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> Yes I know I can get wordy, Im trying to get everything over in one
> go and I tend to fall the side of wordiness as bald statements have
> all to often turned round and bit me on the XXX in the lab...OTOH in the
> same spirit Ill return with the opinion that you need to stop making
> absolute statements and expecting not to get picked up on the precise
> details, because you then dont write enough. Conciseness is good, cutting
> out context from the short statement is bad as it puts over an apparently
> different view to what you might be thinking in what are actually very
> complicated concepts with hairsbreadth differences that one owrd can
> make large differences.
>
> Yes I know...wordy. Im not gonna argue that I am not wordy.
First, I'm glad to see that you realize that you tend to be verbose.
While I understand the danger in making absolute statements, I don't
believe I ever said that nobody at all is ever asymptomatic or simply
mistakes their symptoms due to lack of knowledge. Rather, I said many
less than 90% of people with HSV-2 actually totally lack symptoms of
HSV-2. As I pointed out, 31% of people are afraid to even disclose
their symptoms to a physician.
> Yes this still has the majority of infected people not exhibiting
> symptoms. It lists 22% as being symptomatic - thats 78% asymptomatics.
Huh? LOL. About 22% of the population has HSV-2. That doesn't mean that
the other 78% of the population is necessarily asymptomatic, rather
they don't have the virus at all.
> Full cite please - no authors means thats not coming up in Pubmed. Umm
> also sounds like a percentage of the people who know they have lesions not
> telling their doctor - this isnt the same as a population sample in a
> research study who are not going to be able to hide it and also have the
> benefit of anonymity.
Here it is:
http://www.herpes-foundation.org/do...rpes%2069%25%22
> Yes Ive cited papers fromt he same authors that contradict it though.
> Suggesting there is more to the information than what you are suggesting.
No, it just shows that you need to be more careful in reading what the
authors have to say. Since Corey, Wald and others wrote the article
above, I don't think these authors are contradicting themselves.
> Yes Im citing later literature byt he same authors that contradicts it,
> plus data by other authors eg Sizemore et al, 2006 J Inf Dis vol 193,
> p905-911. There is makes a statement that 82.2% had ONLY antibody evidence
> of infection - that despite listing a number of symptomatic people also
> shedding virus.
Sizemore always says "Of the 516 men enrolled, 465 (90%) were African
American." not to mention the conclusion of merely "Genital HSV
infections are common and largely unrecognized among this segment of
the population". I'm going with Corey on this one.
> Your cited literature had a bunch of people found to be HSV2 positive -
> and then having it shoved in their faces a numberof them start reporting
> symptoms. One problem with this is that it did NOT control for the
> stress of the diagnosis and subsequent self examination. Another is that
> it requires hindsight and does not deal with the 'blind' population, who
> both the authors of the data you cited and others continue to find
> infected but non-symptomatic in the 80+ region.
Just simply look at the article that Corey and Wald wrote I have
above. Read the fact that 31% won't even tell their doctors and then
don't ever utter "HSV-2 is 90% asymptomatic" in your life...LOL
> As a side note - you introduce the word 'truely' as a qualifier - you have
> done this before - its potentially a massively significant qualifier -
> since it steps away from conventional definition but adds a lot of extra
> connotation, particularly the way its used in conversation by
> people in the field...don't answer here yet there's a bit later on in the
> post where its relevant.
I use truely because your definition of asymptomatic is false. A person
who is asymptomatic is a person who is, by definition, without
symptoms. NOT a person who is too embarrassed to tell or someone who
recognizes less than textbook symptoms and bullshits themself.
> For subclinial read asymptomatic, for symptoms they mean the same thing.
> The difference with subclinical is that it recognises biological activity
> much more. Which kind of fits herpes.
Wrong. Subclinical = "Not manifesting characteristic clinical
symptoms". I just told you what asymptomatic means.
> Erm why not - at the point of defining symptomology they cover exactly the
> same area. Both require no detected clinical signs (ie symptoms). A
> symptoms is by definition a clinical event.
Wrong again. Subclinical involves no CHARACTERISTIC symptoms. Many
people with HSV-2 are subclinical, few are asymptomatic.
> Yes and Im citing papers which state that in their dataset, these
> conflict with and argue against.
No, all due respect, you're not because you are thoroughly confused on
what asymptomatic even means.
> There is one view out there that viral shedding should itself be
> considered a symptom. Its a minority view, not because people think
> shedding doesnt mean anything but because there is a long standing
> separation of biological activity and clinical activity for the purposes
> of pratising medicine that controls the mental boxes used in the attached
> research. People in this camp view asymptomatics as a very very tiny
> number (Ive had comments of 'Well basically asymptomatic doesnt exist' to
> 'well there'll be a few true carriers out there but very few, in most its
> active').
Again, many more people are subclinical than asymptomatic.
> Would you consider shedding a symptom personally? If you are looking for
> true asymptomatics why not include shedding - because if thats remotely
> similar to the point you are trying to make then you havent gone far
> enough and you ought to be using the phrase 'truely asymptomatic' more.
Of course shedding is not a symptom. Why do you think we call it
"asymptomatic shedding", just because it sounds good? LOL
> Thats 69% who get symtoms only interacting with the healthcare system.
> Thats underreporting of disease incidence NOT cutting chunks out of the
> random populations in research studies. You are mixing apples and
> oranges. The paper you cite is a social issue, and a problem in getting
> people treated and while it raises massively significant issue for the
> handling of HSV disease is not revealing some flaw in blind research
> study figures.
Finally! You said it! It's underreporting of disease! Too many people
circulate the talking point "well up to 90% of people are asymptomatic
for HSV-2". Bullshit!
The girl who gave me my oral herpes didn't admit to getting cold sores.
I am supposed to then say she's "asymptomatic" because she doesn't know
or care that what she has is HSV-1? Hell no! LOL. She knew there was
something wrong with her lip, she just said it was a "cracked lip".
Likewise, should the 31% of people too ashamed to go to their own
doctors get a free pass under the guise of being "asymptomatic"? I bet
you can't answer that question!
~Eric
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