1. Clinical reactivation of herpes simplex virus type 2 infection in seropositive pregnant women with no history of genital herpes
- Author
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Frenkel, Lisa M., Garratty, Eileen M., Jie Ping Shen, Wheeler, Noel, Clark, Onelio, and Bryson, Yvonne J.
- Subjects
Herpes simplex virus ,Pregnant women -- Diseases ,Herpesvirus diseases -- Causes of ,Health - Abstract
* Objective: To determine the risk for genital herpes and asymptomatic herpes simplex virus (HSV) shedding in late pregnancy and delivery in a population of HSV type 2 (HSV-2)-seropositive but previously asymptomatic pregnant women. * Design: A prospective inception cohort study. * Participants: A total of 1355 pregnant women with no history of genital herpes referred from three private obstetrics practices between November 1985 and June 1988. * Main Outcome Measures: Confidential questionnaires evaluated sexual risk factors in relation to HSV-2 serologic status as determined by Western blot analysis. Herpes simplex virus shedding was determined by viral culture of the cervix and vulva and of any suspicious lesions. * Results: Antibody to HSV-2 was detected in 439 of 1355 pregnant women (32%) with no history of genital herpes. Asymptomatic HSV shedding was detected in 5 of 1160 cultures (0.43%) obtained in late pregnancy and during delivery. A first episode of clinical genital herpes was recognized by 43 of 264 HSV-2-seropositive women (16%) during their pregnancy. * Conclusions: Serologic evidence of unknown HSV-2 infection was common in pregnant women without a history of genital herpes. Asymptomatic viral shedding in these women occurred at a rate similar to that seen in women with symptomatic genital HSV-2 infection. To improve recognition of genital herpes near term, obstetricians should counsel pregnant women about the high prevalence and mild and diverse symptoms of genital HSV-2 infection., Reactivation of herpes simplex virus type 2 (HSV-2) may occur in pregnant women with no history of genital herpes. Seventy-eight to 97% of individuals infected with HSV-2 have no symptoms. Among 1,355 pregnant women with no history of HSV-2 infection, 439 (32%) had developed antibodies to HSV-2. Of 264 women infected HSV-2 who were followed until delivery, 43 (16%) developed their first episode of genital herpes during their pregnancy. Approximately half of these women developed their first episode of genital herpes during the third trimester of pregnancy. Less than one percent of 1,160 cervical cultures obtained from women infected with HSV-2 revealed asymptomatic viral shedding during late pregnancy or at the time of delivery. Newborns exposed to HSV-2 during passage through the birth canal have a 3% to 8% risk of developing an HSV-2 infection.
- Published
- 1993