BACKGROUND Sexually transmitted infections (STIs) associated with genital ulcer disease due to herpes simplex virus-2 (HSV-2) are a prominent cause of morbidity and mortality. Serologic screening for HSV-2 is recommended only for individuals with genital herpes symptom history. However, no validated symptom screening tool currently exists. METHODS Currently asymptomatic adults presenting for routine care at STI clinics in Lima, Peru completed a survey of prior genital herpes symptoms and received HSV-2 serological testing with the Euroimmun Anti-HSV-2 (gG2) ELISA IgG (Lubeck, Germany). A sub-sample of indeterminate results were sent for Western blot confirmatory testing. We assessed associations between past symptoms and anti-HSV-2 positivity and corrected the HSV-2 prevalence by re-classifying indeterminates per Western Blot results. RESULTS We enrolled 131 participants between July and October 2022. HSV-2 antibody test results found 21.4% positive, 41.2% indeterminate, and 37.4% negative. Excluding indeterminate results, 36.4% were positive. Of participants with no prior symptoms 31.2% tested positive, compared to 35.7% with one prior symptom, 50.0% with 2, and 50.0% with 3+ prior symptoms. Among the sub-sample of indeterminates, 92.6% were confirmed positive by Western Blot, bringing the total estimated proportion of participants with HSV-2 antibodies to 59.5%. Either based on the original classification of HSV-2 antibody status or after incorporation of confirmatory testing results, there was no significant association between symptom history and HSV-2 antibody positivity. CONCLUSIONS With currently available tests, recommendations to screen individuals based on genital herpes symptom history may not be useful. More discriminatory symptom screening tools or HSV-2 antibody tests with better performance are needed.

中文翻译：

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生殖器疱疹症状史是否可以预测单纯疱疹病毒 2 型抗体阳性？

背景技术与2型单纯疱疹病毒(HSV-2)引起的生殖器溃疡病相关的性传播感染(STI)是发病和死亡的主要原因。仅建议对有生殖器疱疹症状史的个体进行 HSV-2 血清学筛查。然而，目前尚不存在经过验证的症状筛查工具。方法 目前在秘鲁利马 STI 诊所接受常规护理的无症状成年人完成了对既往生殖器疱疹症状的调查，并接受了 Euroimmun 抗 HSV-2 (gG2) ELISA IgG（德国吕贝克）的 HSV-2 血清学检测。不确定结果的子样本被送去进行蛋白质印迹验证测试。我们评估了既往症状与抗 HSV-2 阳性之间的关联，并通过根据蛋白质印迹结果对不确定因素重新分类来纠正 HSV-2 患病率。结果 我们在 2022 年 7 月至 10 月期间招募了 131 名参与者。HSV-2 抗体检测结果发现 21.4% 为阳性，41.2% 为不确定，37.4% 为阴性。排除不确定的结果，36.4%呈阳性。在没有既往症状的参与者中，31.2% 的检测结果呈阳性，相比之下，有 1 种既往症状的参与者为 35.7%，有 2 种症状的参与者为 50.0%，有 3 种以上症状的参与者为 50.0%。在不确定子样本中，92.6% 的人通过蛋白质印迹法确认为阳性，使具有 HSV-2 抗体的参与者的总估计比例达到 59.5%。无论是基于 HSV-2 抗体状态的原始分类，还是结合验证性检测结果，症状史与 HSV-2 抗体阳性之间没有显着关联。结论 根据目前可用的检测，根据生殖器疱疹症状史进行筛查的建议可能没有用。需要更具歧视性的症状筛查工具或性能更好的 HSV-2 抗体测试。