title: Genital herpes evaluation by quantitative TaqMan PCR: correlating single detection and quantity of HSV-2 DNA in cervicovaginal lavage fluids with cross-sectional and longitudinal clinical data.
abstract: OBJECTIVE
  To evaluate the utility of a single quantitative PCR (qPCR) measurement of HSV (HSV-1&2) DNA in cervicovaginal lavage (CVL) specimens collected from women with predominantly chronic HSV-2 infection in assessing genital HSV shedding and the clinical course of genital herpes (GH) within a cohort with semiannual schedule of follow up and collection of specimens.
  
  
  METHODS
  Two previously described methods used for detection of HSV DNA in mucocutaneous swab samples were adapted for quantification of HSV DNA in CVLs. Single CVL specimens from 509 women were tested. Presence and quantity of CVL HSV DNA were explored in relation to observed cross-sectional and longitudinal clinical data.
  
  
  RESULTS
  The PCR assay was sensitive and reproducible with a limit of quantification of ~50 copies per milliliter of CVL. Overall, 7% of the samples were positive for HSV-2 DNA with median log10 HSV-2 DNA copy number of 3.9 (IQR: 2.6-5.7). No HSV-1 was detected. Presence and quantity of HSV-2 DNA in CVL directly correlated with the clinical signs and symptoms of presence of active symptomatic disease with frequent recurrences.
  
  
  CONCLUSIONS
  Single qPCR measurement of HSV DNA in CVL fluids of women with chronic HSV-2 infection provided useful information for assessing GH in the setting of infrequent sampling of specimens. Observed positive correlation of the presence and quantity of HSV-2 DNA with the presence of active and more severe course of HSV-2 infection may have clinical significance in the evaluation and management of HSV-2 infected patients.
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. an_bulbul@yahoo.com
authors.forename: Bulbulgul
authors.initials: B
authors.lastname: Aumakhan
authors.forename: Andrew
authors.initials: A
authors.lastname: Hardick
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Quinn
authors.forename: Oliver
authors.initials: O
authors.lastname: Laeyendecker
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Gange
authors.forename: Chris
authors.initials: C
authors.lastname: Beyrer
authors.forename: Christopher
authors.initials: C
authors.lastname: Cox
authors.forename: Kathryn
authors.initials: K
authors.lastname: Anastos
authors.forename: Mardge
authors.initials: M
authors.lastname: Cohen
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Greenblatt
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Merenstein
authors.forename: Howard
authors.initials: H
authors.lastname: Minkoff
authors.forename: Marek
authors.initials: M
authors.lastname: Nowicki
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Gaydos
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000821:virology*; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000302:isolation & purification; D005260:Female; D006558:Herpes Genitalis / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000821:virology; D018259:Herpesvirus 1, Human / Q000235:genetics / Q000302:isolation & purification; D018258:Herpesvirus 2, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008137:Longitudinal Studies; D016133:Polymerase Chain Reaction / Q000379:methods*; D015995:Prevalence; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014621:Vagina / Q000821:virology*; D044364:Vaginal Douching; D014773:Virology / Q000379:methods*
chemical_list: D004279:DNA, Viral