Herpes simplex virus (HSV) is a common viral infection, typically classified into two types: HSV-1 and HSV-2. While HSV-1 is often associated with cold sores around the mouth and HSV-2 with genital herpes, both viruses can affect either area. Transmission happens through direct contact with skin or mucous membranes—most often during kissing, oral sex, or genital contact. Once someone is infected, the virus doesn’t leave the body. Instead, it settles into nerve cells and can reactivate from time to time, sometimes without warning.
This lifelong infection is widespread. HSV-1 is often acquired during childhood, while HSV-2 is usually contracted later through sexual contact. Despite how common HSV is, many people living with it don’t realize they’re infected. That’s where the terms “asymptomatic” and “subclinical” come in.
An asymptomatic infection means someone carries the virus but never experiences noticeable symptoms. Yet even without sores or irritation, they can still shed the virus and pass it to others. This silent viral shedding is why herpes often spreads unknowingly. In fact, more than 80% of people with HSV have no idea they’re infected.
A subclinical infection, on the other hand, may involve symptoms so mild or atypical that they’re missed or mistaken for something else. These subtle presentations can still lead to health impacts—for example, in newborns, subclinical HSV infection can cause long-term harm, even if early signs go unnoticed.
Understanding these hidden forms of herpes is essential—not just for individuals, but for public health. Asymptomatic shedding plays a major role in transmission, responsible for the majority of new infections. On some days, people with HSV may shed the virus without any visible signs at all. This stealthy nature of herpes also complicates decisions around screening: testing everyone without symptoms might help control spread but could also lead to anxiety or unnecessary treatment.
Ultimately, awareness is key. Most people living with HSV aren’t doing anything wrong—they simply don’t know. Through education, honest conversations, and thoughtful public health strategies, we can reduce transmission while supporting those affected with dignity and care.
What Does It Mean to Have Asymptomatic Herpes?
For many people, herpes doesn’t announce itself with telltale blisters or sores. Instead, it lives quietly in the body, making its presence known only through testing—or through an unintentional transmission to someone else. This is what it means to have asymptomatic herpes.
You can carry the herpes simplex virus without ever seeing or feeling the “typical” symptoms. Yet even in the absence of visible outbreaks, the virus can still be active. Asymptomatic individuals may shed HSV from their skin or mucosal surfaces, releasing infectious particles that can pass the virus to others. This shedding is completely invisible, and most people don’t realize when it’s happening.
That’s because herpes has a unique ability to lie dormant. After the initial infection, the virus retreats into nerve ganglia—clusters of nerve cells—where it remains for life. Occasionally, it reactivates and travels back to the skin’s surface. This reactivation doesn’t always cause an outbreak; sometimes, it simply results in silent shedding.
Estimates suggest that 85 to 90 percent of people with genital HSV-2 are unaware they have it. These individuals are considered asymptomatic carriers, though the picture is more nuanced than it might seem. Some are truly asymptomatic, meaning they never experience symptoms at all. These cases are often detected only through blood tests or by identifying viral shedding using specialized lab techniques.
Others have unrecognized symptoms—subtle signs that don’t match the classic image of herpes. These might include mild itching, tingling, redness, or irritation that’s easily mistaken for something else, like a yeast infection or razor burn. With education, many people who initially thought they had no symptoms begin to notice patterns. Still, studies show that even when people report genital discomfort, it doesn’t always correlate with detectable virus, highlighting the complexity of symptom recognition.
This mismatch between what herpes “should” look like and how it often behaves makes diagnosis challenging. Many clinicians rely on visible signs, which means subtle or misattributed symptoms can easily slip through the cracks. More sensitive diagnostic tools, such as type-specific antibody tests or daily swabbing with PCR, can reveal the virus even when the skin appears normal.
Another complicating factor is the timing of viral shedding. HSV can become active and contagious before any symptoms appear—or without symptoms at all. Shedding may also continue after a sore has healed. That’s why asymptomatic herpes plays such a large role in transmission: people don’t just miss the signs; often, there are no signs to begin with.
Understanding this quiet version of HSV is critical, both for individuals and for broader public health efforts. It helps explain how the virus spreads so widely and underscores the importance of communication, testing, and self-awareness—especially for those in intimate relationships.
How Common Are Asymptomatic Cases?
The majority of people living with herpes don’t know they have it. This isn’t because they’re careless or ignoring warning signs—it’s because herpes often stays silent. The high rate of asymptomatic or unrecognized infections makes herpes one of the most underdiagnosed sexually transmitted infections globally.
Studies estimate that up to 90% of those infected with HSV-2 are unaware of their status. Even among people who test positive for HSV-2 antibodies, only about 10 to 40% recall ever experiencing symptoms they associated with herpes. The rest either had no symptoms at all or didn’t recognize them for what they were.
Seroprevalence studies—surveys that test large groups of people for antibodies to the virus—reveal just how widespread and underdiagnosed HSV can be. For example, among young women in Russia, HSV-2 infection rates climbed to over 40% by their late 30s, with only a small percentage aware of their diagnosis. In Ukraine, testing in prison populations showed staggering rates: over 70% of women and 50% of men had HSV-2, but fewer than 3% had ever been told they had herpes. These findings reflect a global pattern of missed or unrecognized cases.
Why do so many people remain undiagnosed? Part of the answer lies in how the virus behaves. Many infected individuals experience only mild or infrequent symptoms—such as a bit of redness, itching, or discomfort—that don’t resemble the dramatic outbreaks often shown in medical texts or online images. Others never have symptoms at all. Adding to the confusion is asymptomatic viral shedding, where the virus is active and transmissible without causing any visible signs. People often have no reason to suspect they’re carrying an STI.
Beyond the virus itself, diagnostic challenges and social factors play a major role. Routine sexual health screenings often skip herpes testing, unless specifically requested. Many healthcare providers may also misclassify or overlook symptoms, especially when they don’t follow the “classic” presentation. On top of that, the stigma surrounding herpes can discourage people from seeking answers, even when they suspect something’s wrong. For some, fear of judgment outweighs the drive to get tested.
Gender and anatomy also influence how herpes is detected and experienced. Women are statistically more likely to be infected with HSV-2 than men. In one Estonian study, roughly one in four pregnant women tested positive, compared to about one in ten male blood donors. Women also tend to be more asymptomatic or experience internal symptoms that are harder to notice. The structure of the female genital tract makes it more vulnerable to infection and less likely to show visible lesions. During pregnancy, HSV reactivation is more frequent, potentially increasing the risk of transmission to a baby if precautions aren’t taken.
These patterns—biological, diagnostic, and social—create a situation where the virus thrives quietly. Raising awareness about asymptomatic herpes isn’t just about statistics. It’s about recognizing that most people with herpes are living with it unknowingly, and that knowledge, testing, and understanding are the first steps toward informed care and prevention.
What Happens in the Body During an Asymptomatic Infection?
Herpes simplex virus has an unusual ability to persist in the body quietly, often for years or even a lifetime, without causing symptoms. This is made possible by its unique lifecycle, which includes phases of activity and dormancy that play out deep within the nervous system.
After the virus first enters through the skin or mucous membranes—typically during oral or genital contact—it travels along sensory nerves to specialized clusters of nerve cells known as ganglia. HSV-1 often settles in the trigeminal ganglia near the base of the skull, while HSV-2 usually migrates to the sacral ganglia near the lower spine. Once there, the virus enters a dormant state known as latency.
During latency, the virus halts its replication and produces only minimal genetic material—specifically, latency-associated transcripts (LATs). These LATs don’t make new virus particles but instead help the virus stay hidden. They suppress viral gene expression and prevent the infected nerve cells from dying, which keeps the virus intact but invisible to the immune system. This state of neuronal quiescence means the virus remains tucked away in just a few nerve cells, producing little or no protein and avoiding immune detection.
However, latency isn’t permanent stasis. From time to time, HSV reactivates. Sometimes this is triggered by stress, illness, or hormonal changes—but reactivation can also happen spontaneously. When this occurs, the virus travels back along the nerves to the surface of the skin or mucosa. In many cases, this results in viral shedding—where virus particles are released at the surface—without causing any visible sores or discomfort. This is what makes asymptomatic infections both medically intriguing and socially complex: a person can be contagious without any outward sign.
