HSV- 2 IS SIGNIFICANTLY MORE PREVALENT THAN HSV-1 IN FEMALE EPITHELIA COMPARE TO MALE: ANALYSIS OF ROUTINE CLINICAL DATA

Herpes viruses consist of two strains HSV-1 and HSV-2 which infect the orofacial and the genital tract epithelia. Recently, Yung Lee et al showed that progesterone confers higher susceptibility to HSV-2 infection in an in vitro model that simulate the in vivo conditions of the female reproductive tract. At Israel Central Virology Laboratory, swabs samples collected from different body sites are routinely examined for all three alfa human herpes viruses simultaneously by multiplex real time PCR. Since HSV-2 infectivity was found recently to be influenced by sex hormones we were interested in analyzing the distribution of both strains according to gender. Our analysis included 8772 samples collected between 2011 and 2016. Of the 8772 samples, 6116 were collected from females and 2656 from males. PCR analysis revealed that HSV-2 was rarely detected from orofacial body site (1% and 1.2 % from male and female respectively). On the other hand, analysis of swabs taken from the vaginal / genital area as well as from other body areas showed that HSV-2 was significantly, p<0.01, more abundant in females than in males, 11.54% and 3.78% respectively. HSV-1 infections did not show this phenomenon and was even slightly more common in males than females,17.83% vs 15.47%, respectively. Patients gender did not affect the prevalence of HSV-2 IgG (10.8% for female and 9.7% for male) therefore the higher incidence of HSV-2 might reflect higher reactivation rate rather than differences in primary infection episodes. Our data imply that reactivation of HSV-2, but not HSV-1, in men does not necessarily ends in successful infection of the innervated epithelia One possible explanation is the presence of low levels of progesterone in the males.