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Randomized Controlled Trial
. 2011 Oct;25(7):1475-81.
doi: 10.1016/j.bbi.2011.06.003. Epub 2011 Jun 13.

The effects of daily distress and personality on genital HSV shedding and lesions in a randomized, double-blind, placebo-controlled, crossover trial of acyclovir in HSV-2 seropositive women

Eric Strachan  1 , Misty Saracino, Stacy Selke, Amalia Magaret, Dedra Buchwald, Anna Wald
Affiliations
Randomized Controlled Trial

The effects of daily distress and personality on genital HSV shedding and lesions in a randomized, double-blind, placebo-controlled, crossover trial of acyclovir in HSV-2 seropositive women

Eric Strachan et al. Brain Behav Immun. 2011 Oct.

Abstract

Herpes simplex virus (HSV) infections are ubiquitous in humans, but the determinants of clinical and virologic severity are not completely understood. Prior research has suggested that psychological distress can be a co-factor in reactivation of latent HSV infection. Personality traits such as extraversion and neuroticism influence stress attributions and may inform the relationship between psychological distress and health outcomes. Earlier studies in this area have primarily focused on subjective reports of HSV lesion recurrence, but such reports may be influenced by both personality traits and distress. We report results from a randomized, double-blind, placebo-controlled, crossover trial of acyclovir in 19 women for whom personality was assessed at baseline and daily assessments of genital lesions, stress, anxiety, and depression levels were collected for 22 weeks. In addition, daily swabs of the genital mucosa were collected to assess HSV-2 viral reactivation. We found that daily stress predicted genital lesion frequency, and that daily stress, anxiety, and depression predicted genital lesion onset approximately 5 days before onset. Anxiety was also associated with genital lesions 3 days after onset. Distress and viral reactivation were not associated; and no personality traits were associated with any of the outcomes. These results support the hypothesis that psychological distress is both a cause and a consequence of genital lesion episodes.

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Figures

Figure 1
Figure 1
Rate Ratio (95% CI) for frequency of genital lesion onset comparing women with high and low stress levels by days from lesion onset (N = 27 lesion onsets).
Figure 2
Figure 2
Rate Ratio (95% CI) for frequency of genital lesion onset comparing women with high and low anxiety levels by days from lesion onset (N = 27 lesion onsets).
Figure 3
Figure 3
Rate Ratio (95% CI) for frequency of genital lesion onset comparing women with high and low depression levels by days from lesion onset (N = 27 lesion onsets).
Figure 4
Figure 4
Levels of stress, anxiety, and depression by treatment condition
See this image and copyright information in PMC

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