Clinical reactivation of herpes simplex virus type 2 infection in seropositive pregnant women with no history of genital herpes.
OBJECTIVE
To determine the risk for genital herpes and asymptomatic herpes simplex virus (HSV) shedding in late pregnancy and delivery in a population of HSV type 2 (HSV-2)-seropositive but previously asymptomatic pregnant women.


METHODS
A prospective inception cohort study.


METHODS
A total of 1355 pregnant women with no history of genital herpes referred from three private obstetrics practices between November 1985 and June 1988.


METHODS
Confidential questionnaires evaluated sexual risk factors in relation to HSV-2 serologic status as determined by Western blot analysis. Herpes simplex virus shedding was determined by viral culture of the cervix and vulva and of any suspicious lesions.


RESULTS
Antibody to HSV-2 was detected in 439 of 1355 pregnant women (32%) with no history of genital herpes. Asymptomatic HSV shedding was detected in 5 of 1160 cultures (0.43%) obtained in late pregnancy and during delivery. A first episode of clinical genital herpes was recognized by 43 of 264 HSV-2-seropositive women (16%) during their pregnancy.


CONCLUSIONS
Serologic evidence of unknown HSV-2 infection was common in pregnant women without a history of genital herpes. Asymptomatic viral shedding in these women occurred at a rate similar to that seen in women with symptomatic genital HSV-2 infection. To improve recognition of genital herpes near term, obstetricians should counsel pregnant women about the high prevalence and mild and diverse symptoms of genital HSV-2 infection.
Frenkel
L M
LM
Department of Pediatrics, University of California, Los Angeles.
Garratty
E M
EM
Shen
J P
JP
Wheeler
N
N
Clark
O
O
Bryson
Y J
YJ
D000328:Adult; D005260:Female; D006558:Herpes Genitalis / Q000453:epidemiology; D006561:Herpes Simplex / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000382:microbiology; D011446:Prospective Studies; D012008:Recurrence; D012098:Reproduction; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012725:Sexual Behavior; D012747:Sexual Partners; D017201:Virus Shedding