Shattering the Genital Herpes Myth
March 22, 2000 (Atlanta) -- Many people who have tested positive for the
virus that causes genital herpes, but say they have no symptoms of the disease,
may in fact have the virus in their genital tracts, according to a study in
this week's issue of The New England Journal of Medicine. This is
important, researchers say, because it means that -- contrary to popular belief
-- asymptomatic people are potentially infectious, and they could be
unknowingly fueling the herpes epidemic.
Previous studies have found that almost 25% of adults over age 12 in the
United States are infected with herpes simplex virus type 2 (HSV-2), but only
10% to 25% of people who have the infection report having lesions.
"Most genital infections are caused by herpes simplex virus type 2, and
numerous studies have shown that most people with [HSV-2] infection don't give
a history of genital herpes," study author Anna Wald, MD, MPH, tells WebMD.
"There has always been a question of whether those people are shedding the
virus -- meaning whether they have the virus present in their genital area --
or whether they are truly asymptomatic." Wald is an assistant professor in
the department of medicine and epidemiology at the University of Washington in
"So we followed men and women who were seropositive for HSV-2 and who
denied a history of genital herpes. We taught [this group] what herpes looks
like and explained what genital herpes was like, and we asked them to collect,
on a daily basis, swabs of their genital area," Wald says. "It turned
out that once they knew what herpes was, the majority became symptomatic with
herpes. They recognized that they do in fact have herpes, but their outbreaks
were short and infrequent."
The other major finding, she says, was that 83% of this group were
The researchers recruited 53 people with no reported history of genital
herpes but who were found to be HSV-2 seropositive on a blood test. All
attended an educational session on genital herpes that reviewed lesion types
and symptoms. Herpes lesions include blisters, ulcers, or crusted patches of
skin in the buttocks or genital or anal areas. Other symptoms include pain or
burning, tickling, tingling, or similar sensations. Herpes can also be
This group was then compared to 90 subjects who were aware that they had
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