{"id":22955,"date":"2022-11-20T04:36:00","date_gmt":"2022-11-19T20:36:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=22955"},"modified":"2022-11-20T07:00:35","modified_gmt":"2022-11-19T23:00:35","slug":"jama%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e9%a6%96%e6%ac%a1%e7%94%9f%e6%ae%96%e5%99%a8hsv-1%e6%84%9f%e6%9f%93%e5%90%8e%e4%b8%80%e5%b9%b4%e5%86%85%e6%8e%92%e6%af%92%e6%83%85%e5%86%b5","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=22955","title":{"rendered":"[JAMA\u53d1\u8868\u8bba\u6587]\uff1a\u9996\u6b21\u751f\u6b96\u5668HSV-1\u611f\u67d3\u540e\u4e00\u5e74\u5185\u6392\u6bd2\u60c5\u51b5"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

October 22, 2022<\/p>\n\n\n\n

Viral Shedding 1 Year Following First-Episode Genital HSV-1 Infection<\/h1>\n\n\n\n

Christine\u00a0Johnston,\u00a0Amalia\u00a0Magaret,\u00a0Hyunju\u00a0Son,\u00a0et al<\/h3>\n\n\n\n

JAMA.\u00a0<\/em>Published online October 22, 2022. doi:10.1001\/jama.2022.19061<\/h3>\n\n\n\n

Key Points<\/p>\n\n\n\n

Question<\/strong>  What are the rates of viral shedding after first-episode genital herpes simplex virus type 1 (HSV-1) infection?<\/p>\n\n\n\n

Findings<\/strong>  In this prospective cohort study, 82 participants with first-episode genital HSV-1 infection, of whom 42 had primary HSV-1 infection, self-collected oral and genital swabs daily for HSV polymerase chain reaction testing for two 30-day periods (2 months and 11 months after initial symptoms). Genital HSV-1 shedding was detected on 12.1% of days at 2 months and declined significantly to 7.1% of days at 11 months. Most genital shedding was asymptomatic; genital and oral lesions and oral shedding were rare.<\/p>\n\n\n\n

Meaning<\/strong>  Genital HSV-1 shedding was frequent after first-episode genital HSV-1 and declined rapidly during the first year of infection.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  Herpes simplex virus type 1 (HSV-1) is the leading cause of first-episode genital herpes in many countries.<\/p>\n\n\n\n

Objective<\/strong>  To inform counseling messages regarding genital HSV-1 transmission, oral and genital viral shedding patterns among persons with first-episode genital HSV-1 infection were assessed. The trajectory of the development of HSV-specific antibody and T-cell responses was also characterized.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  Prospective cohort followed up for up to 2 years, with 82 participants followed up between 2013 and 2018. Participants were recruited from sexual health and primary care clinics in Seattle, Washington. Persons with laboratory-documented first-episode genital HSV-1 infection, without HIV infection or current pregnancy, were referred for enrollment.<\/p>\n\n\n\n

Exposures<\/strong>  First-episode genital HSV-1 infection.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  Genital and oral HSV-1 shedding and lesion rates at 2 months, 11 months, and up to 2 years after initial genital HSV-1 infection. Participants self-collected oral and genital swabs for HSV polymerase chain reaction testing for 30 days at 2 and 11 months and up to 2 years after diagnosis of genital HSV-1. Blood samples were collected at serial time points to assess immune responses to HSV-1. Primary HSV-1 infection was defined as absent HSV antibody at baseline or evolving antibody profile using the University of Washington HSV Western Blot. HSV-specific T-cell responses were detected using interferon \u03b3 enzyme-linked immunospot.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0Among the 82 participants, the median (range) age was 26 (16-64) years, 54 (65.9%) were women, and 42 (51.2%) had primary HSV-1 infection. At 2 months, HSV-1 was detected from the genital tract in 53 participants (64.6%) and in the mouth in 24 participants (29.3%). Genital HSV-1 shedding was detected on 275 of 2264 days (12.1%) at 2 months and declined significantly to 122 of 1719 days (7.1%) at 11 months (model-predicted rate, 6.2% [95% CI, 4.3%-8.9%] at 2 months vs 3.2% [95% CI, 1.8%-5.7%] at 11 months; relative risk, 0.52 [95% CI, 0.29-0.93]). Genital lesions were rare, reported on 65 of 2497 days (2.6%) at 2 months and 72 of 1872 days (3.8%) at 11 months. Oral HSV-1 shedding was detected on 88 of 2247 days (3.9%) at 2 months. Persons with primary HSV-1 infection had a higher risk of genital shedding compared with those with nonprimary infection (model-predicted rate, 7.9% [95% CI, 5.4%-11.7%] vs 2.9% [95% CI, 1.7%-5.0%]; relative risk, 2.75 [95% CI, 1.40-5.44]). Polyfunctional HSV-specific CD4+ and CD8+ T-cell responses were maintained during the follow-up period.<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  Genital HSV-1 shedding was frequent after first-episode genital HSV-1, particularly among those with primary infection, and declined rapidly during the first year after infection.<\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  October 22, 2022 […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/22955"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=22955"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/22955\/revisions"}],"predecessor-version":[{"id":22956,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/22955\/revisions\/22956"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=22955"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=22955"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=22955"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}