title: Herpes simplex virus type 2 infection in young adult women: risk factors for infection and frequency of viral shedding.
abstract: BACKGROUND
  Population-based studies suggest that acquisition of herpes simplex virus 2 (HSV 2) is most common between ages 20 and 29, especially in minority women. We examined HSV 2 infection and viral shedding in a cohort of young women.
  
  
  METHODS
  Women, age 18 to 24 (median 21), who were part of an observational cohort enrolled between ages 14 to 17, had blood obtained for HSV 2 antibody. Intensive diary collections on sexual behavior and genital symptoms and weekly vaginal swabs were obtained at regular intervals.
  
  
  RESULTS
  HSV 2 antibodies were detected in 43 of 127 participants (33.9%), only 4 of whom were previously known to be positive. Factors associated with a positive test included older age, years of sexual activity, and number of lifetime partners. Testing for HSV 2 DNA by polymerase chain reaction on weekly vaginal swabs from a 13-week sampling period for each HSV 2 antibody positive participant showed 32 of 43 (74.4%) were positive at least once. The positive predictive value of pain for viral shedding was poor.
  
  
  CONCLUSIONS
  HSV 2 infection is very common among young adult women, but symptomatic genital herpes is not. Shedding of HSV 2 DNA can be detected in most antibody positive persons. Early intervention strategies will be needed to control HSV 2 infection.
authors.affiliation: Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA. kfife@iupui.edu
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Fife
authors.forename: James A
authors.initials: JA
authors.lastname: Williams
authors.forename: Allyson L
authors.initials: AL
authors.lastname: Thomas
authors.forename: Susan
authors.initials: S
authors.lastname: Ofner
authors.forename: Barry P
authors.initials: BP
authors.lastname: Katz
authors.forename: J Dennis
authors.initials: JD
authors.lastname: Fortenberry
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control; D000293:Adolescent; D000914:Antibodies, Viral; D004279:DNA, Viral; D005260:Female; D006558:Herpes Genitalis / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control; D018258:Herpesvirus 2, Human / Q000302:isolation & purification*; D006801:Humans; D016015:Logistic Models; D008499:Medical Records; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014621:Vagina / Q000276:immunology / Q000473:pathology*; D017201:Virus Shedding / Q000276:immunology; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral