Study Shows Genital Herpes Virus Reactivates Widely Throughout Genital Tract
January 22, 2010 - Genital herpes caused by a reactivation of herpes simplex
virus type 2 (HSV-2) is generally treated as a lesion in one specific area of the genital region. A new study,
however, finds that the virus can frequently reactivate throughout the genital tract, an
important new concept that could help guide both HSV-2 treatment and prevention.
Now available online ,
the study appears in the Feb. 15 issue of The Journal of Infectious Diseases.
In the study, Christine Johnston, MD, MPH, and colleagues at the University of Washington and the Fred Hutchinson
Cancer Research Center in Seattle collected daily samples during a 30-day period from seven separate genital sites in four women
infected with HSV-2. HSV-2 was detected from more than one anatomic site on 56 percent of days when there was viral
shedding-and on genital surfaces on both sides of the participants' bodies on most days when virus was detected at more than one site.
Using a detailed sampling method and a sensitive assay, the authors showed that both symptomatic and
asymptomatic HSV-2 reactivations often occurred at widely spaced regions throughout the genital tract. These reactivations were
often on both sides of the body, even though clinical lesions typically emanate from one anatomic spot. The study's
findings illustrate an important new concept in HSV-2 pathogenesis, the authors wrote, and may help in developing
comprehensive treatment that both suppresses and limits the transmission of HSV-2 infection.
The authors also noted limitations of their study, including a small sample size and the unique features of the
study's subjects. For example, all participants had a history of symptomatic genital herpes, and three of the four had acquired
HSV-2 infection within the past year, increasing the chances of high viral reactivation and lesion rates. Additionally,
although there were a high proportion of days with lesions during the study period, two of the participants who had
recently acquired genital herpes contributed the majority of lesion days.
In an accompanying editorial, Edward W. Hook III, MD, of the University of Alabama at Birmingham, called the
study's findings "of great potential importance, as they further challenge widely held beliefs regarding genital herpes and,
by extension, its management." Many clinicians treat patients with newly diagnosed herpes episodically, managing the signs
and symptoms of periodic symptomatic recurrences, Dr. Hook wrote. "From a personal and public health perspective, the
biology of the infection suggests that a national campaign for serological testing of those at risk would provide
the foundation for more effective efforts to control HSV transmission to others, and that for most sexually
active persons with HSV-2 whose sex partners are not known to also be infected, suppressive therapy should be the preferred approach."
Founded in 1904, The Journal of Infectious Diseases is the premier publication in the Western Hemisphere for original
research on the pathogenesis, diagnosis, and treatment of infectious diseases;
on the microbes that cause them; and on disorders of host immune mechanisms. Articles in JID include research results from
microbiology, immunology, epidemiology, and related disciplines. JID is published under the auspices of the Infectious
Diseases Society of America (IDSA). Based in Arlington, Va., IDSA is a professional society representing more than
9,000 physicians and scientists who specialize in infectious diseases. For more information,
visit www.idsociety.org .
Source:IDSA: Infectious Diseases Society Of America
"Reproduced with permission - Infectious Diseases Society of America "
Infectious Diseases Society of America