Shedding tends to happen in low levels and short bursts, particularly in people with healthy immune systems. Still, those brief episodes are enough to pass the virus to a partner during close contact.
The immune system plays a critical role in keeping herpes in check, especially during these silent reactivations. HSV-specific memory T cells, particularly CD8+ T cells, patrol the ganglia and mucosal surfaces, poised to act at the first sign of viral activity. They suppress reactivation by releasing antiviral substances like interferon-gamma and through direct cell-killing mechanisms. CD4+ T cells support this process by helping CD8+ cells stay functional over time and by contributing their own antiviral responses. Even before symptoms appear—or in many cases, before they have a chance to—these immune players work together to keep the virus from gaining momentum.
In addition to adaptive immunity, the body’s innate defenses jump into action during reactivation. Cells like dendritic cells and macrophages release rapid-fire signals to help contain the virus locally, often stopping an outbreak before it starts.
This constant behind-the-scenes balance between viral persistence and immune suppression explains how herpes can remain quiet for so long. For people living with HSV, especially those without symptoms, the infection is far from inactive—it’s just operating in a complex dance of latency, reactivation, and immune containment that happens largely beneath the surface.
Asymptomatic Shedding: What You Need to Know
One of the most misunderstood aspects of herpes is asymptomatic shedding—the release of virus from the skin or mucosa when there are no visible symptoms. This quiet process is a key reason herpes continues to spread, even among people who believe they’re not contagious.
Asymptomatic shedding happens when the herpes virus, dormant in nerve cells, becomes active and travels to the surface of the skin or mucosal lining. This doesn’t always lead to a visible outbreak. Instead, the virus may be present on the skin for a short period—often just a day or two—without causing any signs at all. These silent episodes are hard to detect unless someone undergoes frequent laboratory testing, such as daily swabs analyzed by PCR.
Despite being subtle, this form of shedding is surprisingly common. In people with genital HSV-2, shedding occurs on roughly 10 to 20 percent of days—even in those who’ve never had an obvious outbreak. For those with HSV-1, oral shedding is frequent too. Studies show that over 70 percent of people shed HSV-1 from the mouth at least once a month, often through saliva or tears. Many of them don’t even know they carry the virus.
Shedding patterns can vary widely. Some people shed the virus randomly, while others experience more frequent shedding during specific times—such as soon after first infection, or when dealing with stress, illness, or immune suppression. Most episodes are brief, lasting between one and three days, but even short windows can be enough for transmission.
It’s important to understand that shed virus is still contagious. Even small amounts of HSV released during asymptomatic periods can lead to transmission through skin-to-skin or mucosal contact. This is why someone can pass the virus to a partner without ever having a visible sore—and why many people are surprised when they or their partners test positive despite never noticing symptoms.
Several factors influence how often shedding occurs:
- Type of virus: HSV-2 causes more frequent genital shedding than HSV-1. Individuals with genital HSV-2 tend to shed the virus about twice as often as those with genital HSV-1.
- Time since infection: Shedding is more frequent in the months following a primary infection. While the rate usually declines over time, it rarely stops completely.
- Immune function: People with weakened immune systems, such as those living with HIV, often experience higher rates of viral shedding.
- Antiviral therapy: Daily antiviral medication, such as valacyclovir, can reduce the frequency of shedding by up to 70%. However, it doesn’t eliminate the risk entirely.
Understanding asymptomatic shedding is crucial not just for managing personal health, but also for protecting partners and making informed choices about testing, treatment, and prevention. While you can’t see shedding, being aware of it empowers you to navigate herpes with greater confidence and care.
Risks and Implications of Asymptomatic Herpes
While the idea of herpes often centers around visible outbreaks, the reality is that the virus frequently spreads in the absence of symptoms. Asymptomatic shedding plays a central role in transmission, making it both a personal and public health concern.
