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

J Clin Invest. 1997 Mar 1;99(5):1092-7. doi: 10.1172/JCI119237.

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.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acyclovir / administration & dosage
  • Acyclovir / therapeutic use*
  • Administration, Oral
  • Adult
  • Antibodies, Viral / analysis
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / therapeutic use*
  • Blotting, Western
  • Cross-Over Studies
  • DNA, Viral / drug effects
  • DNA, Viral / isolation & purification
  • Double-Blind Method
  • Female
  • Genitalia, Female / virology
  • Herpes Genitalis / drug therapy*
  • Herpes Genitalis / virology*
  • Herpesvirus 2, Human / drug effects
  • Herpesvirus 2, Human / growth & development
  • Herpesvirus 2, Human / isolation & purification*
  • Humans
  • Immunocompetence
  • Pilot Projects
  • Polymerase Chain Reaction / methods
  • Recurrence
  • Serologic Tests
  • Sexually Transmitted Diseases / drug therapy*
  • Sexually Transmitted Diseases / virology*
  • Time Factors
  • Virus Latency
  • Virus Shedding*

Substances

  • Antibodies, Viral
  • Antiviral Agents
  • DNA, Viral
  • Acyclovir