Rapidly cleared episodes of herpes simplex virus reactivation in immunocompetent adults.
BACKGROUND
Herpes simplex virus (HSV) remains latent in nerve root ganglia of infected persons and is thought to reactivate several times yearly. Recent in situ data show the localization of HSV-specific CD8(+) T cells at the dermal epidermal junction next to peripheral sensory nerve endings, suggesting that viral reactivation may occur more frequently than previously appreciated.


METHODS
Twenty-five HSV-2-seropositive and 18 HSV-1-seropositive healthy adults collected anogenital and oral swabs, respectively, 4 times per day for 60 days. Swabs were assayed for HSV, using a quantitative polymerase chain reaction assay.


RESULTS
Twenty-four percent of anogenital reactivations and 21% of oral reactivations lasted < or =6 h, and 49% of anogenital reactivations and 39% of oral reactivations lasted < or =12 h. Lesions were reported in only 3 (7%) of 44 anogenital reactivations and 1 (8%) of 13 oral reactivations lasting < or =12 h. The median HSV DNA levels at initial and last detection were 10(3.5) and 10(3.3) copies/mL, respectively, during anogenital reactivation and 10(3.7) and 10(3.0) copies/mL, respectively, during oral reactivation.


CONCLUSIONS
This high frequency of short subclinical HSV reactivation in immunocompetent hosts strongly suggests that the peripheral mucosal immune system plays a critical role in clearing HSV reactivations.
Mark
Karen E
KE
Department of Medicine, University of Washington, Seattle, Washington 98122, USA. kmark@u.washington.edu
Wald
Anna
A
Magaret
Amalia S
AS
Selke
Stacy
S
Olin
Laura
L
Huang
Meei-Li
ML
Corey
Lawrence
L
D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D005260:Female; D005835:Genitalia / Q000821:virology; D006558:Herpes Genitalis / Q000276:immunology* / Q000821:virology; D006561:Herpes Simplex / Q000276:immunology* / Q000821:virology; D018259:Herpesvirus 1, Human / Q000276:immunology / Q000502:physiology*; D018258:Herpesvirus 2, Human / Q000276:immunology / Q000502:physiology*; D006801:Humans; D007121:Immunocompetence; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000821:virology; D013997:Time Factors; D014775:Virus Activation / Q000276:immunology*; D017201:Virus Shedding
D000914:Antibodies, Viral
Clin Infect Dis. 2006 Jan 1;42(1):8-13
16323085
J Virol. 2007 Jul;81(13):6817-26
17459924
Ann Intern Med. 1992 Feb 1;116(3):197-202
1309413
J Virol. 2005 Dec;79(23):14843-51
16282484
J Clin Microbiol. 2007 May;45(5):1618-20
17329447
J Clin Invest. 1998 Apr 1;101(7):1500-8
9525993
Biometrics. 2005 Mar;61(1):193-8
15737093
J Infect Dis. 2002 Jan 1;185(1):45-52
11756980
J Clin Invest. 1997 Mar 1;99(5):1092-7
9062368
J Oral Pathol Med. 1994 Feb;23(2):80-4
8164158
AIDS. 2006 Jan 2;20(1):73-83
16327322
J Med Virol. 2005 Jul;76(3):350-5
15902702
J Immunol. 2006 Dec 15;177(12):8356-64
17142732
J Clin Microbiol. 1988 Apr;26(4):662-7
2835389
Proc Natl Acad Sci U S A. 2007 Feb 27;104(9):3496-501
17360672
Immunity. 2003 May;18(5):593-603
12753737
Clin Infect Dis. 2002 Apr 1;34(7):944-8
11880960
J Infect Dis. 1991 Jan;163(1):23-8
1845807
J Acquir Immune Defic Syndr. 2004 Apr 15;35(5):435-45
15021308
J Infect Dis. 2006 Aug 15;194(4):420-7
16845624
J Infect Dis. 1997 Sep;176(3):766-70
9291329
JAMA. 2003 Jan 8;289(2):203-9
12517231
J Infect Dis. 2006 Sep 1;194(5):571-8
16897653
J Infect Dis. 2007 Aug 15;196(4):505-9
17624834
N Engl J Med. 2004 Jan 1;350(1):11-20
14702423
N Engl J Med. 1995 Sep 21;333(12):770-5
7643884
J Clin Invest. 1985 Jan;75(1):226-33
3880773
Viral Immunol. 2001;14(2):111-8
11398806
J Clin Microbiol. 2002 Jul;40(7):2609-11
12089286
J Infect Dis. 1998 Oct;178(4):978-82
9806024
Ann Intern Med. 1994 Dec 1;121(11):847-54
7978697
J Infect Dis. 2003 Nov 1;188(9):1345-51
14593592
J Exp Med. 2007 Mar 19;204(3):595-603
17325200
JAMA. 2006 Aug 23;296(8):964-73
16926356
J Clin Invest. 2002 Aug;110(4):537-48
12189248
J Infect Dis. 2002 Dec 15;186(12):1718-25
12447756
Clin Infect Dis. 2002 Apr 1;34(7):958-62
11880962
J Exp Med. 2000 May 1;191(9):1459-66
10790421
Sex Transm Infect. 2007 Aug;83(5):359-64
17475687