Isolation of herpes simplex virus from the genital tract during symptomatic recurrence on the buttocks.
OBJECTIVE
To estimate the frequency of isolation of herpes simplex virus (HSV) from the genital tract when recurrent herpes lesions were present on the buttocks.


METHODS
Data were extracted from a prospectively observed cohort attending a research clinic for genital herpes infections between 1975 and 2001. All patients with a documented herpes lesion on the buttocks, upper thigh or gluteal cleft ("buttock recurrence") and concomitant viral cultures from genital sites including the perianal region were eligible.


RESULTS
We reviewed records of 237 subjects, 151 women and 86 men, with a total of 572 buttock recurrences. Of the 1,592 days with genital culture information during a buttock recurrence, participants had concurrent genital lesions on 311 (20%, 95% confidence interval [CI] 14-27%) of these days. Overall, HSV was isolated from the genital region on 12% (95% CI 8-17%) of days during a buttock recurrence. In the absence of genital lesions, HSV was isolated from the genital area on 7% (95% CI 4%-11%) of days during a buttock recurrence and, among women, from the vulvar or cervical sites on 1% of days.


CONCLUSIONS
Viral shedding of herpes simplex virus from the genital area is a relatively common occurrence during a buttock recurrence of genital herpes, even without concurrent genital lesions, reflecting perhaps reactivation from concomitant regions of the sacral neural ganglia. Patients with buttock herpes recurrences should be instructed about the risk of genital shedding during such recurrences.


METHODS
II-2.
Kerkering
Katrina
K
Department of Medicine, University of Washington, Seattle, Washington 98195, USA.
Gardella
Carolyn
C
Selke
Stacy
S
Krantz
Elizabeth
E
Corey
Lawrence
L
Wald
Anna
A
D000293:Adolescent; D000328:Adult; D002081:Buttocks / Q000821:virology*; D005260:Female; D005835:Genitalia / Q000821:virology*; D018023:HIV Seronegativity; D006561:Herpes Simplex / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D018139:Simplexvirus / Q000302:isolation & purification*; D017201:Virus Shedding