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INDIANAPOLIS, Indiana - A new study finds human papillomavirus to be "extremely common" in sexually active female adolescents in the United States.

     The researchers studied 60 females, ages 14-17, attending an Indianapolis primary-care clinic, for an average of two years. African Americans comprised 85 percent of the subjects, Caucasians 11 percent, and Hispanics 3 percent. Ninety-five percent of the girls reported being sexually active; the girls had, on average, two partners.

     During the study, 49 participants (82 percent) tested positive for HPV, reported Dr. Darron R. Brown and colleagues at Indiana University School of Medicine in Indianapolis. Twenty-five percent to 40 percent had detectable HPV infection at any given time. Thirty-nine percent of specimens indicated types of HPV linked to a high risk of cervical cancer; 20 percent of specimens indicated low-risk types of HPV. Multiple HPV types were detected in many participants. Abnormal Pap smear results - detected in 37 percent of the women - were significantly associated with high-risk HPV infection.

     The researchers attributed the high cumulative rate of HPV to the large number of specimens collected from each subject. Many of the infections were detectable only for a few weeks. The authors noted that these infections would have been missed if specimens had been collected at four- to six-month intervals - a finding called "inconsistent" with earlier studies suggesting that most HPV infections clear.

     A key question, the researchers noted, is "whether infections at a very young age are those that resurge and are detected later in life, versus acquisition of a new infection." If these infections persist at low levels from young adulthood, it is important to learn more about the factors that cause progression to malignancy, they concluded.

     The full report, "A Longitudinal Study of Genital Human Papillomavirus Infection in a Cohort of Closely Followed Adolescent Women," was published in the Journal of Infectious Diseases

Herpes Type 2

Herpes is a sexually transmitted disease (STD) caused by the herpes simplex viruses type 1 (HSV -1) and type 2 (HSV-2).   

Most individuals have no or only minimal signs or symptoms from HSV-1 or HSV-2 infection. When signs do occur, they typically appear as one or more blisters on or around the genitals or rectum. The blisters break, leaving tender ulcers (sores) that may take two to four weeks to heal the first time they occur. Typically, another outbreak can appear weeks or months after the first, but it almost always is less severe and shorter than the first episode. Although the infection can stay in the body indefinitely, the number of outbreaks tends to go down over a period of years.

Type specific Herpes testing

    HSV-1 and HSV-2 can be found and released from the sores that the viruses cause, but they also are released between episodes from skin that does not appear to be broken or to have a sore. A person almost always gets HSV-2 infection during sexual contact with someone who has a genital HSV-2 infection. HSV-1 causes infections of the mouth and lips, so-called "fever blisters." A person can get HSV-1 by coming into contact with the saliva of an infected person. HSV-1 infection of the genitals almost always is caused by oral-genital sexual contact with a person who has the oral HSV-1 infection.

    Results of a recent, nationally representative study show that genital herpes infection is common in the United States. Nationwide, 45 million people ages 12 and older, or one out of five of the total adolescent and adult population, are infected with HSV-2.

HSV-2 infection is more common in women (approximately one out of four women) than in men (almost one out of five). This may be due to male-to-female transmission being more efficient than female-to-male transmission. HSV-2 infection also is more common in blacks (45.9%) than in whites (17.6%). Race and ethnicity in the United States correlate with other, more fundamental determinants of health such as poverty, access to good quality health care, behavior for seeking health care, illicit drug use, and living in communities with a high prevalence of STDs.

    Since the late 1970s, the number of Americans with genital herpes infection has increased 30%. The largest increase is currently occurring in young white teens. HSV-2 infection is now five times more common in 12- to 19-year-old whites, and it is twice as common in young adults ages 20 to 29 than it was 20 years ago.

    HSV-2 usually produces only mild symptoms or signs or no symptoms at all. However, HSV-2 can cause recurrent painful genital sores in many adults, and HSV-2 infection can be severe in people with suppressed immune systems. Regardless of severity of symptoms, genital herpes frequently causes psychological distress in people who know they are infected.

In addition, HSV-2 can cause potentially fatal infections in infants if the mother is shedding virus at the time of delivery. It is important that women avoid contracting herpes during pregnancy because a first episode during pregnancy causes a greater risk of transmission to the newborn. If a woman has active genital herpes at delivery, a cesarean delivery is usually performed. Fortunately, infection of an infant from women with HSV-2 infection is rare.

In the United States, HSV-2 may play a major role in the heterosexual spread of HIV, the virus that causes AIDS. Herpes can make people more susceptible to HIV infection, and it can make HIV-infected individuals more infectious.