FREQUENT GENITAL HERPES-SIMPLEX-VIRUS-2 SHEDDING IN IMMUNOCOMPETENT WOMEN - EFFECT OF ACYCLOVIR TREATMENT

Reactivation of herpes simplex virus type 2 (HSV-2) occurs intermitten tly as perceived clinically and by viral culture, We performed a serie s of studies to evaluate the frequency and pattern of HSV-2 reactivati on using both viral isolation and HSV PCR assay, Daily samples of geni tal secretions were obtained from 27 HSV-2 seropositive women; a subse t of subjects obtained samples while receiving oral acyclovir 400 mg P O twice a day, HSV DNA was detected in genital swab specimens on 28% o f 1,410 d compared with 8.1% of days by viral isolation, 11 of 20 wome n had HSV DNA detected on > 20% of days, 4 on > 50%, and 2 on > 75% of days; in contrast, none of the women shed on > 21% of days by viral i solation. The daily administration of oral acyclovir promptly reduced the frequency of HSV DNA detection by a median of 80%. Within 3-4 d of discontinuing daily acyclovir, HSV DNA again appeared in the genital area, HSV-2 shedding in the genital mucosa occurs much more frequently than previously appreciated, This frequent reactivation likely plays a role in the epidemic spread of genital herpes worldwide.