Herpes simplex virus type 2 detection by culture and polymerase chain reaction and relationship to genital symptoms and cervical antibody status during the third trimester of pregnancy☆,☆☆,★,★★
Section snippets
Patient population
Pregnant women obtaining prenatal care at the University of Washington have HSV serum antibodies determined by Western blot. Between Sept. 1 and Dec. 31, 1994, all human immunodeficiency virus–negative women between 26 and 31 weeks' gestation with serum antibodies to HSV-2 or to both herpes simplex virus type 1 (HSV-1) and HSV-2 were asked to enroll. Approval was obtained from the University of Washington Institutional Review Board, and written consent was obtained from all subjects. Patients
Results
Thirty-six pregnant women were eligible to participate; 13 enrolled and 9 completed specimen collection. The reasons for nonparticipation were time requirements (n = 17), loss to follow-up (n = 4), and termination of pregnancy (n = 2). The median age of the subjects was 32 years (range 20 to 37 years). Eight (88.9%) of 9 were married and 8 (88.9%) were white. Four (44.4%) were nulliparous and 2 (22.2%) were smokers. Eight (88.9%) woman had only anti-HSV-2 serum antibody, and 1 woman had both
Comment
Detailed sampling of the genital tract revealed several new observations about the natural history of asymptomatic genital HSV during the third trimester of pregnancy. Asymptomatic HSV genital shedding by PCR was common and occurred equally in women with no history of genital herpes and those with a history of symptoms, emphasizing the risk of asymptomatic shedding even among women who are unaware that they have genital herpes. Women without a history of genital herpes could potentially be at a
Acknowledgements
We thank Anne Cent and Julie Dalessio for laboratory support and Dr. John Boggess for assistance with preparation of figures.
References (24)
- et al.
Characteristics and management of pregnancy in women with genital herpes simplex virus infection
Am J Obstet Gynecol
(1983) - et al.
Genital herpes in pregnancy: risk factors associated with recurrences and asymptomatic vital shedding
Am J Obstet Gynecol
(1985) - et al.
Monoclonal antibody blocking tests for the detection of HSV-1 and HSV-2 specific humoral responses: comparison with Western blot assay
J Virol Methods
(1995) - et al.
Predictors of morbidity and mortality in neonates with herpes simplex virus infections. The National Institute of Allergy and Infectious Disease Collaborative Antiviral Study Group
N Engl J Med
(1991) - et al.
Failure of antepartum cultures to predict the infant's risk of exposure to herpes simplex virus at delivery
N Engl J Med
(1986) - et al.
Low risk of herpes simplex virus infections in neonates exposed to the virus at the time of vaginal delivery to mothers with recurrent genital herpes simplex virus infections
N Engl J Med
(1987) - et al.
Effects on infants of a first episode of genital herpes during pregnancy
N Engl J Med
(1987) - et al.
Neonatal herpes simplex virus infection in relation to asymptomatic maternal infection at the time of labor
N Engl J Med
(1991) - et al.
Recurrent genital herpes simplex virus infection in pregnancy: infant outcome and frequency of asymptomatic recurrences
Am J Obstet Gynecol
(1982) - et al.
A seroepidemiologic survey of the prevalence of herpes simplex virus type 2 infection in the United States
N Engl J Med
(1990)
Reasons for the absence of history of recurrent genital infections in mothers of neonates infected with herpes simplex virus
Pediatrics
Use of routine viral cultures at delivery to identify neonates exposed to herpes simplex virus
N Engl J Med
Cited by (35)
Premature Rupture of Membranes with Concurrent Viral Infection
2020, Obstetrics and Gynecology Clinics of North AmericaCitation Excerpt :When a patient presents with clinical symptoms, type-specific serologic and direct virologic assays are required in order to establish a diagnosis. In the setting of an active genital ulcer, the vesicle may be unroofed and swabbed sent for polymerase chain reaction (PCR) testing, which has improved sensitivity compared with viral culture.94,95 If the swab results are positive for HSV, but the HSV-1 and HSV-2 antibodies are negative, the patient has a primary infection.
Oral and vulvar changes in pregnancy
2006, Clinics in DermatologyHerpes simplex virus in pregnancy: New concepts in prevention and management
2005, Clinics in PerinatologyInfectious emergencies in neonatology
2004, AntibiotiquesPrenatal testing for infectious disease
2003, Clinics in Laboratory Medicine
- ☆
From the Departments of Obstetrics and Gynecologya and Laboratory Medicine,b University of Washington Medical Center.
- ☆☆
Supported by National Institute of Allergy and Infectious Diseases training grant AI-01740-17 and Program Project grant AI-30731-04.
- ★
Reprint requests: Kim A. Boggess MD, Department of Obstetrics and Gynecology, Duke University Medical Center, Box 3967, Durham, NC 27710.
- ★★
6/1/78619