Reactivation of genital herpes simplex virus type 2 infection in asymptomatic seropositive personsWald A, Zeh J, Selke S, Warren T, Ryncarz AJ, Ashley R, Krieger JN, Corey LN Engl J Med. 2000;342:844-850
Roughly 25% of adults in the United States are estimated to be herpes simplex virus 2 (HSV-2) seropositive, but only 10% to 25% of HSV-2–seropositive individuals have a known history of recognized genital lesions. It has been generally assumed that asymptomatic HSV-2–seropositive individuals not only have less frequent and less severe recurrences but also are less likely to have asymptomatic viral shedding. Two observations, however, suggest evidence contrary to this belief. First, HSV-2–seropositive individuals who do not have a history of genital lesions do notice that they have recurrent episodes once they are educated about the clinical signs and symptoms of HSV infections. Second, most HSV-2 infections are acquired from partners who lack a history of genital HSV infection.