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Ann Intern Med. 1992 Mar 15;116(6):433-7.

Asymptomatic reactivation of herpes simplex virus in women after the first episode of genital herpes.

Author information

1
University of Washington, Seattle.

Abstract

OBJECTIVE:

To determine frequency, anatomic site, and host factors associated with asymptomatic shedding of herpes simplex virus after initial episodes of genital herpes.

DESIGN:

Cohort study with follow-up for a median of 63 weeks.

SETTING:

Referral clinic.

PATIENTS:

Women (306) with first episode of herpes; 43 had primary herpes simplex virus type 1, and 227 and 36 had primary and nonprimary herpes simplex virus type 2, respectively.

MEASUREMENTS:

Cultures were obtained for herpes simplex virus every 4 to 6 weeks at times in which genital lesions and symptoms were not present.

MAIN RESULTS:

Asymptomatic shedding was detected among 11.9%, 18.3%, and 22.9% of women with primary herpes simplex virus type 1, primary HSV type 2, and nonprimary HSV type 2, respectively. Among patients with type 2 infection, previous type 1 antibody was associated with a lower rate of asymptomatic vulvar shedding. Asymptomatic cervical shedding was 3 times more frequent during the first three months after resolution of primary type 2 disease than during later time periods. In contrast, the rate of symptomatic recurrent herpes did not change over time.

CONCLUSIONS:

Asymptomatic genital herpes simplex type 2 is more common than type 1. Asymptomatic genital shedding occurs more often during the first 3 months after acquisition of primary type 2 disease than during later periods. Patients with HSV type 2 should be advised of this high early rate of asymptomatic shedding and of potential transmission to sexual partners.

PMID:
1310837
PMCID:
PMC4084907
DOI:
10.7326/0003-4819-116-6-433
[Indexed for MEDLINE]
Free PMC Article

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