Most herpes simplex virus (HSV) transmission happens during periods when no sores or lesions are present. People who feel completely healthy may still shed the virus from their skin or mucosal surfaces—and unknowingly pass it to others. In immunocompetent individuals, this silent shedding can occur on 2 to 8 percent of days. The frequency is even higher in those with compromised immune systems, such as people living with HIV.
This means that even someone who has tested positive for HSV and has never had a noticeable outbreak can still infect a partner. Many people with HSV-2, in particular, remain unaware of their status and engage in sexual activity without using protection or discussing risks with partners. This lack of awareness contributes to the ongoing cycle of transmission, especially since there’s no outward sign that the virus is active.
These dynamics can create significant stress within relationships. The potential for asymptomatic transmission raises difficult questions about trust, disclosure, and safety. For couples, navigating this invisible risk can be emotionally challenging. Stigma, fear of rejection, and misinformation often compound the strain, even when partners are committed to understanding and supporting one another.
Pregnancy introduces another layer of complexity. If a woman acquires HSV late in pregnancy—or has an undiagnosed infection—she may shed the virus during childbirth without any symptoms. This asymptomatic shedding can result in neonatal herpes, a rare but serious condition. Most newborn infections occur not because the mother had a known history of herpes, but because she was asymptomatically shedding the virus during delivery. These cases account for as much as 50 to 80 percent of neonatal infections.
Beyond individual cases, asymptomatic herpes is a broader public health concern. High rates of undiagnosed HSV-2, particularly among sexually active adults, make it difficult to control the virus’s spread. Widespread screening could help, but current guidelines do not recommend routine testing for asymptomatic individuals—partly due to concerns about stigma, false positives, and the psychological toll of a diagnosis.
The implications of herpes also extend into the realm of HIV. HSV-2 infection, even without symptoms, increases the risk of both acquiring and transmitting HIV. It does so by creating microscopic openings in the skin and boosting inflammation, which weakens the body’s natural defenses. Treating HSV-2 with daily antivirals can reduce this inflammatory effect and slightly lower HIV viral load, though it doesn’t eliminate the risk.
Ultimately, asymptomatic herpes reminds us that not all infections announce themselves. The invisible nature of shedding challenges our assumptions about what it means to be contagious—and calls for a more informed, compassionate approach to sexual health. Awareness, honest conversations, and appropriate precautions can make a meaningful difference, both for individuals and communities.
How to Know If You Have Herpes Without Symptoms
Discovering a herpes diagnosis without ever experiencing symptoms can feel confusing, but it’s more common than many realize. Fortunately, testing tools exist that can help identify a silent infection, giving people the opportunity to make informed decisions about their health and relationships—even in the absence of visible signs.
The most reliable way to detect herpes in someone without symptoms is through a type-specific IgG antibody blood test. These tests look for antibodies to HSV-1 or HSV-2, the body’s way of signaling that it has encountered the virus in the past. Unlike older, non-type-specific methods, modern IgG tests target a viral protein called glycoprotein G (gG), allowing them to distinguish between HSV-1 and HSV-2 with much greater accuracy.
This is especially important for people who’ve never had noticeable symptoms. Even without outbreaks, a person can still carry the virus and pass it to others. Identifying this through blood testing can be a crucial step for sexual health, especially when someone is planning a pregnancy or entering a new relationship.
So, who should consider getting tested? Type-specific testing is often recommended in several key situations:
- If you have a partner who has tested positive for HSV, testing can clarify your own risk level and guide decisions around protection or antiviral use.
- If you’re pregnant and either your partner has herpes or you experience unexplained genital irritation, knowing your HSV status can help assess the risk of transmission to your baby during birth.
- If you’ve had recurring symptoms like redness, itching, or irritation that haven’t been fully explained—especially if they’re mistaken for yeast infections or UTIs—testing may reveal an underlying herpes infection that’s presenting atypically.
However, testing isn’t without its challenges. Some IgG tests, particularly those aimed at detecting HSV-1, may miss infections, especially in people who’ve been recently exposed or who have very mild symptoms. In one study, a notable percentage of people with confirmed recurrent infections still tested negative using commercial assays.
False positives can also occur, particularly when test results fall within a “low-positive” range—index values between 1.0 and 3.0 on some assays may indicate past infection, or may be inaccurate, especially in populations where HSV is less common. This makes interpretation and follow-up counseling important, especially for people who weren’t expecting the results or whose test results fall into a gray area.
Another complication is the variability between different test brands. Some people may receive different results from different labs, so in ambiguous cases, confirmatory testing (using methods like Immunoblot or Western Blot) may be advised.
In the end, knowing your herpes status—even when symptoms are absent—can provide clarity. Testing isn’t perfect, but it’s a valuable tool for people who want to better understand their sexual health, reduce risk to partners, or plan for pregnancy safely. Awareness opens the door to informed choices—and in many cases, peace of mind.
Managing and Reducing the Risk of Asymptomatic Transmission
Because herpes can be spread even when there are no visible symptoms, managing asymptomatic transmission is an important part of caring for yourself and protecting others. Fortunately, there are several effective strategies—medical, relational, and lifestyle-based—that can significantly reduce the likelihood of passing the virus on.
One of the most well-researched tools is suppressive antiviral therapy. Taking medication daily, such as 500 mg of valacyclovir, has been shown to reduce the risk of HSV-2 transmission by nearly half. Even more notably, it cuts the risk of symptomatic infection in partners by about 75%. Suppressive treatment doesn’t just prevent visible outbreaks; it also reduces how often the virus is shed from the skin during asymptomatic periods. For couples where one partner is HSV-positive and the other isn’t, this approach is FDA-approved specifically to help prevent transmission and can offer both physical and emotional peace of mind.
Barrier methods, especially condoms, also play an important role. While they don’t provide complete protection—because herpes can be spread from areas not covered by a condom—they still significantly reduce risk. For women with male partners who have HSV-2, consistent condom use offers up to 96% protection per sex act. Overall, using condoms regularly lowers the risk of acquiring HSV-2 by about 30%. Though the level of protection can vary by gender, with condoms generally being more effective at protecting women, any consistent use is better than none.
Yet prevention isn’t just medical—it’s relational too. Open communication with partners is a powerful protective tool. When someone with herpes shares their status, it allows both people to make informed decisions about sexual activity, condom use, and timing. Studies show that disclosure leads to safer behavior and helps reduce the stigma that can otherwise complicate relationships. For long-term couples, especially those navigating recurring symptoms or uncertain HSV status, mutual type-specific testing can help clarify risk and guide decisions together.
Beyond medication and communication, lifestyle choices can support immune health and reduce the chances of reactivation. Stress is a well-known trigger for herpes outbreaks, and interventions like mindfulness, talk therapy, or relaxation techniques can help lower that risk. Sleep, nutrition, and overall wellness also matter—keeping the immune system resilient makes it harder for the virus to resurface. For some, maintaining a diet rich in immune-supportive nutrients (like lysine) and avoiding common triggers such as sunburn, excessive alcohol, or overexertion can make a noticeable difference.
Managing asymptomatic herpes is about more than just avoiding transmission. It’s about understanding your body, making empowered choices, and caring for your health and your relationships in a way that’s grounded in knowledge—not fear.
Living with the Unknown—And Finding Peace in Knowledge
Herpes doesn’t always come with clear signs. For many, the virus lives quietly in the body—unnoticed, undiagnosed, and unknowingly shared. That reality can feel unsettling, especially when it’s wrapped in silence and misunderstanding. But understanding asymptomatic herpes is more than a medical detail; it’s a reminder of how complex, resilient, and quietly interconnected our bodies truly are.
Whether you’re living with HSV, supporting a partner who is, or simply learning for your own awareness, know this: you’re not alone. Asymptomatic herpes is incredibly common, and with the right tools—testing, open communication, medical support, and self-care—it’s also manageable. More than that, it doesn’t define your worth, your relationships, or your ability to live fully and confidently.
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References
Adler-Storthz, K., Matson, D., Adam, E., & Dreesman, G. (1983). A micro solid-phase radioimmunoassay for detection of herpesvirus type-specific antibody. Journal of Virological Methods, 6(2), 85–97.
Al-Dujaili, L. J., Clerkin, P., Clement, C., McFerrin, H., Bhattacharjee, P., Varnell, E., Kaufman, H., & Hill, J. (2011). Ocular herpes simplex virus: how are latency, reactivation, recurrent disease and therapy interrelated? Future Microbiology, 6(8), 877–907.
Alice, D. (2016). Shedding light on viral shedding.
Arduino, P., & Porter, S. (2007). Herpes Simplex Virus Type 1 infection: overview on relevant clinico-pathological features. Journal of Oral Pathology & Medicine, 37(2), 107-121.
Augenbraun, M., Feldman, J., Chirgwin, K., Zenilman, J., Clarke, L., Dehovitz, J., Landesman, S., & Minkoff, H. (1995). Increased genital shedding of herpes simplex virus type 2 in HIV-seropositive women. Annals of Internal Medicine, 123, 845–847.
Balaeva, T. V., Grjibovski, A. M., Sidorenkov, O., Samodova, O. V., Firsova, N. A., Sannikov, A. L., & Klouman, E. (2014). Prevalence and socio-demographic correlates of herpes simplex virus type 2 (HSV-2) seropositivity among young adults in Arkhangelsk, Northwest Russia. European Journal of Public Health.
Bourne, N., Perry, C. L., Banasik, B. N., Miller, A. L., White, M., Pyles, R., Schäfer, H., & Milligan, G. (2018). Increased frequency of virus shedding by herpes simplex virus 2-infected guinea pigs in the absence of CD4+ T lymphocytes. Journal of Virology.
Brown, Z. A., Benedetti, J., Ashley, R., Burchett, S., Selke, S., Berry, S., Vontver, L., & Corey, L. (1991). Neonatal herpes simplex virus infection in relation to asymptomatic maternal infection at the time of labor. The New England Journal of Medicine, 324(18), 1247–1252.
Corey, L., & Ashley, R. (2004). Prevention of herpes simplex virus type 2 transmission with antiviral therapy. Herpes, 11(Suppl 3), 170A-174A.
Crawford, K. H. D., Selke, S., Pepper, G., et al. (2024). Performance characteristics of highly automated HSV-1 and HSV-2 IgG testing. Journal of Clinical Microbiology, 62.
Dovrat, S., Shabat, A., Yahav-Dovrat, A., Soufiev, Z., Mendelson, E., Kashi-Zagdoun, E., & Rahav, G. (2024). Analysis of HSV1/2 Infection Reveals an Association between HSV-2 Reactivation and Pregnancy. Viruses.
Duran, N., Yarkın, F., Evruke, C., & Koksal, F. (2004). Asymptomatic herpes simplex virus type 2 (HSV-2) infection among pregnant women in Turkey. The Indian Journal of Medical Research, 120(2), 106–110.
Dutton, A., Turnbaugh, E. M., Patel, C. D., Garland, C. R., Taylor, S. A., Alers-Velazquez, R., … & Leib, D. A. (2025). Asymptomatic neonatal herpes simplex virus infection in mice leads to persistent CNS infection and long-term cognitive impairment. PLoS Pathogens, 21(2), e1012935.
Geretti, A. (2006). Genital herpes. Sexually Transmitted Infections, 82(iv31-iv34).
H. Mark. (2013). Asymptomatic sexually active adolescents and young adults should not be screened for herpes simplex virus. JAMA Pediatrics, 167(8), 691-692.
Halioua, B., & Malkin, J. (1999). Epidemiology of genital herpes – recent advances. European Journal of Dermatology.
Hammad, W., & Konje, J. (2021). Herpes simplex virus infection in pregnancy – An update. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 259, 38–45.
Johnston, C., Magaret, A., Son, H., et al. (2022). Viral shedding 1 year following first-episode genital HSV-1 infection. JAMA.
Johnston, C., Morrow, R., & Stanberry, L. (2014). Human Herpesviruses: Herpes Simplex Virus Types 1 and 2. In Human Herpesviruses (pp. 829–853).
