0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Risk Factors for the Sexual Transmission of Genital Herpes

Gregory J. Mertz, MD; Jacqueline Benedetti, PhD; Rhoda Ashley, PhD; Stacy A. Selke, MA; and Lawrence Corey, MD
[+] Article and Author Information

Grant Support: By grants AI-20381 and AI-30731 from the National Institutes of Health.

Requests for Reprints: Lawrence Corey, MD, Department of Laboratory Medicine, University of Washington, Pacific Medical Center, Room 9301, 1200 12th Avenue South, Seattle, WA 98144.

Current Author Addresses: Dr. Mertz: Department of Medicine, University of New Mexico, HSSB 302, Box 608, Albuquerque, NM 87131.

Dr. Benedetti: Department of Biostatistics, University of Washington, ZH-15, Seattle, WA 98195.

Dr. Ashley: Department of Laboratory Medicine, University of Washington, Children's Hospital and Medical Center, 4800 Sand Point Way NE. Seattle, WA 98105.

Ms. Selke: Department of Laboratory Medicine, University of Washington, ZH-15, Seattle, WA 98195.

Dr. Corey: Department of Laboratory Medicine, University of Washington, Pacific Medical Center, Room 9301, 1200 12th Avenue South, Seattle, WA 98144.


© 1992 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1992;116(3):197-202. doi:10.7326/0003-4819-116-3-197
Text Size: A A A

Objective: To determine the risk of sexual transmission of genital herpes simplex virus (HSV) in heterosexual couples.

Design: Prospective study of couples who were participants in a clinical trial. Each source partner had symptomatic, recurrent genital HSV, and each susceptible partner was without serologic or clinical evidence of genital herpes. Couples were followed for a median of 334 days.

Setting: Two university-based research clinics.

Patients: One hundred forty-four heterosexual couples were studied out of an initial enrollment of 214 couples.

Main Outcome Measures: Development of culture-proven HSV infection or type-specific antibodies in the susceptible partner.

Main Results: Transmission occurred in 14 (9.7%) couples, including 11 (16.9%) of 65 couples with male and 3 (3.8%) of 79 with female source partners (P = 0.05). The annual rate of acquisition was higher (31.8%) in susceptible female partners who lacked antibodies to either HSV type 1 or 2 at entry compared with females with HSV type 1 antibodies at entry (9.1%). Couples avoiding transmission of HSV reported fewer days with genital lesions in source partners. Detailed histories were available at the time of transmission in 13 couples. In nine couples, transmission occurred when the source partner was reported to be asymptomatic and in four, it resulted from sexual contact at the time of prodrome (1 case) or within hours before lesions were first noticed by the source partner (3 cases).

Conclusions: Despite clear recognition of genital herpes in source partners, there was substantial risk for transmission; in 70% of patients, transmission appeared to result from sexual contact during periods of asymptomatic viral shedding. The risk for acquisition of HSV was higher in women than men, and previous HSV type 1 infection appeared to reduce the risk for acquisition of HSV type 2 infection among women.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)