[HTML][HTML] Reactivation of genital herpes simplex virus type 2 infection in asymptomatic seropositive persons
A Wald, J Zeh, S Selke, T Warren… - … England Journal of …, 2000 - Mass Medical Soc
A Wald, J Zeh, S Selke, T Warren, AJ Ryncarz, R Ashley, JN Krieger, L Corey
New England Journal of Medicine, 2000•Mass Medical SocBackground Most persons who have serologic evidence of infection with herpes simplex
virus (HSV) type 2 (HSV-2) are asymptomatic. Historically, it has been assumed that these
persons have less frequent viral reactivation than those with symptomatic infection. Methods
We conducted a prospective study to investigate genital shedding of HSV among 53
subjects who had antibodies to HSV-2 but who reported having no history of genital herpes,
and we compared their patterns of viral shedding with those in a similar cohort of 90 subjects …
virus (HSV) type 2 (HSV-2) are asymptomatic. Historically, it has been assumed that these
persons have less frequent viral reactivation than those with symptomatic infection. Methods
We conducted a prospective study to investigate genital shedding of HSV among 53
subjects who had antibodies to HSV-2 but who reported having no history of genital herpes,
and we compared their patterns of viral shedding with those in a similar cohort of 90 subjects …
Background
Most persons who have serologic evidence of infection with herpes simplex virus (HSV) type 2 (HSV-2) are asymptomatic. Historically, it has been assumed that these persons have less frequent viral reactivation than those with symptomatic infection.
Methods
We conducted a prospective study to investigate genital shedding of HSV among 53 subjects who had antibodies to HSV-2 but who reported having no history of genital herpes, and we compared their patterns of viral shedding with those in a similar cohort of 90 subjects with symptomatic HSV-2 infection. Genital secretions of the subjects in both groups were sampled daily and cultured for HSV for a median of 94 days.
Results
HSV was isolated from the genital mucosa in 38 of the 53 HSV-2–seropositive subjects (72 percent) who reported no history of genital herpes, and HSV DNA was detected by the polymerase-chain-reaction assay in cultures prepared from genital mucosal swabs in 6 additional subjects. The rate of subclinical shedding of HSV in the subjects with no reported history of genital herpes was similar to that in the subjects with such a history (3.0 percent vs. 2.7 percent). Of the 53 subjects who had no reported history of genital herpes, 33 (62 percent) subsequently reported having typical herpetic lesions; the duration of their recurrences in these subjects was shorter (median, three days vs. five days; P<0.001) and the frequency lower (median, 3.0 per year vs. 8.2 per year; P<0.001) than in the 90 subjects with previously diagnosed symptomatic infection. Only 1 of these 53 subjects had no clinical or virologic evidence of HSV infection.
Conclusions
Seropositivity for HSV-2 is associated with viral shedding in the genital tract, even in subjects with no reported history of genital herpes.
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