we report concordance data of 3 viral STIs: human papillomavirus (HPV), HIV, and herpes simplex virus type 2 (HSV-2) among heterosexual couples in Kigali, Rwanda. METHODS: : Cervical and penile HPV typing was performed among 166 community-sampled fertile couples in Kigali, Rwanda (median sampling interval 10 days (interquartile range: 5-36). HIV and HSV-2 serostatus, curable STIs, and sociobehavioral and clinical characteristics were also assessed. RESULTS: : Concordance rates for all 3 viral STIs were higher than expected by chance alone. Positive concordance among couples was 25% for HSV-2, 15.7% for any HPV, 8.4% for high-risk (HR)-HPV, and 6% for HIV. HR-HPV prevalence among women and men was 19.9% and 26.5%, respectively. Partner's HIV status was more strongly associated with HR-HPV detection in men (OR: 8.5; confidence interval: 2.9-24.6) than in women (OR: 1.9; confidence interval 0.5-6.7). CONCLUSION: : More than half of the couples were discordant for HIV, HPV, and/or HSV-2, indicating that prevention strategies directed to infected cases are important to protect their uninfected sexual partners.

Soen Eng Yap Bjerke1,2, Ellen Holter3, Siri Vangen2,4, Babill Stray-Pedersen1,21Medical Faculty, University of Oslo, Oslo, Norway; 2Women and Children’s Division, 3Department of Microbiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway; 4National Resource Centre for Women’s Health, Oslo, NorwayAim: To assess frequency and determine the factors associated with Chlamydia trachomatis, herpes simplex virus type 2, and hepatitis B seropositivity among Pakistani pregnant women and their husbands in Norway.Methods: All together 112 couples of Pakistani origin living in Norway participated in our study. Blood samples were tested for immunoglobulin G (IgG) antibodies against C. trachomatis, herpes simplex virus type 2, and hepatitis B.Results: Pakistani women had significantly lower age, education level, and years of residence in Norway compared to their male partners. Among the men, 12% had positive chlamydial IgG antibodies in contrast to 1% of the women. These couples were discordant, meaning that the 13 wives of positive men were not infected with C. trachomatis, and the husband of one positive woman was not infected either. Four percent of women and 2% of men were positive for herpes simplex type 2. Only one couple was concordantly positive for herpes simplex type 2, the remaining four couples were discordant. Twelve percent of women and 21% of men were, or had been, infected with hepatitis B.Conclusion: Sexually transmitted infections did not seem to be prevalent in Pakistani immigrant couples in Norway. However, it was striking that most couples were discordant. Pakistani immigrants should be offered hepatitis B vaccine.Keywords: Chlamydia trachomatis, herpes simplex virus type 2, hepatitis B, Pakistan, Norway

Background: Herpes simplex virus type 2 (HSV-2) infection increases acquisition and transmission of HIV, but the results of trials measuring the impact of HSV-2 therapy on HIV genital shedding and HIV acquisition are mixed, and the potential impact of HSV-2 therapy on the incidence of HIV at the population level is unknown. Methods: The effects of episodic and suppressive HSV-2 therapy were simulated using the individual-level model STDSIM fitted to data from Cotonou, Benin (relatively low HIV prevalence) and Kisumu, Kenya (high HIV prevalence). Clinician- and patient-initiated episodic therapy, started when symptomatic, were assumed to reduce ulcer duration. Suppressive therapy, given regardless of symptoms, was also assumed to reduce ulcer frequency and HSV-2 infectiousness. Results: Clinician- initiated episodic therapy in the general population had almost no effect on the incidence of HIV. The impact of patient-initiated therapy was higher because of earlier treatment initiation, but still low (< 5%) unless symptom recognition and treatment-seeking behaviour were very high. Suppressive therapy given to female sex workers (FSW) in Kisumu had little effect on population HIV incidence. In Cotonou, suppressive therapy in FSW with high coverage and long duration reduced population HIV incidence by > 20% in the long term. Impact was increased in both cities by also treating a proportion of their clients. Long-term suppressive therapy with high coverage in the general population could reduce HIV incidence by more than 30%. Conclusions: These results show that HSV-2 therapy could potentially have a population-level impact on the incidence of HIV, especially in more concentrated epidemics. However, a substantial impact requires high coverage and long duration therapy, or very high symptom recognition and treatment-seeking behaviour.

