Association of major histocompatibility complex determinants with the development of symptomatic and asymptomatic genital herpes simplex virus type 2infections

The clinical spectrum of herpes simplex virus (HSV) infections, ranging fro m asymptomatic to frequently distressing outbreaks, suggests that there may be immunologic determinants of disease severity that are associated with h uman leukocyte antigen (HLA) expression. A controlled, prospective study id entified several major histocompatibility complex (MHC) class I and II anti gens whose frequencies are associated with HSV-2 infection or with frequent symptomatic genital recurrences. Previous studies were hampered by the ina bility to serologically identify patients with asymptomatic HSV-2 infection . Clinical evaluation and Western blot assay were used to identify 3 subjec t cohorts: 1 with no prior HSV infections, 1 with HSV-2 antibodies but no r ecognized symptoms, and 1 with HSV-2 antibodies and frequent genital recurr ences. Statistical comparisons of HLA frequencies among these cohorts showe d associations of HLA-B27 and -Cw2 with symptomatic disease, Also, HLA-Cw4 was significantly associated with HSV-2 infection, These associations indic ate that immunologic factors linked to the MHC influence the risk of HSV-2 infection and disease expression.