Stephen E. Straus, MD; James F. Rooney, MD; Claire Hallahan, MD
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Straus S., Rooney J., Hallahan C.; Acyclovir Suppresses Subclinical Shedding of Herpes Simplex Virus. Ann Intern Med. 1996;125:776. doi: 10.7326/0003-4819-125-9-199611010-00015
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Published: Ann Intern Med. 1996;125(9):776.
TO THE EDITOR:
Asymptomatic shedding of herpes simplex virus (HSV) is a prominent factor in the transmission of genital herpes. Theoretically, reducing the rate of asymptomatic HSV shedding could reduce virus transmission. Our study  showed that suppressive acyclovir had little effect on asymptomatic genital shedding; these findings contrast with those of Wald and colleagues . We reanalyzed our data in the hope that the basis for the conflicting findings could be explained.
Our study involved patients with recurring genital herpes who obtained cultures from themselves and maintained symptom and lesion diaries for a total of more than 6500 days. In this study, asymptomatic shedding was defined by “a positive culture … not associated with symptoms or lesions on that day or on a preceding or following day” . The intent was to exclude shedding that was associated with episodes of symptoms. By that definition, acyclovir markedly reduced symptomatic shedding but not asymptomatic shedding.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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