Recurrent genital herpes in a population attending a clinic for sexually transmitted diseases

Patients with recurrent genital herpes attending a sexually transmitted dis ease clinic were studied and transmission of the infection was elucidated b y evaluating serostatus in their partners. Of 84 patients attending for rec urrent genital herpes, 94% had a herpes simplex virus type 2 (HSV-2) infect ion and only 6% (5 patients) a type 1 infection, The mean age of the patien ts was 36 years and the duration of their infection was up to 37 years (med ian 4 years). In most patients the number of recurrences had not decreased between the first year and the last year. About half had experienced a more severe first episode infection. Of the patients, 64% were not aware of asy mptomatic shedding and the risk of sexual transmission without clinical sym ptoms. Of 67 steady partners of patients with genital HSV-2, 15% had a hist ory of genital herpes. By HSV serology, HSV-2 antibodies (indicating subcli nical genital herpes) were demonstrated in more than half of the partners. The duration of the relationship or condom use did not seem to influence th e frequency of transmission to the partner, which may indicate an individua l susceptibility for acquiring a genital HSV-2 infection, Eleven per cent o f the patients were on suppressive antiviral therapy, while 39% had no expe rience of antiviral therapy, Type-specific HSV serology was found to be of value in counselling partners of patients with genital herpes.