Shattering the Genital Herpes Myth
This group was then compared to 90 subjects who were aware that they had genital herpes.
During the follow-up period, 26 of the women and seven of the men who had said they had no history of herpes reported having typical lesions in the genital area, with 19 of these people reporting more than one recurrence. Thirteen people reported genital symptoms but no lesions. A total of 46 of the participants reported having either lesions or other genital symptoms. HSV-2 was isolated by viral culture of the swabs at least once in 38 of the participants. Only one of the 53 had no clinical or virologic evidence of HSV infection.
While the study participants with known herpes had more total viral shedding and more frequent and longer attacks than those who had been asymptomatic, both groups had the same rate of subclinical viral shedding (meaning they had a positive culture for the virus but no symptoms or lesions).
"Asymptomatic shedding is a phenomenon that occurs both in people who know they have genital herpes and the people who don't know they have it," says Ward. "When we compared the two groups, the interesting finding was that the frequency of asymptomatic shedding was about 3% in both groups.
"I think the study is important because people who are HSV-2 seropositive, but don't have a history of clinical disease with herpes, have been ignored by the medical community [for] several reasons," she says. "One is, good tests haven't been available until recently. But I think the conviction has always been, if they don't know they have it, they shouldn't be told," because there was thought to be no benefit to breaking this bad news.
Ward says better education and more widespread testing could help people realize they have genital herpes and take steps to control its spread. "It is probably worth reminding people that more than one out of five people in this country has HSV-2 and that most of those people have active infections."
Previous studies have shown nearly 25% of Americans over age 12 are infected with herpes simplex virus-2 (HSV-2), although only 10% to 25% of those who are infected report having had symptoms.
New research shows that even among asymptomatic people, the virus is often present in the genital area and potentially contagious.
Once people with HSV-2 are educated about what the symptoms are, many realize that they do experience symptoms, though outbreaks may be short and infrequent.