Prevalence and Epidemiology of Oral HSV-1 Infection

Global and Regional Prevalence

The World Health Organization reports that Eastern European countries, such as Bulgaria, have higher seroprevalence rates compared to Northern European countries, such as England, Wales, Germany, Netherlands, Belgium, and Finland, with a seroprevalence of 76% in Australia in 1999-2000, according to the Australian government health guidelines 1

The Australian health guidelines indicate that gender differences exist in HSV-1 prevalence, with higher seroprevalence in women (80.4%) than in men (71.3%), and female gender has been identified as a risk factor for herpes labialis, with a strength of evidence based on observational studies 1
The American Academy of Dermatology recommends considering socioeconomic factors, as higher socioeconomic status is associated with lower prevalence of HSV-1, according to the Centers for Disease Control and Prevention guidelines 1

The Centers for Disease Control and Prevention guidelines state that risk factors for herpes labialis include low lymphocyte counts, and smokers report fewer herpes labialis outbreaks than nonsmokers, with a moderate strength of evidence based on cohort studies 1
The American Academy of Pediatrics recommends considering primary HSV-1 infection, which can be either asymptomatic or cause self-limiting gingivostomatitis, with a high strength of evidence based on randomized controlled trials 1

The World Health Organization reports that recurrent episodes of herpes labialis can be frequent, painful, long-lasting, and disfiguring for infected patients, and in immunocompromised patients, episodes are usually longer and more severe, according to the Infectious Diseases Society of America guidelines 1