Valence and risk factors for herpes simplex virus type 2 infection among pregnant women in Israel

Background. Although usually a nuisance to the adult patient, herpes simplex virus type 2 (HSV-2) infection can have devastating consequences on the infected newborn. It is thus important to document the prevalence and risk factors of this infection among pregnant women in a defined population. The availability of the new type-specific assays that provide accurate serologic results prompted us to study the seroprevalence of HSV-2 infection among pregnant women in Israel. Study Design: In a cross-sectional descriptive study, 512 pregnant women were tested. The study population included Israeli-born Jewish and Arab women, and new immigrants from the former Soviet Union. A competition-based enzyme-linked immunosorbent assay (ELISA) was used to detect type-specific HSV-1 and HSV-2 antibodies. Univariate and multivariate analyses were performed to identify risk factors for HSV-2 seropositivity. Results: The prevalence of HSV-2 infection was 13.3% (95% confidence interval, 10.5-16.5%) and that of HSV-1 was 94.9%. History of genital or labial herpes was reported by 1.3% and 26.8% of the participants, respectively. The HSV-2 infection rate was 3-fold higher among immigrants from the former Soviet Union (27.5%) than among Israeli-born Jewish and Arab women (9%). The only risk factor independently associated with HSV-2 seropositivity was multiple lifetime sexual partners. Conclusion: We have documented a relatively low seroprevalence of HSV-2 infection in a demographically mixed group of pregnant women in Israel. The role of high-risk sexual behavior in the spread of the infection has been reconfirmed.