The first clinical study to document risk of acquiring herpes simplex virus type 1 infection based on sexual activity has linked oral sex and vaginal intercourse with a demonstrably higher rate of infection, particularly in young women, researchers from the University of Pittsburgh report in the February issue of Sexually Transmitted Diseases, the journal of the American Sexually Transmitted Diseases Association.

Genital herpes is one of the most common sexually transmitted diseases in the United States. Nationwide, at least 45 million people ages 12 and older – or one out of five adolescents and adults – have had a genital herpes infection. Between the late 1970s and the early 1990s, the number of Americans with genital herpes infection increased by 30 percent, according to the U.S. Centers for Disease Control and Prevention. While there is no cure, antiviral medications can shorten and prevent outbreaks. Daily suppressive therapy can reduce, but not eliminate, risk of transmission to non-infected partners.

Medical students traditionally have been taught that herpes simplex type 1 (HSV-1) infections most often take place above the waist, while herpes simplex type 2 (HSV-2) predominates below the belt. More recent evidence, however, suggests that HSV-1 also is an important pathogen in genital herpes infections, especially in younger women. HSV-1 is more commonly known to cause infections of the mouth and lips, often called fever blisters or cold sores. Viral shedding and disease transmission is possible even in the absence of a visible outbreak.

“Receptive oral sex and vaginal intercourse were found to be significant risk factors for the acquisition of HSV-1,” said Thomas Cherpes, M.D., an infectious diseases fellow at the University of Pittsburgh School of Medicine and the study’s first author. “Because oral HSV-1 infections are less frequent in childhood and adolescence, future prevention strategies will need to consider increased susceptibility for HSV-1 among young adults, and the important contribution of HSV-1 to the growing genital herpes epidemic.”

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