Objective: Oncogenic human papillomaviruses (HPVs) are the etiological agents of cervical cancer. Different cofactors might be needed for malignant transformation, but they still remain elusive. Methods: To delineate the role of Chlamydia trachomatis (CT) and herpes simplex virus type 2 (HSV2) in HPV-positive cervical intraepithelial neoplasia (CIN) lesions and cervical carcinoma a series of 149 cervical cancer and CIN biopsies were analyzed for CT and HSV2 DNA by PCR, and HPV genotyped by InnoLipa. Monitoring of aberrations in key intracellular pathways due to CT/HSV2 and HPV co-expression were analyzed with 13 biomarkers. Results: Of the 149 samples tested, 136 were HPV DNA positive; 32/136 contained also CT DNA and 29 HSV2 DNA. Detection of CT was significantly (p = 0.0001) related to multiple-type HPV infections, while HSV2 was of borderline significance (p = 0.053). Of the 13 biomarkers tested, cytoplasmic and nuclear NF-ĸB and VEGF-C were significantly increased in CT+/HPV+ lesions; p = 0.023, p = 0.045, and p = 0.020 as well as survivin, p = 0.026. Survivin was the only marker that was overexpressed also in HSV2+/HPV+ lesions, p = 0.027. Conclusions: CT infection favors the entry and persistence of multiple HR-HPV types, which leads to viral integration, inhibition of apoptosis, overexpression of E6/E7 oncogenes and cell transformation.

Objectives: Rates of reactivation of herpes simplex virus type 2 (HSV-2) change over time and these changes affect transmission and clinical management strategies. We conducted a longitudinal study of HSV-2 infection to quantify rates of change in HSV-2 reactivation, mucosal shedding and recurrences of genital lesions, using a newly available model of HSV within-host dynamics. Methods: A cohort of 18 women was studied at two time periods spaced 2 years apart. The cohort provided daily mucosal swabs for HSV PCR analysis for 10 weeks during each time period and recorded recurrences in diaries. We fit the model of HSV dynamics to the mucosal shedding data using Bayesian methods to produce estimates of HSV reactivation, shedding and longitudinal rates of change. The model was validated using a separate group of 67 individuals. Results: According to the viral dynamic modelling results, rates of HSV-2 reactivation from latency in the ganglia varied > 10-fold among the women, and were estimated to be >= 10% higher than rates of mucosal shedding episodes for many individuals. The mucosal shedding associated with each reactivation typically lasted 1-3 days. Reactivation frequency was estimated to be declining by three reactivations a year on average. The median number of recurrences, based on patient diaries, declined from 6.8 per year to 2.1 per year over the 2-year period. Conclusions: Rates of HSV-2 reactivation, shedding and recurrence generally decline over time but remain high in some individuals 4-5 years after primary infection. Viral dynamic modelling provides quantification of HSV infection that cannot be obtained by other methods.

The objective of this study was to improve the knowledge on the epidemiology of herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) in Italy. The goal of this study was to study the seroincidence and seroprevalence of HSV-1 and HSV-2 infections among Italian adolescents. We conducted a retrospective longitudinal study among 345 Italian adolescents tested for anti-HSV-1 and anti-HSV-2 on samples collected at 11 and 17 years of age. At 11 years of age the HSV-1 prevalence was 51.6% and the HSV-2 prevalence was 2.6%; when 17 years old these rates increased to 61.4% and 4.9% respectively. The HSV-1 incidence was 1.6 per 100 person-years and was higher among females. The HSV-2 incidence was 0.4 per 100 person-years with no gender differences. HSV-1 is apparently widespread among Italian adolescents whereas HSV-2 is limited. These data are of paramount importance when considering that HSV-1 can cause genital herpes and that HSV-2 plays a role in HIV transmission. (authors)

Context: There are sparse data on herpes simplex virus type 2 (HSV-2) infection in India. HSV-2 is one of the most common sexually transmitted infections and the primary cause of genital ulcer disease worldwide. Aim: The aim of this study is to describe the incidence of HSV-2 infection among young reproductive age women in Mysore, India. Setting and Design: Between October 2005 and April 2006, 898 women were enrolled into a prospective cohort study in Mysore, India, and followed quarterly for 6 months. Materials and Methods: An interviewer administered questionnaire was used to collect demographic and social risk factors, and physical examination was conducted for collection of biological specimens to screen for reproductive tract infections at each visit. Serologic testing was conducted for the presence of HSV-2 antibodies using HerpeSelect HSV-2 enzyme-linked immunosorbent assay. Statistical Analysis Used: Data were analyzed using R. Incidence density rates were calculated using Poisson distributions with person-time of follow-up as denominator. Person-time was calculated as time from enrollment until time of first positive HSV-2 test. Results: There were 107 women with HSV-2 antibodies leaving 700 women with negative results at enrollment. The analysis included 696 out of which, there were 36 HSV-2 seroconversions during the study period. The study cohort accumulated roughly 348 woman-years of follow-up, yielding an HSV-2 acquisition rate of 10.4 cases/100 woman-years. All detected infections were asymptomatic. Conclusions: HSV-2 incidence is moderate in this community sample of young reproductive age monogamous women. More research is needed to establish incidence estimates in different Indian settings.

