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Use of the designation "shedder" in mucosal detection of herpes simplex virus DNA involving repeated sampling.

Magaret, Amalia S and Johnston, Christine and Wald, Anna (2009) Use of the designation "shedder" in mucosal detection of herpes simplex virus DNA involving repeated sampling. Sexually transmitted infections, 85 (4). pp. 270-275. ISSN 1472-3263

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OBJECTIVES: We evaluated two methods to describe detection of HSV from the genital mucosa. METHODS: We assessed genital swabs from HSV-2 seropositive persons participating in longitudinal studies of HSV DNA detection at the University of Washington Virology Research Clinic. We determined the length of observation period necessary to ensure some HSV detection for most persons. We compared two measures to assess differences in shedding according to HIV status, the shedding rate ratio, defined as the proportion of total samples with detectable HSV in HIV-1 seropositive versus HIV-1 seronegative persons, and the ratio of "shedders", defined as the proportion of persons with any shedding over the interval in HIV-1 seropositive versus HIV-1 seronegative persons. RESULTS: While only 17% (51/308) of HSV-2 seropositive persons shed on their first day on study, 77% (238/308) had some genital shedding over 30 days (any HSV DNA detected on genital swabs). Shedding rate ratios for HIV-seropositive versus HIV-seronegative persons varied from SRR=1.42 using 10 samples to SRR=1.35 using 50 samples. The ratio of "shedders" approached 1 as the observation period increased (RS=1.13 using 10 samples to RS=1.01 using 50 samples). In a hypothetical case, the ratio of "shedders" was shown to exceed one when shedding rates were equal. CONCLUSIONS: Most HSV-2 seropositive persons shed HSV from the genital mucosa. Dichotomization of persons into "shedders" and "nonshedders" or "high" and "low" shedders yields inferences that depend upon sampling interval length. Overall shedding rates provide consistent measures regardless of the number of swabs collected.

Item Type: Article or Abstract
Additional Information: This article has been accepted for publication in STI following peer review. The definitive copyedited, typeset version [insert complete citation information when available] is available online at :
DOI: 10.1136/sti.2008.034751
PubMed ID: 19211593
PMCID: PMC2730769
Grant Numbers: P01 AI030731-13, K24 AI071113-01
Keywords or MeSH Headings: * Female * Genitalia/virology * HIV Seropositivity/virology * Herpes Genitalis/diagnosis* * Herpesvirus 2, Human/isolation & purification* * Herpesvirus 2, Human/physiology * Humans * Male * Mucous Membrane/virology* * Specimen Handling/methods * Statistics as Topic * Time Factors * Virus Shedding*
Depositing User: Library Staff
Date Deposited: 16 Apr 2009 16:22
Last Modified: 14 Feb 2012 14:42

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