What is herpes shedding

Article Contents References. Mertz Gregory J. Reprints or correspondence: Dr. Oxford Academic. Cite Cite Gregory J. Select Format Select format. Permissions Icon Permissions. Extended duration of herpes simplex virus DNA in genital lesions by the polymerase chain reaction. Google Scholar Crossref. Search ADS. Virologic characteristics of subclinical and symptomatic genital herpes infections.

Frequency of acquisition of first-episode genital infection with herpes simplex virus from symptomatic and asymptomatic source contacts. Reasons for the absence of a history of recurrent genital infections in mothers of neonates infected with herpes simplex virus. Google Scholar PubMed. Frequency of asymptomatic shedding of herpes simplex virus in women with genital herpes. Herpesvirus type 2: study of semen in male subjects with recurrent infections.

Frequent genital herpes virus 2 shedding in immunocompetent women: effect of acyclovir treatment. Asymptomatic reactivation of herpes simplex virus in women after the first episode of genital herpes. Herpes simplex virus type 2 shedding in HIV-negative men who have sex with men: frequency, patterns, and risk factors. Valacyclovir and acyclovir for suppression of shedding of herpes simplex virus in the genital tract. Once daily valacyclovir to reduce the risk of transmission of genital herpes.

Comparative efficacy of famciclovir and valacyclovir for suppression of recurrent genital herpes and viral shedding. There is an estimated 2- to 4-fold increased risk of acquiring HIV, if individuals with genital herpes infection are genitally exposed to HIV. In persons with both HIV and genital herpes, local activation of HIV replication at the site of genital herpes infection can increase the risk that HIV will be transmitted during contact with the mouth, vagina, or rectum of an HIV-uninfected sex partner.

Neonatal herpes is one of the most serious complications of genital herpes. Women should be counseled to abstain from intercourse during the third trimester with partners known to have or suspected of having genital herpes. While women with genital herpes may be offered antiviral medication late in pregnancy through delivery to reduce the risk of a recurrent herpes outbreak, third trimester antiviral prophylaxis has not been shown to decrease the risk of herpes transmission to the neonate.

HSV nucleic acid amplification tests NAAT are the most sensitive and highly specific tests available for diagnosing herpes. However, in some settings viral culture is the only test available. The sensitivity of viral culture can be low, especially among people who have recurrent or healing lesions.

Because viral shedding is intermittent, it is possible for someone to have a genital herpes infection even though it was not detected by NAAT or culture. Type-specific virologic tests can be used for diagnosing genital herpes when a person has recurrent symptoms or lesion without a confirmatory NAAT, culture result, or has a partner with genital herpes. Both virologic tests and type-specific serologic tests should be available in clinical settings serving patients with, or at risk for, sexually transmitted infections.

If confirmatory tests are unavailable, patients should be counseled about the limitations of available testing before serologic testing. Healthcare providers should also be aware that false-positive results occur. In instances of suspected recent acquisition, serologic testing within 12 weeks after acquisition may be associated with false negative test results.

HSV-1 serologic testing does not distinguish between oral and genital infection, and typically should not be performed for diagnosing genital HSV-1 infection.

Diagnosis of genital HSV-1 infection is confirmed by virologic tests from lesions. Patients who are at higher risk of infection e. There is no cure for herpes. Antiviral medications can, however, prevent or shorten outbreaks during the period of time the person takes the medication. There is currently no commercially available vaccine that is protective against genital herpes infection. Candidate vaccines are in clinical trials. Correct and consistent use of latex condoms can reduce, but not eliminate, the risk of transmitting or acquiring genital herpes because herpes virus shedding can occur in areas that are not covered by a condom.

The surest way to avoid transmission of STDs, including genital herpes, is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested for STDs and is known to be uninfected.

Persons with herpes should abstain from sexual activity with partners when herpes lesions or other symptoms of herpes are present. It is important to know that even if a person does not have any symptoms, he or she can still infect sex partners.

Sex partners of infected persons should be advised that they may become infected and they should use condoms to reduce the risk. Sex partners can seek testing to determine if they are infected with HSV. Daily treatment with valacyclovir decreases the rate of HSV-2 transmission in discordant, heterosexual couples in which the source partner has a history of genital HSV-2 infection. It turns out that it's possible to experience a herpes outbreak—and transmit it to others!

This phenomenon is known as asymptomatic shedding. Asymptomatic shedding occurs when the herpes virus is present on the skin but no visible symptoms develop.

This is different from symptomatic shedding, which occurs when someone infected with the herpes simplex virus HSV experiences genital sores, blisters, or other obvious symptoms during a herpes outbreak. If an infected person becomes symptomatic, the first outbreak is usually the most severe. Symptoms of an initial outbreak last two to four weeks and may include:. Fortunately, herpes outbreaks typically become shorter and less painful over time.

In order to create the model simulations, a previous retrospective study of discordant couples was utilized to provide data on the median number of sex acts prior to transmission of HSV On average, 40 sex acts were required before transmission occurred. This allowed for the calculation of a viral infectivity parameter, which directly correlated to the rate of transmission. When entered into the model simulations, viral infectivity predicted both the probability of transmission and the viral load in the genital tract when transmission events happened.

The outcome from the model simulations was that an intervention that maintains viral load below 10, copies would prevent most if not all transmission events. Antiviral medications can reduce viral shedding episodes both in duration and intensity.

However, HSV-2 transmission from patients on therapy still occurs. Schiffer and colleagues had previously shown that this likely stems from the short half-lives of currently available antiviral drugs, resulting in periods of sub-therapeutic drug levels, during which the virus is able to actively replicate and achieve high viral loads in the genital tract Schiffer et al.

It is during these periods that transmission likely occurs.