Oral herpes simplex virus type 2 reactivation in HIV-positive and -negative men.
BACKGROUND
Previous studies using viral cultures rarely reported herpes simplex virus type 2 (HSV-2) isolation from the mouth. We sought to characterize oral HSV-2 shedding as detected by HSV DNA polymerase chain reaction among HSV-2-seropositive men.


METHODS
Participants collected daily swabs from oral and anogenital areas for HSV detection with a quantitative polymerase chain reaction assay.


RESULTS
A total of 109 HSV-2-seropositive men (59 of whom were human immunodeficiency virus [HIV] negative, and 50 of whom were HIV positive) were sampled for a median of 64 consecutive days. Forty-four (40.4%) had HSV-2 detected from oral swabs on at least 1 day. Oral HSV-2 was detected on 148 (2.3%) of 6,422 days, genital HSV-2 was detected on 1,110 (17%) of 6,505 days, oral HSV-1 was detected on 220 (5.5%) of 4,018 days, and genital HSV-1 was detected on 88 (2.2%) of 4,073 days. Oral HSV-2 shedding was never associated with an oral lesion, but it was often concurrent with genital HSV-2 shedding. Both oral and genital HSV-2 were detected on 90 (61%) of 148 days with oral HSV-2 shedding. Oral HSV-2 shedding occurred on 90 (8.2%) of 1,110 days with genital HSV-2 shedding, versus 58 (1.1%) of 5,316 days without genital HSV-2 shedding (P<.001). The HIV-positive men shed HSV-2 orally more frequently than did the HIV-negative men (odds ratio, 2.7 [95% confidence interval, 1.1-7.1]).


CONCLUSIONS
Oral HSV-2 reactivation was common (especially among HIV-positive men), was always asymptomatic, and often occurred on days of genital HSV-2 reactivation.
Kim
H Nina
HN
Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, 98104, USA. hyangkim@u.washington.edu
Meier
Amalia
A
Huang
Meei-Li
ML
Kuntz
Steve
S
Selke
Stacy
S
Celum
Connie
C
Corey
Lawrence
L
Wald
Anna
A
D000328:Adult; D000368:Aged; D004279:DNA, Viral / Q000032:analysis; D015658:HIV Infections / Q000150:complications*; D006558:Herpes Genitalis / Q000150:complications / Q000821:virology*; D018258:Herpesvirus 2, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009960:Oropharynx / Q000821:virology*; D016133:Polymerase Chain Reaction; D014775:Virus Activation; D017201:Virus Shedding
D004279:DNA, Viral