title: Persistent genital herpes simplex virus-2 shedding years following the first clinical episode.
abstract: BACKGROUND
  Patients with newly acquired genital herpes simplex virus 2 (HSV-2) infection have virus frequently detected at the genital mucosa. Rates of genital shedding initially decrease over time after infection, but data on long-term viral shedding are lacking.
  
  
  METHODS
  For this study, 377 healthy adults with history of symptomatic genital HSV-2 infection collected anogenital swabs for HSV-2 DNA polymerase chain reaction for at least 30 consecutive days.
  
  
  RESULTS
  Time since first genital herpes episode was significantly associated with reduced genital shedding. Total HSV shedding occurred on 33.6% of days in participants <1 year, 20.6% in those 1-9 years, and 16.7% in those ≥10 years from first episode. Subclinical HSV shedding occurred on 26.2% of days among participants <1 year, 13.1% in those 1-9 years, and 9.3% in those ≥10 years from first episode. On days with HSV detection, mean quantity was 4.9 log₁₀ copies/mL for those <1 year, 4.7 log₁₀ copies/mL among those 1-9 years, and 4.6 log₁₀ copies/mL among those ≥10 years since first episode.
  
  
  CONCLUSIONS
  Rates of total and subclinical HSV-2 shedding decrease after the first year following the initial clinical episode. However, viral shedding persists at high rates and copy numbers years after infection, and therefore may pose continued risk of HSV-2 transmission to sexual partners.
authors.affiliation: Department of Medicine, University of Washington, Seattle, Washington, USA.
authors.forename: Warren
authors.initials: W
authors.lastname: Phipps
authors.forename: Misty
authors.initials: M
authors.lastname: Saracino
authors.forename: Amalia
authors.initials: A
authors.lastname: Magaret
authors.forename: Stacy
authors.initials: S
authors.lastname: Selke
authors.forename: Mike
authors.initials: M
authors.lastname: Remington
authors.forename: Meei-Li
authors.initials: ML
authors.lastname: Huang
authors.forename: Terri
authors.initials: T
authors.lastname: Warren
authors.forename: Corey
authors.initials: C
authors.lastname: Casper
authors.forename: Lawrence
authors.initials: L
authors.lastname: Corey
authors.forename: Anna
authors.initials: A
authors.lastname: Wald
mesh_terms: D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000821:virology; D002353:Carrier State / Q000821:virology*; D004279:DNA, Viral / Q000235:genetics / Q000302:isolation & purification; D005260:Female; D005836:Genitalia, Female / Q000821:virology; D005837:Genitalia, Male / Q000821:virology; D006558:Herpes Genitalis / Q000821:virology*; D018258:Herpesvirus 2, Human / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D013997:Time Factors; D017201:Virus Shedding
chemical_list: D004279:DNA, Viral