Increased Genital Shedding in Symptomatic HSV-2 Patients

High shedding rates and more frequent lesions in those with symptomatic herpes simplex virus-2

TUESDAY, April 12 (HealthDay News) -- Genital shedding of herpes simplex virus type 2 (HSV-2) is less frequent in individuals with asymptomatic infection who also have less frequent genital lesions, according to a study published April 13 in an infectious disease and immunology themed issue of the Journal of the American Medical Association.

Elizabeth Tronstein, M.P.H., from the University of Washington in Seattle, and colleagues evaluated the virologic and clinical course of HSV-2 genital shedding among 410 individuals with symptomatic and 88 individuals with asymptomatic HSV-2 infection. Between 1992 and 2008, self-collected swabs of genital secretions were obtained from each participant for at least 30 days. Quantitative real-time fluorescence polymerase chain reaction for HSV DNA was used to measure the rate of viral shedding in the genital swabs.

The investigators found that HSV-2 was detected on 20.1 percent of days in symptomatic genital HSV-2 infection compared to 10.2 percent of days in asymptomatic infection. Individuals with symptomatic infection had significantly higher subclinical shedding rates compared to those with asymptomatic infection (13.1 versus 8.8 percent), but the amount of HSV detected was similar for both. Days with lesions accounted for significantly more of the genital shedding in individuals with symptomatic genital HSV-2 infection compared to individuals with asymptomatic infection (43 versus 16.4 percent).

"We found that the risk for genital shedding was twice as high and the risk for lesions almost three times as high among persons with symptomatic genital HSV-2 infection," the authors write.

Several authors disclosed financial relationships with the pharmaceutical and vaccine development industry. One of the study authors is listed as a co-inventor on patents describing antigens and epitopes to which T-cell responses to HSV-2 are directed.

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