Oral Herpes Simplex Virus Type 2 Reactivation in HIV‐Positive and ‐Negative Men
1Department of Medicine, Division of Allergy and Infectious Diseases, and Departments of 2Epidemiology and 3Laboratory Medicine, 4Fred Hutchinson Cancer Research Center, and 5Virology Research Clinic, University of Washington, Seattle
Background.
Previous studies using viral cultures rarely reported herpes simplex virus type 2 (HSV‐2) isolation from the mouth. We sought to characterize oral HSV‐2 shedding as detected by HSV DNA polymerase chain reaction among HSV‐2–seropositive men.
Methods.Participants collected daily swabs from oral and anogenital areas for HSV detection with a quantitative polymerase chain reaction assay.
Results.A total of 109 HSV‐2–seropositive men (59 of whom were human immunodeficiency virus [HIV] negative, and 50 of whom were HIV positive) were sampled for a median of 64 consecutive days. Forty‐four (40.4%) had HSV‐2 detected from oral swabs on at least 1 day. Oral HSV‐2 was detected on 148 (2.3%) of 6422 days, genital HSV‐2 was detected on 1110 (17%) of 6505 days, oral HSV‐1 was detected on 220 (5.5%) of 4018 days, and genital HSV‐1 was detected on 88 (2.2%) of 4073 days. Oral HSV‐2 shedding was never associated with an oral lesion, but it was often concurrent with genital HSV‐2 shedding. Both oral and genital HSV‐2 were detected on 90 (61%) of 148 days with oral HSV‐2 shedding. Oral HSV‐2 shedding occurred on 90 (8.2%) of 1110 days with genital HSV‐2 shedding, versus 58 (1.1%) of 5316 days without genital HSV‐2 shedding (
). The HIV‐positive men shed HSV‐2 orally more frequently than did the HIV‐negative men (odds ratio, 2.7 [95% confidence interval, 1.1–7.1]).
Conclusions.Oral HSV‐2 reactivation was common (especially among HIV‐positive men), was always asymptomatic, and often occurred on days of genital HSV‐2 reactivation.
Received 28 January 2006; accepted 30 March 2006; electronically published 12 July 2006.
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Presented in part: 16th Biennial International Society for Sexually Transmitted Diseases meeting, Amsterdam, The Netherlands, July 2005 (abstract TP‐021).
Potential conflicts of interest: none reported.
Financial support: National Institutes of Health Herpes Program Project (grant AI‐30731); National Institutes of Health STD/AIDS (research training grant T32 AI007140 to H.N.K.).