title: Frequent genital HSV-2 shedding among women during labor in Soweto, South Africa.
abstract: BACKGROUND
  Despite high herpes simplex virus type 2 (HSV-2) incidence and prevalence among women in Africa, we are unaware of published neonatal herpes reports. To assess neonatal HSV transmission potential in South Africa, we investigated the frequency of the strongest risk factors: HSV acquisition in late pregnancy and HSV shedding during labor.
  
  
  METHODS
  Women admitted in early labor to a hospital in Soweto underwent HSV serologic testing and genital swab collection for HSV PCR. HSV-2 seronegative women were assessed for seroconversion 4-6 weeks after delivery.
  
  
  RESULTS
  Of 390 women enrolled, 229 (58.7%) were HSV-2 seropositive. Genital HSV-2 was detected in 17.2% of HSV-2 seropositive women, including 26 of 115 HIV-positive and 13 of 110 HIV-negative women (22.6% versus 11.8%; RR, 1.91; 95% CI, 1.04-3.53; P = 0.038), but in none of 161 HSV-2 seronegative women. Among the 91 HSV-2 seronegative women followed after delivery, none seroconverted.
  
  
  CONCLUSIONS
  HSV-2 reactivation is common among South African women during labor, especially those with HIV coinfection. To determine the epidemiology of neonatal herpes in South Africa and to investigate whether the lack of reported cases is due to alterations in immune control or HSV-2 virulence, studies evaluating acutely ill neonates for HSV and studies of maternal HSV-2 shedding patterns are needed.
authors: Department of Medicine, University of Washington, Seattle, WA, USA.
authors: Tara
authors: 0000-0002-4754-2646
authors: T
authors: Perti
authors: Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
authors: Mandisa
authors: M
authors: Nyati
authors: Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
authors: Glenda
authors: G
authors: Gray
authors: Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
authors: Guy
authors: G
authors: De Bruyn
authors: Department of Laboratory Medicine, University of Washington, Seattle, WA, USA.
authors: Stacy
authors: S
authors: Selke
authors: Department of Laboratory Medicine, University of Washington, Seattle, WA, USA ; Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors: Amalia
authors: A
authors: Magaret
authors: Department of Laboratory Medicine, University of Washington, Seattle, WA, USA ; Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors: Meei-Li
authors: ML
authors: Huang
authors: Department of Pediatrics, Chris Hani Baragwanath Hospital, University of the Witwatersrand, Johannesburg, South Africa.
authors: Sithembiso
authors: S
authors: Velaphi
authors: Department of Medicine, University of Washington, Seattle, WA, USA ; Department of Laboratory Medicine, University of Washington, Seattle, WA, USA ; Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors: Lawrence
authors: L
authors: Corey
authors: Department of Medicine, University of Washington, Seattle, WA, USA ; Department of Laboratory Medicine, University of Washington, Seattle, WA, USA ; Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA ; Department of Epidemiology, University of Washington, Seattle, WA, USA.
authors: Anna
authors: A
authors: Wald
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D005260:Female; D006558:Herpes Genitalis / Q000453:epidemiology / Q000821:virology*; D018258:Herpesvirus 2, Human / Q000302:isolation & purification*; D006801:Humans; D007743:Labor, Obstetric; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000821:virology*; D013019:South Africa / Q000453:epidemiology; D014621:Vagina / Q000821:virology; D017201:Virus Shedding; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral