An Explanation for Systemic Symptoms During Primary Genital HSV Infection?

Clinicians have long been puzzled by the systemic and meningeal symptoms manifested by some patients, often women, who have primary genital infection due to herpes simplex virus (HSV). Now, a new study suggests that viremia could be responsible for this phenomenon.

Researchers at the University of Washington in Seattle analyzed stored plasma samples from 164 patients who had clinical, serologic, and microbiological evidence of primary HSV genital infection. One hundred eight patients (66%) were women, and 146 (89%) were white. Almost three quarters of patients were infected with HSV-2.

Forty patients (24%) were found to have viremia (i.e., plasma viral loads, >50 copies/mL on PCR); all were white, and 83% were women. Viremia was more common w…