title: The effects of daily distress and personality on genital HSV shedding and lesions in a randomized, double-blind, placebo-controlled, crossover trial of acyclovir in HSV-2 seropositive women.
abstract: Herpes simplex virus (HSV) infections are ubiquitous in humans, but the determinants of clinical and virologic severity are not completely understood. Prior research has suggested that psychological distress can be a co-factor in reactivation of latent HSV infection. Personality traits such as extraversion and neuroticism influence stress attributions and may inform the relationship between psychological distress and health outcomes. Earlier studies in this area have primarily focused on subjective reports of HSV lesion recurrence, but such reports may be influenced by both personality traits and distress. We report results from a randomized, double-blind, placebo-controlled, crossover trial of acyclovir in 19 women for whom personality was assessed at baseline and daily assessments of genital lesions, stress, anxiety, and depression levels were collected for 22 weeks. In addition, daily swabs of the genital mucosa were collected to assess HSV-2 viral reactivation. We found that daily stress predicted genital lesion frequency, and that daily stress, anxiety, and depression predicted genital lesion onset approximately 5 days before onset. Anxiety was also associated with genital lesions 3 days after onset. Distress and viral reactivation were not associated; and no personality traits were associated with any of the outcomes. These results support the hypothesis that psychological distress is both a cause and a consequence of genital lesion episodes.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98101, United States. erstrach@uw.edu
authors.forename: Eric
authors.initials: E
authors.lastname: Strachan
authors.forename: Misty
authors.initials: M
authors.lastname: Saracino
authors.forename: Stacy
authors.initials: S
authors.lastname: Selke
authors.forename: Amalia
authors.initials: A
authors.lastname: Magaret
authors.forename: Dedra
authors.initials: D
authors.lastname: Buchwald
authors.forename: Anna
authors.initials: A
authors.lastname: Wald
mesh_terms: D000212:Acyclovir / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001007:Anxiety / Q000523:psychology / Q000821:virology; D018592:Cross-Over Studies; D003863:Depression / Q000523:psychology / Q000821:virology; D004311:Double-Blind Method; D005260:Female; D006558:Herpes Genitalis / Q000188:drug therapy* / Q000523:psychology / Q000821:virology; D018258:Herpesvirus 2, Human / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D010551:Personality; D013315:Stress, Psychological / Q000523:psychology / Q000821:virology*; D016896:Treatment Outcome; D017201:Virus Shedding / Q000187:drug effects*
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir