Genital Shedding of Herpes Simplex Virus Among Symptomatic and Asymptomatic Persons With HSV-2 Infection

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Abstract
Herpes simplex virus type 2 (HSV-2) is one of the most frequent sexually transmitted infections worldwide, with global estimates of 536 million infected persons and an annual incidence of 23.6 million cases among persons aged 15 to 49 years.1-3 In the United States, 16% of adults are HSV-2 seropositive,4 but only 10% to 25% of persons with HSV-2 infection have recognized genital herpes.5 Moreover, most HSV-2 infections are acquired from persons without a clinical history of genital herpes.6 Thus, the risk of sexual transmission does not correlate with the recognition of clinical signs and symptoms of HSV-2 but most likely correlates with viral mucosal shedding.7