Study shows shedding continues decades into infection

While previous research has shown that those newly infected with genital HSV-2 have high rates of viral shedding, there is little data on shedding rates years, or even decades, into infection. New research presented at the 48th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC)/Infectious Diseases Society of America (IDSA) in October demonstrated that patients with a long-standing genital HSV-2 infection, characterized as at least 10 years, continued to have high rates of viral shedding.

The eighty-nine participants enrolled in this study collected daily genital swabs for a median of 60 days, which researchers tested for the presence of HSV-2 DNA. More than 5000 swabs were analyzed overall. The duration of infection for participants ranged between 10 and 36 years, with the median being 19 years.

The results demonstrated that individuals with decades long infection do continue to shed virus, both with and without signs and symptoms present. Seventy-four percent of the participants had detectable HSV at least once during the course the study. The mean viral shedding rate was 13.8 percent of days. HSV was detected on 64 percent of days where lesions were present 9.4 percent of days with no lesions.

With high rates of viral shedding (including asymptomatic shedding) continuing years into infection, the risk of transmission to an uninfected partner continues. Those with long-term infection, though, are familiar with all the steps that can be taken to reduce this risk: avoiding sexual contact during an active outbreak, using condoms for sexual contact between outbreaks, and daily suppressive antiviral therapy.