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  • Title: Prospective cohort study showing persistent HSV-2 shedding in women with genital herpes 2 years after acquisition.
    Author: Ramchandani M, Selke S, Magaret A, Barnum G, Huang MW, Corey L, Wald A.
    Journal: Sex Transm Infect; 2018 Dec; 94(8):568-570. PubMed ID: 29175899.
    Abstract:
    OBJECTIVES: Herpes simplex virus type 2 (HSV-2) is a prevalent infection with great variability in clinical and virological manifestations among individuals. This prospective cohort study aims to evaluate the natural history of HSV-2 reactivation in the genital area in the same group of women over time. METHODS: Eighteen immunocompetent HSV-2 seropositive women were evaluated for viral shedding for 70 consecutive days within a median of 8 months (range 1-24 months) of HSV-2 acquisition and again approximately 2.5 years later from the original study. Participants obtained daily swabs of genital secretions for HSV PCR and recorded genital symptoms. RESULTS: The viral shedding rate was 29% during the initial study and 19% in the follow-up study (32% reduction, P=0.019). Subclinical shedding rate also decreased from 24% to 13% (37% reduction, P=0.032), as did the rate of days with genital lesions from 22% to 15% (33% reduction, P=0.24). The mean copy number during viral shedding remained unchanged over time at 4.8 log10 c/mL (SD=2.0 and 1.6 during each study, respectively, P=0.33). Women with high viral shedding rates in the past were likely to continue to have high shedding rates (r=0.63, P=0.005). CONCLUSIONS: Despite some reduction, high viral shedding rates persist in women with genital HSV-2 greater than 2 years after acquisition.
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