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From the Department of Pediatrics, Division of Infectious Diseases and Biomathematics, University of California, Los Angeles, California. Grant Support: In part by a grant from the University of California, Los Angeles, Academic Senate. Anyone can submit a comment any time after publication, but only those submitted within 4 weeks of an article’s publication will be considered for print publication. From Chiron Biocine, Emeryville, California, and the University of Washington School of Medicine, Seattle, Washington.
Requests for Reprints: Andria Langenberg, MD, Chiron Biocine, Chiron Corporation, 4560 Horton Street, Emeryville, CA 94608.
Clinical Reactivation of Herpes Simplex Virus Type 2 Infection in Seropositive Pregnant Women with No History of Genital Herpes.
One month after publication, editors review all posted comments and select some for publication in the Letters section of the print version of Annals.

One hundred thirty-three patients were seropositive for only HSV-2 by Western blot, and 249 patients were HSV-1-seropositive only. Asymptomatic HSV shedding was detected in 5 of 1160 cultures (0.43%) obtained in late pregnancy and during delivery.
Among HSV-1-seropositive patients, one immunization produced increases in gD2 and gB2 ELISA antibody titers and HSV-2-neutralizing antibody titers that were 3 to 5 times greater than those in persons with naturally acquired HSV-2 infection.
The dose of each glycoprotein at each injection and the number of patients receiving each dose are shown.
Herpes simplex virus type 2 neutralizing antibodies in patients 2 weeks after the third immunization with the 30- micrograms vaccine.
Among HSV-seronegative patients, frequency analysis assays showed a marked increase in the precursor frequency of gD2- and gB2-specific T cells after vaccination: T-cell responses after two immunizations were equal to the responses of HSV-2-seropositive patients and were sustained at day 180.
The geometric mean titer (GMT) to glycoproteins B2 and D2 for persons with naturally acquired HSV-2 infection are 3560 and 1209, respectively (see text).

Asymptomatic viral shedding in these women occurred at a rate similar to that seen in women with symptomatic genital HSV-2 infection. To improve recognition of genital herpes near term, obstetricians should counsel pregnant women about the high prevalence and mild and diverse symptoms of genital HSV-2 infection.
Friedland and their patients, without whom this project could not have been done; and Gretchen Spindel and Susan Ames for secretarial support.

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