Herpes Simplex Virus Shedding in Genital Secretions

Virologic Characteristics of Subclinical and Symptomatic Genital Herpes Infections

“…The proportion of women who had subclinical viral shedding in our study (51 percent) and the rate of subclinical shedding were higher than previously report- 8,[14][15][16][17][18][19] and reflected the relatively long study period. Our results indicate that there is great variability in the rates of subclinical shedding among women with genital herpes.…”

“…8,[14][15][16][17][18][19][20] The duration of sampling, biologic variation in the expression of the infection, and the varying length of episodes all appear to influence the observed rates of subclinical shedding. The rates of shedding were likely to vary most among women with few days of sampling, with most having no episodes of shedding and a few with extremely high rates of shedding, depending on whether a prolonged shedding episode happened to be included in the days sampled.…”

Asymptomatic Reactivation of Herpes Simplex Virus in Women after the First Episode of Genital Herpes

“…It should be recognized, however, that asymptomatic and symptomatic reactivation occurred during all periods sampled. Although our current cohort exhibited only a few asymptomatic shedding events late after firstepisode disease, the number of days sampled during later intervals were small, and our previous studies and those of other groups clearly indicate that asymptomatic reactivation of HSV in the genital region can occur in those who have longstanding infection of the genitourinary tract (14,(22)(23)(24)(25)(26)(27).…”

“…In a previous study, for example, asymptomatic shedding was detected in five of six patients sampled for more than 50 days and less frequently among patients sampled less intensively (14). Studies by Barton and colleagues (22), Stenzel-Poore and colleagues (24), and Straus and colleagues (23) reported asymptomatic shedding rates of 50% (4 of 8), 45% (5 of 11 women), and 12% (2 of 17) of patient samples, respectively. Further study is needed to determine whether all persons with genital HSV type 2 shed asymptomatically, especially in the first 3 months after acquisition.…”