Association between dietary zinc intake and herpes simplex virus seropositivity in U.S. adults: a cross-sectional study

Q: What are the key findings of this study?

Low-moderate dietary zinc intake (7.51–10.87 mg/day) was associated with a 16% reduced odds of HSV-1 seropositivity and 19% reduced odds of HSV-2 seropositivity compared to the lowest intake group in U.S. adults aged 14-49.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: U.S. adults aged 14-49 years with available dietary zinc intake and HSV-1/HSV-2 serostatus data (n=6483). Intervention: Dietary zinc intake vs. Lowest zinc intake quartile (<7.51 mg/day). Primary outcome: HSV-1 and HSV-2 seropositivity (HSV-1 OR 0.84 (95% CI 0.70-0.99) for low-moderate zinc intake (7.51–10.87 mg/day); HSV-2 OR 0.81 (95% CI 0.66-0.99) for low-moderate zinc intake compared to lowest quartile, 95% CI See effect sizes, p=HSV-1 p=0.028; HSV-2 p=0.039).

Chunhua Liu; Y. Liu; Jingjing Liu; Zhaoyong Lv; Yanan Qin; Mengpeng Li

doi:10.1186/s12879-026-12927-1

February 26, 2026BMC Infectious DiseasesOpen Access

Association between dietary zinc intake and herpes simplex virus seropositivity in U.S. adults: a cross-sectional study

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Key result

Low-moderate zinc intake is linked to ~16% lower odds of HSV-1 seropositivity vs lowest intake.

HSV-1 OR 0.84 (95% CI 0.70-0.99) for low-moderate zinc intake (7.51–10.87 mg/day); HSV-2 OR 0.81 (95% CI 0.66-0.99) for low-moderate zinc intake compared to lowest quartile
P HSV-1 p=0.028; HSV-2 p=0.039
n=6,483

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Why the study?

Although serum zinc deficiency is associated with susceptibility to various viral infections, the relationship between dietary zinc intake and herpes simplex virus seropositivity remains unclear.

Does moderate dietary zinc intake reduce HSV-1 and HSV-2 seropositivity in U.S. adults?

Key Points

To investigate the association between dietary zinc intake and herpes simplex virus seropositivity in U.S. adults.
Analysis of NHANES data (2007–2016)
Measured dietary zinc intake and HSV-1/HSV-2 seropositivity
Utilized multivariate logistic regression and restricted cubic spline analysis
Conducted subgroup analysis to evaluate results across different populations.
58.9% tested positive for HSV-1 and 19.3% for HSV-2
Higher dietary zinc intake correlated with lower odds ratios for HSV-1 and HSV-2
U-shaped association noted, suggesting moderate zinc intake offers protective effects against both HSV types.

Study Design

Type

Cross-Sectional (n=6,483)

Multicenter

Yes

Structured PICO

Does moderate dietary zinc intake reduce HSV-1 and HSV-2 seropositivity in U.S. adults?

P

Population

6,483 U.S. adults from the National Health and Nutrition Examination Survey (NHANES) 2007-2016, mean age 34.52, 61.4% male.

I

Intervention

Higher dietary zinc intake (categorized into quartiles: Q2 7.51-10.87 mg/day, Q3 10.87-15.63 mg/day, Q4 >15.63 mg/day)

C

Comparator

Lowest dietary zinc intake group (Q1: <7.51 mg/day)

O

Outcome

Herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) seropositivity measured via solid-phase enzyme immunopoint assaysurrogate

Main Result

Effect estimate: HSV-1 OR 0.84 (95% CI 0.70-0.99) for low-moderate zinc intake (7.51–10.87 mg/day); HSV-2 OR 0.81 (95% CI 0.66-0.99) for low-moderate zinc intake compared to lowest quartile (95% CI See effect sizes)

p-value: p=HSV-1 p=0.028; HSV-2 p=0.039

Moderate dietary zinc intake is associated with a reduced risk of HSV-1 and HSV-2 seropositivity in U.S. adults, exhibiting a U-shaped dose-response relationship.

Limitations

Cross-sectional design precludes causal inference.
Reliance on self-reported dietary data may introduce recall bias.
Seropositivity reflects exposure but not necessarily active infection or clinical disease.
Study limited to U.S. noninstitutionalized population aged 14-49, limiting generalizability.
Cross-sectional design precludes causal inference and may reflect reverse causation
Survey weights may reduce statistical precision in nonlinear spline modeling
Small sample sizes at extreme zinc intake levels
Residual confounding cannot be entirely excluded
Reliance on self-reported 24-hour dietary recall is subject to recall bias
Timing of initial HSV infection could not be determined

Implication

Should not alter dietary counseling for HSV prevention; hypothesis-generating observational data warranting prospective RCTs for causality.

Discussion

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Cite This Study

Liu et al. (2026) conducted a cross-sectional in U.S. adults aged 14-49 years with available dietary zinc intake and HSV-1/HSV-2 serostatus data (n=6,483). Dietary zinc intake vs. Lowest zinc intake quartile (<7.51 mg/day) was evaluated on HSV-1 and HSV-2 seropositivity (HSV-1 OR 0.84 (95% CI 0.70-0.99) for low-moderate zinc intake (7.51–10.87 mg/day); HSV-2 OR 0.81 (95% CI 0.66-0.99) for low-moderate zinc intake compared to lowest quartile, 95% CI See effect sizes, p=HSV-1 p=0.028; HSV-2 p=0.039). Low-moderate dietary zinc intake (7.51–10.87 mg/day) was associated with a 16% reduced odds of HSV-1 seropositivity and 19% reduced odds of HSV-2 seropositivity compared to the lowest intake group in U.S. adults aged 14-49.

synapsesocial.com/papers/69a286c90a974eb0d3c01fcf https://doi.org/10.1186/s12879-026-12927-1

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Association between dietary zinc intake and herpes simplex virus seropositivity in U.S. adults: a cross-sectional study

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Discussion

Cite This Study

Association between dietary zinc intake and herpes simplex virus seropositivity in U.S. adults: a cross-sectional study

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Discussion

Cite This Study

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