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Andre J Nahmias

Publications and source records attributed to Andre J Nahmias.

5 recordsLinked to original sources
PubMed2006

Trends in herpes simplex virus type 1 and type 2 seroprevalence in the United States.

CONTEXT: Herpes simplex virus type 1 (HSV-1) and type 2 are common infections worldwide. Herpes simplex virus type 2 (HSV-2) is the cause of most genital herpes and is almost always sexually transmitted. In contrast, HSV-1 is usually transmitted during childhood via nonsexual contacts. Preexisting HSV-1 antibodies can alleviate clinical manifestations of subsequently acquired HSV-2. Furthermore, HSV-1 has become an important cause of genital herpes in some developed countries. OBJECTIVE: To examine trends in HSV-1 and HSV-2 seroprevalence in the United States in 1999-2004 compared with 1988-1994. DESIGN, SETTINGS, AND PARTICIPANTS: Cross-sectional, nationally representative surveys (US National Health and Nutrition Examination Surveys [NHANES]), were used to compare national seroprevalence estimates from 1999-2004 with those from 1988-1994, and changes in HSV-1 and HSV-2 seroprevalence since 1976-1980 were reviewed. Persons aged 14 to 49 years were included in these analyses. MAIN OUTCOME MEASURES: Seroprevalence of HSV-1 and HSV-2 antibodies based on results from type-specific immunodot assays; diagnosis of genital herpes. RESULTS: The overall age-adjusted HSV-2 seroprevalence was 17.0% (95% confidence interval [CI], 15.8%-18.3%) in 1999-2004 and 21.0% (95% CI, 19.1%-23.1%) in 1988-1994, a relative decrease of 19.0% between the 2 surveys (95% CI, -28.6% to -9.5%; P<.001). Decreases in HSV-2 seroprevalence were especially concentrated in persons aged 14 to 19 years between 1988 and 2004. In adolescents aged 17 to 19 years and young adults, the decreases in HSV-2 seroprevalence were significant even after adjusting for changes in sexual behaviors. Among those infected with HSV-2, the percentage who reported having been diagnosed with genital herpes was statistically different (14.3% in 1999-2004 and 9.9% in 1988-1994; P = .02). Seroprevalence of HSV-1 decreased from 62.0% (95% CI, 59.6%-64.6%) in 1988-1994 to 57.7% (95% CI, 55.9%-59.5%) in 1999-2004, a relative decrease of 6.9% between the 2 surveys (95% CI, -11.6% to -2.3%; P = .006). Among persons infected with HSV-1 but not with HSV-2, a higher percentage reported having been diagnosed with genital herpes in 1999-2004 compared with 1988-1994 (1.8% vs 0.4%, respectively; P<.001). CONCLUSIONS: These data show declines in HSV-2 seroprevalence, suggesting that the trajectory of increasing HSV-2 seroprevalence in the United States has been reversed. Seroprevalence of HSV-1 decreased but the incidence of genital herpes caused by HSV-1 may be increasing.

Adolescent↗
PubMed2004

Neonatal HSV infection Part I: continuing challenges.

Neonatal herpes still presents diagnostic and management problems in view of continuing high mortality and morbidity rates, even though effective antiviral therapy is now available. This article, which reviews current knowledge and progress, provides practical guidelines for the diagnosis, management and treatment of neonatal herpes, based on the literature and decades of experience. It is advisable to focus at the local level on detecting maternal cervical infection, applying the available diagnostic tools and obtaining appropriate medical specialty consultations, as well as improving health worker and patient education about detecting and managing herpes simplex virus infections.

Female↗
PubMed2004

Neonatal HSV infection Part II: Obstetric considerations -- a tale of hospitals in two cities (Seattle and Atlanta, USA).

This article presents various aspects of maternal genital and neonatal herpes simplex virus (HSV)-1 and HSV-2 infection for hospitals in two cities in the USA - Seattle and Atlanta - to serve as models for the different subpopulations within developed and developing countries. Reasons are given for the disparity between the increasing rates of genital HSV-1 and HSV-2 infections observed in several areas of the world and the general low rates of newborn herpes noted in sites other than some hospitals in Seattle, Atlanta, Cincinnati and Helsinki. A key reason for the disparity appears to be the continuing difficulty in diagnosing maternal genital herpes and neonatal herpes. Contributing factors include the variability in different communities in sexual behaviour patterns, and in the rates of maternal genital HSV infection, caesarean sections and postmortem procedures. Unresolved challenges in the obstetric management of genital herpes aimed at preventing neonatal herpes are also presented.

Female↗
PubMed2002

Seroprevalence and coinfection with herpes simplex virus type 1 and type 2 in the United States, 1988-1994.

Seroprevalence of and coinfection with herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) in the United States were analyzed by use of data from a nationally representative survey (National Health and Nutrition Examination Survey III, 1988-1994). Evidence was explored for possible protection by prior HSV-1 infection against infection and clinical disease with HSV-2. Overall, 27.1% of persons aged > or =12 years were seronegative for HSV-1 and HSV-2; 51.0% were seropositive for HSV-1 only, 5.3% for HSV-2 only, and 16.6% for both HSV-1 and HSV-2. The seroprevalence of HSV-2 was higher in persons with HSV-1 antibody. Approximately 76% of persons who had HSV-2 antibody also had HSV-1 antibody. Persons seropositive for HSV-2 only reported a history of genital herpes more frequently (16.2%) than persons seropositive for both HSV-1 and HSV-2 (5.9%). The seroprevalence of HSV-1 and age at infection may influence the epidemiology of clinical genital herpes, even if prior HSV-1 infection does not prevent HSV-2 infection.

Adolescent↗