Kaufman, H. E., Azcuy, A. M., Varnell, E. D., et al. (2005). HSV-1 DNA in tears and saliva of normal adults. Investigative Ophthalmology & Visual Science, 46(1), 241–247.
Khanna, K., Lepisto, A. J., Decman, V., & Hendricks, R. (2004). Immune control of herpes simplex virus during latency. Current Opinion in Immunology, 16(4), 463–469.
Koelle, D. M., Benedetti, J., Langenberg, A., & Corey, L. (1992). Asymptomatic reactivation of herpes simplex virus in women after the first episode of genital herpes. International Journal of Gynecology & Obstetrics, 39.
Koelle, D., & Wald, A. (2000). Herpes simplex virus: the importance of asymptomatic shedding. The Journal of Antimicrobial Chemotherapy, 45(Suppl T3), 1-8.
Koutsky, L., et al. (1992). Underdiagnosis of genital herpes by current clinical and viral-isolation procedures. The New England Journal of Medicine, 326(23), 1533–1539.
Kriebs, J. M. (2008). Understanding herpes simplex virus: transmission, diagnosis, and considerations in pregnancy management. Journal of Midwifery & Women’s Health, 53(3), 202–208.
Kriebs, J. M. (2008). Understanding herpes simplex virus: transmission, diagnosis, and considerations in pregnancy management. Journal of Midwifery & Women’s Health, 53(3), 202–208.
Legoff, J., Péré, H., & Bélec, L. (2014). Diagnosis of genital herpes simplex virus infection in the clinical laboratory. Virology Journal, 11, 83.
Leone, P. (2005). Reducing the risk of transmitting genital herpes: advances in understanding and therapy. Current Medical Research and Opinion, 21(1577–1582).
Magaret, A., Mujugira, A., Hughes, J., et al. (2015). Effect of condom use on per-act HSV-2 transmission risk in HIV-1, HSV-2-discordant couples. Clinical Infectious Diseases, 62(4), 456–461.
Margolis, T., Elfman, F., Leib, D., Pakpour, N., Apakupakul, K., Imai, Y., & Voytek, C. (2007). Spontaneous reactivation of herpes simplex virus type 1 in latently infected murine sensory ganglia. Journal of Virology, 81(20), 11069–11074.
Martin, E. T., Krantz, E., Gottlieb, S. L., et al. (2009). A pooled analysis of the effect of condoms in preventing HSV-2 acquisition. Archives of Internal Medicine, 169(13), 1233–1240.
Mertz, G. J. (1993). Epidemiology of genital herpes infections. Infectious Disease Clinics of North America, 7(4), 825–839.
Miller, C. S., & Danaher, R. (2008). Asymptomatic shedding of herpes simplex virus (HSV) in the oral cavity. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 105(1), 43–50.
Morand, P. (2002). Natural history of HSV-1 and HSV-2 infection: Asymptomatic viral excretion and transmission. Annales de Dermatologie et de Vénéréologie, 129(4 Pt 2), 577–585.
Ojinmah, U., Ozoh, G., & Onyekonwu, C. (2014). Factors influencing herpes simplex virus type 2 infection among females in Enugu. Nigerian Journal of Medicine, 23(2), 130-141.
Osinskaya, T., Zapolsky, M., Lebedyuk, M., Shcherbakova, Y., & Dzhoraeva, S. (2022). Prevalence of the herpes simplex virus (types 1 and 2) among patients in the places of detention. Georgian Medical News, 328-329, 43–46.
Panchanadeswaran, S., Johnson, S., Mayer, K., et al. (2006). Gender differences in the prevalence of sexually transmitted infections and genital symptoms in an urban setting in southern India. Sexually Transmitted Infections, 82, 491–495.
Patel, R., et al. (2001). European guideline for the management of genital herpes. International Journal of STD & AIDS, 12, 34–39.
Perng, G., & Jones, C. (2010). Towards an understanding of the herpes simplex virus type 1 latency-reactivation cycle. Interdisciplinary Perspectives on Infectious Diseases, 2010.
