Risk of Recurrence after First Episode of Genital Herpes

Abstract

To define the risk factors associated with recurrent genital herpes simplex virus infection caused by either type 1 or 2 herpes virus (HSV-1 or HSV-2), the authors prospectively studied 224 patients. Those who reported any previous episode of vesicular, pustular, or ulcerative genital lesions not attributable to other causes were classified as having a recurrent episode of HSV infection, and those who had no such history were classified as having a first clinical episode. The group of first episodes was divided on the basis of serologic findings in acute-phase serum samples into primary HSV infections (no complement-fixing or neutralizing antibody to HSV) [# 78] and nonprimary infections (complement fixing antibody to HSV, with or without neutralizing antibody to HSV) [# 59]. There were 87 consecutive patients with recurrent episodes (46 males and 41 females) and 137 consecutive patients with first episodes (59 males and 78 females). The infection was confirmed at the first clinic visit by isolation of HSV. All patients returned for at least one follow-up examination after the genital herpes of the index period was completely healed. Mean duration of follow-up was 221 days. During the follow-up period, 143 (64%) of the patients had at least one clinical recurrence of genital herpes.