Patterns of Viral Shedding After First-Time Genital HSV-1 Infection

Herpes simplex virus type 1 (HSV-1) is responsible for a rising proportion of genital herpes, yet most data on virologic shedding pertain to HSV-2 infection. Investigators at a single U.S. site enrolled a prospective cohort of 82 participants (median age, 26; 66% women, 81% white, 51% with primary HSV-1 [i.e., HSV-1 seronegative at baseline]) with a first episode of genital HSV-1 (defined as viral detection in a genital ulcer with no prior genital herpes). All participants were HSV-2 and HIV seronegative, and all agreed to avoid suppressive therapy and to provide anogenital and oral swabs daily for 4 weeks beginning at 2 months (session 1) and 11 months (session 2) after the first episode; swabs were tested with viral PCR, culture, and sequ…