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.
Author(s): Strachan E, Saracino M, Selke S, Magaret A, Buchwald D, Wald A.
Affiliation(s): Department of Psychiatry and Behavioral Sciences, University of Washington,
Seattle, WA 98101, United States. erstrach@uw.edu
Publication date & source: 2011, Brain Behav Immun. , 25(7):1475-81
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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