Viral shedding in symptomatic and asymptomatic HSV infections

January 01, 0001

Viral shedding in symptomatic and asymptomatic HSV infections

These US researchers compared the HSV genital shedding in both symptomatic and asymptomatic patients via a cohort study (n=498). Only immunocopetent patients were enrolled. Enrollees collected genital swabs daily for 30 days or more, and the amount of viral shedding was measured by polymerase chain reaction.

The researchers found: "Herpes simplex virus type 2 was detected on 4753 of 23 683 days (20.1) in 410 persons with symptomatic genital HSV-2 infection compared with 519 of 5070 days (10.2) in 88 persons with asymptomatic infection. Subclinical shedding rates were higher in persons with symptomatic infection compared with asymptomatic infection (2708 of 20 735 days {13.1%}) vs 434 of 4929 days {8.8%}). However, the amount of HSV detected during subclinical shedding episodes was similar (median, 4.3 log10 copies in the in the asymptomatic infection group). Days with lesions accounted for 2045 of 4753 days (43.0%) with genital viral shedding among persons with symptomatic genital HSV-2 infection compared with 85 of 519 days (16.4%) among persons with asymptomatic infection."

The researchers concluded: "Persons with asymptomatic HSV-2 infection shed virus in the genital tract less frequently than persons with symptomatic infection, but much of the difference is attributable to less frequent genital lesions because lesions are accompanied by frequent viral shedding."

This study characterizes rates of viral shedding in patients both with symptomatic and asymptomatic HSV infections

For the full abstract, click here.

JAMA 305(14):1441-1449, 13 April 2011 © 2011 American Medical Association
Genital Shedding of Herpes Simplex Virus Among Symptomatic and Asymptomatic Persons With HSV-2 Infection. Elizabeth Tronstein, Christine Johnston, Meei-Li Huang, et al.

Category: X. Female Genital System, Breast, Y. Male Genital System. Keywords: herpes, simplex 2, HSV, shedding, genital, cohort study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 10 May 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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