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Clinical Trial
. 1997 Mar 1;99(5):1092-7.
doi: 10.1172/JCI119237.

Frequent genital herpes simplex virus 2 shedding in immunocompetent women. Effect of acyclovir treatment

A Wald  1 , L Corey, R Cone, A Hobson, G Davis, J Zeh
Affiliations
Clinical Trial

Frequent genital herpes simplex virus 2 shedding in immunocompetent women. Effect of acyclovir treatment

A Wald et al. J Clin Invest. .

Abstract

Reactivation of herpes simplex virus type 2 (HSV-2) occurs intermittently as perceived clinically and by viral culture. We performed a series of studies to evaluate the frequency and pattern of HSV-2 reactivation using both viral isolation and HSV PCR assay. Daily samples of genital secretions were obtained from 27 HSV-2 seropositive women; a subset of subjects obtained samples while receiving oral acyclovir 400 mg PO twice a day. HSV DNA was detected in genital swab specimens on 28% of 1,410 d compared with 8.1% of days by viral isolation. 11 of 20 women had HSV DNA detected on > 20% of days, 4 on > 50%, and 2 on > 75% of days; in contrast, none of the women shed on > 21% of days by viral isolation. The daily administration of oral acyclovir promptly reduced the frequency of HSV DNA detection by a median of 80%. Within 3-4 d of discontinuing daily acyclovir, HSV DNA again appeared in the genital area. HSV-2 shedding in the genital mucosa occurs much more frequently than previously appreciated. This frequent reactivation likely plays a role in the epidemic spread of genital herpes worldwide.

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