title: Herpes simplex virus type 2 detection by culture and polymerase chain reaction and relationship to genital symptoms and cervical antibody status during the third trimester of pregnancy.
abstract: OBJECTIVE
  Our goal was to define the frequency of asymptomatic herpes simplex virus type 2 shedding by culture and polymerase chain reaction and to correlate our findings with cervical anti-herpes simplex virus type 2 immunoglobulin A production.
  
  
  METHODS
  Women who were seropositive for herpes simplex virus type 2 collected daily genital tract samples during the third trimester for culture and deoxyribonucleic acid quantitation by polymerase chain reaction. Cervical secretions were collected weekly for anti-herpes simplex virus type 2 immunoglobulin A. Asymptomatic shedding by culture versus polymerase chain reaction and anti-herpes simplex virus type 2 immunoglobulin A detection with and without genital shedding were compared by means of McNemar's chi 2 test.
  
  
  RESULTS
  Asymptomatic shedding was more frequent by polymerase chain reaction than by culture (13.8% vs 2.3%, p < 0.0001). When cervical anti-herpes simplex virus type 2 immunoglobulin A was present, patients were more likely to have negative results by polymerase chain reaction than positive results (66.7% vs 26.7%, p = 0.001). Anti-herpes simplex virus type 2 immunoglobulin A was detected beyond 37 weeks in only one subject.
  
  
  CONCLUSIONS
  Polymerase chain reaction was more sensitive than culture for detecting asymptomatic genital herpes simplex virus. The role of immunoglobulin A in clearing genital herpes simplex virus remains to be determined.
authors.affiliation: Department of Obstetrics and Gynecology, University of Washington Medical Center, Seattle, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Boggess
authors.forename: D H
authors.initials: DH
authors.lastname: Watts
authors.forename: A C
authors.initials: AC
authors.lastname: Hobson
authors.forename: R L
authors.initials: RL
authors.lastname: Ashley
authors.forename: Z A
authors.initials: ZA
authors.lastname: Brown
authors.forename: L
authors.initials: L
authors.lastname: Corey
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis*; D002584:Cervix Uteri / Q000276:immunology* / Q000821:virology; D004279:DNA, Viral / Q000302:isolation & purification*; D005260:Female; D006558:Herpes Genitalis / Q000821:virology*; D018258:Herpesvirus 2, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis*; D007074:Immunoglobulin G / Q000032:analysis; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology*; D011263:Pregnancy Trimester, Third; D017201:Virus Shedding
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral; D007070:Immunoglobulin A; D007074:Immunoglobulin G