Aims: To determine the seroprevalence of herpes simplex type 2 (HSV-2) infection in pregnant females, assess the frequency of unrecognized infection and identify the demographic profile and risk factors associated with the seroprevalence. Materials and Methods: Two hundred randomly selected, asymptomatic pregnant females attending the Obstetrics and Gynecology Outpatient Department for a routine antenatal check-up constituted the study group. Serum specimens were screened for HSV-2 infection by detecting IgG class antibodies against HSV-2-specific glycoprotein G-2 using an enzyme-linked immunosorbent assay kit. Results: A seroprevalence of 7.5% was found in our study. Seropositivity was maximum in the age group ≥30 years (22.20%), followed by 26–30 years (9.7%), 21–25 years (2.20%) and ≤20 years (0%). HSV-2 seropositivity was found to be significantly associated with increasing age, parity, number of sexual partners, duration of sexual activity and history of abortions (P < 0.05). No statistically significant correlation was observed between seropositivity and other demographic variables such as place of residence, education, annual family income and occupation (P > 0.05). No statistically significant association of seropositivity with present or past history suggestive of other sexually transmitted infections was found. None of our cases tested positive for human immunodeficiency syndrome (HIV). Conclusion: A relatively low prevalence of HSV-2 seropositivity was found in our study, with a high frequency of unrecognized and asymptomatic infections. Our findings suggest that type-specific serotesting could be an efficient strategy to diagnose clinically asymptomatic HSV-2 infections and, therefore, to reduce the risk of HSV-2 and HIV sexual transmission by prophylactic counseling against unprotected intercourse. It may also be a useful adjunct in detecting cases who present with symptoms not directly suggestive of genital herpes.

Published version. Source at http://doi.org/10.1186/s12879-016-1954-8. License CC BY 4.0. Background: Herpes simplex virus type 2 (HSV-2) infection is the most common cause of genital ulcer disease (GUD) worldwide. Mother to child transmission causes high morbidity and mortality among infants. Russia is on the brink of a generalized HIV-epidemic, but Arkhangelsk is still a low-prevalence area. HSV-2 infection is associated with a three-fold increased risk of HIV-infection. The evidence on the seroprevalence of HSV-2 in Russia is limited. The aim of this study was to assess HSV-2 seroprevalence and correlates among young adults in the city of Arkhangelsk. Methods: 1243 adults aged 18-39 years participated in a cross-sectional population-based study, recruited by a public opinion agency applying a quota sampling method to achieve a data set with similar age- and sex-distribution as the population in Arkhangelsk. All participants completed a standardized, self-administrated questionnaire and were tested for HSV-2. Associations between HSV-2 seropositivity and selected sociodemographic and behavioral factors, and self-reported history of sexually transmitted infections (STIs) were studied by multivariable logistic regression. Results: HSV-2 seroprevalence was 18.8 %: 12.2 % (95 % confidence interval, CI 9.7-15.2) among men and 24.0 % (95 % CI 20.1-27.3) among women. Among men, HSV-2 positivity was associated with being divorced/widowed (OR = 2.85, 95 % CI 1.06-7.70), cohabitation (OR = 2.45, 95 % CI 1.07-5.62), and a history of STIs (OR = 2.11, 95 % CI 1.14-3.91). In women, HSV-2 positivity was associated with high income (OR = 3.11, 95 % CI 1.45-6.71) and having a lifetime number of sexual partners between 2 and 5 (OR = 2.72, 95 % CI 1.14-6.51), whereas sexual debut at age 18 years or older was inversely associated with the outcome (OR = 0.47, 95 % CI 0.31-0.72). In both sexes, increasing age was the strongest correlate of HSV-2 seropositivity in multivariable analyses. Conclusion: The HSV-2 seroprevalence was twice as high in women than in men and increased with age in both sexes, and similar to that reported from high-prevalence countries in Europe and the USA. The high prevalence of HSV-2 among women in childbearing age reveals the potential for HSV-2 transmission from mothers to infants and increased risk of acquisition HIV-infection; it also contributes to the burden GUD among both sexes. This emphasizes the public health implications of the HSV-2 epidemic in an urban population in North-West Russia.