ArticleJAMA2011
Genital shedding of herpes simplex virus among symptomatic and asymptomatic persons with HSV-2 infection.
Article in JAMA, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 157 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
157 citing papers in PubMed, 4 syntheses or guidelines pooled it, 289 citations in OpenAlex.
- Estimated global and regional incidence and prevalence of herpes simplex virus infections and genital ulcer disease in 2020: mathematical modelling analyses.Sexually transmitted infections · 2025Pooled it
- Prevalence of herpes simplex virus 2 among MSM in Mainland China: a systematic review and meta-synthesis.AIDS research and therapy · 2022Pooled it
- Sexually Transmitted Infections Treatment Guidelines, 2021.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2021Guideline
- Oral antiviral therapy for prevention of genital herpes outbreaks in immunocompetent and nonpregnant patients.The Cochrane database of systematic reviews · 2014Pooled it
- A Randomized, Double-Blinded, Placebo-Controlled, Phase 1 Study of a Replication-Defective Herpes Simplex Virus (HSV) Type 2 Vaccine, HSV529, in Adults With or Without HSV Infection.The Journal of infectious diseases · 2019Trial
- Oral and Vaginal Tenofovir for Genital Herpes Simplex Virus Type 2 Shedding in Immunocompetent Women: A Double-Blind, Randomized, Cross-over Trial.The Journal of infectious diseases · 2015Trial
- The impact of brief messages on HSV-2 screening uptake among female defendants in a court setting: a randomized controlled trial utilizing prospect theory.Journal of health communication · 2015Trial
- Reactivation of herpes simplex virus type 2 after initiation of antiretroviral therapy.The Journal of infectious diseases · 2013Trial
- High-dose valacyclovir decreases plasma HIV-1 RNA more than standard-dose acyclovir in persons coinfected with HIV-1 and HSV-2: a randomized crossover trial.Journal of acquired immune deficiency syndromes (1999) · 2013Trial
- The effects of daily distress and personality on genital HSV shedding and lesions in a randomized, double-blind, placebo-controlled, crossover trial of acyclovir in HSV-2 seropositive women.Brain, behavior, and immunity · 2011Trial
- Epithelial interferon-γ responsiveness shapes chemokine induction and clinical outcomes in herpes simplex virus infection.PLoS pathogens · 2026Article
- Genital Herpes Simplex Virus (HSV) Infection During Pregnancy - Recommendations of the Working Group on Obstetrics and Prenatal Medicine (AGG - Section on Maternal Disorders).Geburtshilfe und Frauenheilkunde · 2026Article
- Mathematical modeling of the population-level impact of hypothetical herpes simplex virus type 2 curative therapy.Communications medicine · 2026Article
- Immunization with Herpes Simplex Virus Nanoparticles Targeting Both Attachment and Fusion Protect Against Infection.bioRxiv : the preprint server for biology · 2026Article
- Sex-specific biological susceptibility and sexual mixing patterns in herpes simplex virus type 2 transmission: a mathematical modeling study.BMC global and public health · 2026Article
- An mRNA vaccine confers enhanced protection against herpes simplex virus through an IFN-I-dependent pathway.NPJ vaccines · 2026Article
- Maternal-Fetal Implications of Herpes Virus Infection: An Updated Review.Diagnostics (Basel, Switzerland) · 2026Review
- [Management of genital herpes].Dermatologie (Heidelberg, Germany) · 2026Review
- Herpes simplex virus genomes from an under-sampled population in Namibia reveal novel genetic diversity.medRxiv : the preprint server for health sciences · 2026Article
- Herpes Simplex Virus Type 2 Screening in Persons with and Without HIV: Evidence, Challenges, and Future Directions.Current HIV/AIDS reports · 2026Review
97 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
contextSince herpes simplex virus type 2 (HSV-2) antibody tests have become commercially available, an increasing number of persons have learned that they have genital herpes through serologic testing. The course of natural history of HSV-2 in asymptomatic, seropositive persons is uncertain.
objectiveTo evaluate the virologic and clinical course of HSV genital shedding among individuals with symptomatic and asymptomatic HSV-2 infection. DESIGN, SETTING, AND
participantsCohort of 498 immunocompetent HSV-2-seropositive persons enrolled in prospective studies of genital HSV shedding at the University of Washington Virology Research Clinic, Seattle, and Westover Heights Clinic, Portland, Oregon, between March 1992 and April 2008. Each participant obtained daily self-collected swabs of genital secretions for at least 30 days.
main outcome measureThe rate of viral shedding measured by quantitative real-time fluorescence polymerase chain reaction for HSV DNA from genital swabs.
resultsHerpes simplex virus type 2 was detected on 4753 of 23,683 days (20.1%; 95% confidence interval [CI], 18.3%-22.0%) in 410 persons with symptomatic genital HSV-2 infection compared with 519 of 5070 days (10.2%; 95% CI, 7.7%-13.6%) in 88 persons with asymptomatic infection (P < .001). Subclinical shedding rates were higher in persons with symptomatic infection compared with asymptomatic infection (2708 of 20,735 days [13.1%; 95% CI, 11.5%-14.6%) vs 434 of 4929 days [8.8%; 95% CI, 6.3%-11.5%]) (P < .001). However, the amount of HSV detected during subclinical shedding episodes was similar (median, 4.3 [interquartile range, 3.1-5.6] log(10) copies in the symptomatic infection group vs 4.2 [interquartile range, 2.9-5.5] in the asymptomatic infection group, P = .27). Days with lesions accounted for 2045 of 4753 days (43.0%; 95% CI, 39.8%-46.5%) with genital viral shedding among persons with symptomatic genital HSV-2 infection compared with 85 of 519 days (16.4%; 95% CI, 11.2%-23.9%) among persons with asymptomatic infection (P < .001).
conclusionPersons with asymptomatic HSV-2 infection shed virus in the genital tract less frequently than persons with symptomatic infection, but much of the difference is attributable to less frequent genital lesions because lesions are accompanied by frequent viral shedding.
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