The study results showed that psychological distress was temporally associated with the onset of HSV-2 lesions. Daily distress ratings predict lesion onset, as approximately five days before the episode, high levels of stress, anxiety, and depression were reported. High levels of anxiety were present three days after the onset of lesions, leading to a possibility that increased anxiety is related to the continuation of symptoms. No effect was found for viral shedding, which is very important in regard to disease transmission risk. Lesions may occur when the virus is present and systemic or local immunity is impaired, as HSV-2 infection is very dynamic.
Strachan and colleagues found that psychological distress is both a cause and consequence of HSV-2 lesions. No effects were found for viral shedding, and differences in personality traits did not contribute to distress on either disease outcome. The temporal analysis showed that daily monitoring is required to best unravel the relationship between lesion outbreak and changes in distress levels. Due to these findings, the group recommends research on interventions to reduce stress in otherwise healthy individuals.
Strachan E, Saracino M, Selke S, Magaret A, Buchwald D, Wald A. 2011. 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. Brain, Behavior, and Immunity. 25; 1475-1481.