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Study finds 98% of subjects shed HSV-1

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"[This study, published in 2005,] found that 98% of the participants who are healthy individuals with no evidence of any symptoms did in fact shed herpes simplex virus type I (HSV-1) DNA in their tears and saliva at least once during the course of the 30-day study."

This study involved only 50 people.

Two very interesting findings:

1. the 98% HSV-1 infection rate

2. seropositivity was only 74%, meaning 12 people had the virus but tested negative

As for the first finding, there are reasons to believe that this does not hold true for the broader adult population.

1. It's only 50 people

2. of unknown socioeconomic background

3. of unknown ages; the age distribution is 19 to 71, but if the majority are near the high end of the scale, that would tip the results toward a high infection rate

4. 78% of the participants are black, so it is not representative of the US adult population, and tips the results toward a high infection rate

As for the second finding – again, it’s such a small study that this could just be chance, but some possible explanations:

1. the false negative rate of HSV-1 IgG tests is roughly 10%, so that could account for 1 or 2 cases.

2. perhaps a couple of participants were only recently infected, so no antibodies are detected yet

3. another assay used accounted for 2 more positives, so instead of 12, we get to 10 infected persons who test negative for antibodies

4. the PCR test used on saliva and tears is more sensitive than the IgG antibody tests. This would imply that the actual HSV-1 infection rate is much higher than seroprevalence studies indicate.

The full study for those interested: http://www.iovs.org/cgi/content/full/46/1/241

Has anyone seen other studies that arrive at similar infection rates amongst US adults? Or any that refute this study's findings?

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