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. 2022 Oct 22;328(17):1730–1739. doi: 10.1001/jama.2022.19061

Table 2. Shedding Rates, Lesion Rates, and Quantity of Herpes Simplex Virus Type 1 (HSV-1) Detected .

Outcome No. (%)
8-12 wk after onset (session 1) 48-52 wk after onset (session 2)
All (n = 82) Primary HSV-1 infection (n = 42)a Prior or unknown HSV-1 infection (n = 40)b,c All (n = 64) Primary HSV-1 infection (n = 35)a Prior or unknown HSV-1 infection (n = 29)b,c
HSV-1 DNA detected by polymerase chain reaction testing
Persons with any genital shedding 53 (64.6) 32 (76.2) 21 (52.5) 21 (32.8) 14 (40.0) 7 (24.1)
Overall genital shedding rated 275/2264 (12.1) 199/1156 (17.2) 76/1108 (6.9) 122/1719 (7.1) 79/933 (8.5) 43/786 (5.5)
Asymptomatic genital sheddinge 239/2189 (10.9) 167/1099 (15.2) 72/1090 (6.6) 89/1637 (5.4) 48/871 (5.5) 41/766 (5.4)
Persons with any genital lesions 12 (14.6) 8 (19.1) 4 (10.0) 15 (23.4) 12 (34.3) 3 (10.4)
Days with genital lesionsf 65/2497 (2.6) 60/1271 (4.7) 5/1226 (0.4) 72/1872 (3.8) 66/1042 (6.3) 6/830 (0.7)
Genital lesion sheddingg 34/62 (54.8) 32/57 (56.1) 2/5 (40.0) 33/68 (48.5) 31/62 (50.0) 2/6 (33.3)
Persons with any oral shedding 24 (29.3) 16 (38.1) 8 (20.0) 17 (26.6) 11 (31.4) 6 (20.7)
Overall oral shedding rated 88/2247 (3.9) 63/1140 (5.5) 25/1107 (2.3) 87/1714 (5.1) 64/925 (6.9) 23/789 (2.9)
Asymptomatic oral sheddinge 87/2223 (3.9) 63/1140 (5.5) 24/1083 (2.2) 86/1690 (5.1) 64/919 (7.0) 22/771 (2.9)
Persons with any oral lesions 2 (2.4) 0 2 (5.0) 3 (4.7) 1 (2.9) 2 (6.9)
Days with oral lesionsf 11/2497 (0.4) 0/1271 11/1226 (0.9) 10/1872 (0.5) 6/1042 (0.6) 4/830 (0.5)
Oral lesion sheddingg 1/11 (9.1) 1/11 (9.1) 1/10 (10.0) 0/6 1/4 (25.0)
Log10 copies/mL HSV-1, median (IQR)
Genital 2.9 (2.5-3.6) [n = 275] 2.9 (2.5-3.7) [n = 199] 2.8 (2.5-3.4) [n = 76] 4.4 (3.2-5.8) [n = 122] 4.5 (3.1-6.5) [n = 79] 4.4 (3.2-4.7) [n = 43]
When lesions present 5.1 (2.5-7.1) [n = 34] 5.2 (2.6-7.3) [n = 32] 2.6 (2.3-2.8) [n = 2] 6.1 (4.3-6.9) [n = 33] 6.1 (4.3-7.4) [n = 31] 5.0 (3.2-6.9) [n = 2]
When asymptomatic 2.8 (2.5-3.4) [n = 239] 2.8 (2.5-3.4) [n = 167] 2.8 (2.5-3.4) [n = 72] 4.2 (3.0-4.8) [n = 89] 3.9 (2.9-5.4) [n = 48] 4.4 (3.2-4.7) [n = 41]
Oral 3.5 (2.5-4.3) [n = 88] 3.4 (2.5-4.4) [n = 63] 3.5 (2.6-4.2) [n = 25] 3.6 (2.7-4.7) [n = 87] 3.5 (2.7-4.8) [n = 64] 3.8 (2.7-4.7) [n = 23]
When lesions present 3.0h 3.0h 2.2h 2.2h
When asymptomatic 3.5 (2.5-4.3) [n = 87] 3.4 (2.5-4.4) [n = 63] 3.6 (2.5-4.2) [n = 24] 3.6 (2.8-4.7) [n = 86] 3.5 (2.7-4.8) [n = 64] 3.9 (2.9-4.7) [n = 22]
a

Primary defined as HSV-1 seronegative or HSV-1 indeterminate at first blood draw or increasing antibody over time.

b

Nonprimary defined as HSV-1 seropositive with first blood sample drawn <42 days after symptom onset.

c

Unknown defined as HSV-1 seropositive with first blood sample drawn ≥42 days after symptom onset or seroconversion not observed.

d

Overall shedding includes all positive swabs over all swabs taken and includes all persons (days with shedding/total daily swabs).

e

Asymptomatic shedding is defined as the proportion of days with shedding in the absence of genital lesions/total daily swabs collected in absence of lesions.

f

The denominator for “days with [genital or oral] lesions” is obtained from diary data. There are slight discrepancies between days in which the diary was completed and days with swabs obtained.

g

Lesion shedding is defined as the proportion of days that with shedding in the presence of genital lesions/total days with genital lesions.

h

The CI was omitted because there was only 1 swab collected.