Prince, H. E., Ernst, C., & Hogrefe, W. (2000). Evaluation of an enzyme immunoassay system for measuring herpes simplex virus type-specific IgG antibodies. Journal of Clinical Laboratory Analysis, 14(1), 13–16.
Roberts, S. (2009). Herpes simplex virus: incidence of neonatal herpes, maternal screening, management during pregnancy, and HIV. Current Opinion in Obstetrics and Gynecology, 21, 124–130.
Roest, W., Rooijen, M., Kwa, D., Jansen, G., & de Vries, H. D. (2013). False negative HSV IgG1 and IgG2 antibody responses in individuals with a recurrent genital herpes infection. Sexually Transmitted Infections, 89, A62.
Sacks, S., Griffiths, P., Corey, L., et al. (2004). HSV-2 transmission. Antiviral Research, 63(Suppl 1), S27–S35.
Sánchez Pujol, M. J., Docampo Simón, A., Sanguino, L., Blanes, M., & Betlloch, I. (2022). Herpes simplex virus infection in neonates born to asymptomatic mothers: A case series. Cureus, 14.
Schiffer, J., & Corey, L. (2013). Rapid host immune response and viral dynamics in herpes simplex virus-2 infection. Nature Medicine, 19(3), 280–288.
Sperling, R., Fife, K., Warren, T., Dix, L., & Brennan, C. (2008). The effect of daily valacyclovir suppression on herpes simplex virus type 2 viral shedding. Sexually Transmitted Diseases, 35, 286–290.
Srivastava, R., Khan, A. A., Chilukuri, S., Syed, S. A., Tran, T. T., Furness, J. N., Bahraoui, E., & BenMohamed, L. (2017). CXCL10/CXCR3-dependent mobilization of herpes simplex virus-specific CD8+ T cells allows efficient protection against recurrent herpesvirus infection and disease. Journal of Virology, 91(17).
Tanchev, S., & Shentov, B. (2005). Herpes simplex virus infection in pregnancy and transmission to neonatal. Akusherstvo i Ginekologiia, 44(6), 31–35.
Tarchini, G. (2010). Asymptomatic herpes simplex virus type 2 shedding—potential pitfalls of broader testing and aggressive suppression. The Journal of Infectious Diseases, 202(6), 979.
Tronstein, E., Johnston, C., Huang, M. L., et al. (2011). Genital shedding of herpes simplex virus among symptomatic and asymptomatic persons with HSV-2 infection. JAMA, 305(14), 1441–1449.
Uusküla, A., Nygård-Kibur, M., Cowan, F., Mayaud, P., French, R., Robinson, J. N. R., & Brown, D. W. G. (2004). The burden of infection with herpes simplex virus type 1 and type 2: Seroprevalence study in Estonia. Scandinavian Journal of Infectious Diseases, 36(10), 727–732.
van Rooijen, M. V., Roest, W., Hansen, G., Kwa, D., & de Vries, H. D. (2016). False-negative type-specific glycoprotein G antibody responses in STI clinic patients with recurrent HSV-1 or HSV-2. Sexually Transmitted Infections, 92, 257–260.
Ventura, A., Merajver, S., Shew, M., et al. (2013). HSV: herpes simplex virus reactivation and immune interplay. Annual Review of Medicine, 59, 381–395.
Wald, A., & Corey, L. (1996). Acyclovir suppresses subclinical shedding of herpes simplex virus. Annals of Internal Medicine, 125, 776–777.
Wald, A., Langenberg, A. G., Link, K., et al. (2001). Effect of condoms on reducing the transmission of herpes simplex virus type 2 from men to women. JAMA, 285(24), 3100–3106.
Wald, A., Langenberg, A., Krantz, E., et al. (2005). The relationship between condom use and herpes simplex virus acquisition. Annals of Internal Medicine, 143, 707–713.
Wald, A., Zeh, J., Selke, S., et al. (2000). Reactivation of genital herpes simplex virus type 2 infection in asymptomatic seropositive persons. New England Journal of Medicine, 342(12), 844–850.
Whitley, R., & Hook, E. (2022). Shedding Patterns of Genital Herpes Simplex Virus Infections. JAMA.
