genital herpes
Clinical features and psychosocial factors in young adults with genital herpes.

Swanson JM, Dibble SL, Chenitz WC.

Samuel Merritt College, Department of Nursing, Oakland, CA 94609, USA.

Clinical features of genital herpes, perceived causes, stress symptoms, treatments, and psychosocial factors in 70 young adults as compared to normative data for non-patient controls are described. The clinical features of the disease were congruent with those of other groups studied. Stress was viewed as the major cause of recurrence, headaches the major stress symptom, and acyclovir (an antiviral drug), was the major treatment. Statistically significant differences were found between scores obtained from the sample of young adults with genital herpes on three of four standardized psychological instruments when compared with normative data for non patient controls. Young adults with genital herpes had a lower self concept, more psychopathology, a greater frequency of daily hassles, and less intensity of uplifts. No differences were found, however, between the two groups in scores on depression.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7721305&dopt=Abstract genital herpes



genital herpes
[Antiviral activity of the natural immunostimulant "Vegetan" in murine herpetic meningoencephalitis, guinea pig genital herpes, and canine parvoviral enteritis]

[Article in Russian]

L'vov ND, Chekanovskaia LA, Alimbarova LM, Mel'nikov VR, Zontov SV, Slepushkin VA, Barinskii IF.

Antiviral activity of vegetan, a new natural immunostimulator, in herpetic meningoencephalitis of mice, genital herpes of guinea pigs, and parvoviral enteritis of dogs was compared to that of acylguanosine and phosphonoformic acid (PFA). Vegetan incorporated in liposomes or pure was the most active if used for prevention 5 days before intracerebral infection of mice with herpes simplex type 1 virus, whatever the dose of infective agent (10 to 100 LD50). Protective efficacy of vegetan was 57-63%, whereas for ara-A, acylguanosine, and PFA these values were, respectively, 20, 25, and 33%. Use of liposomal vegetan preparation ensured a 80% protective effect. Vegetan had a manifest antiviral effect in guinea pigs with genital herpes and in dogs with parvoviral enteritis.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7762239&dopt=Abstract genital herpes



genital herpes
Genital herpes during pregnancy: no lesions, no cesarean.

Roberts SW, Cox SM, Dax J, Wendel GD Jr, Leveno KJ.

Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas.

OBJECTIVE: To determine the effects at our hospital of adoption of the 1988 guidelines recommended by ACOG for management of genital herpes infections during pregnancy. METHODS: Between 1984-1986, 96 pregnancies complicated by active genital herpes were delivered at Parkland Hospital. The outcome of these pregnancies were compared with 217 similar pregnancies managed after implementation of the 1988 ACOG herpes guidelines. RESULTS: Adoption of the 1988 ACOG herpes guidelines resulted in a 37% decrease in the use of cesarean delivery for women with genital herpes infections at our hospital. Most of this decrease was because the new guidelines eliminated the need for a confirmatory negative herpes culture before permitting vaginal delivery. No neonatal herpes infections occurred as a result of implementing the ACOG recommendations. CONCLUSION: The rate of cesarean delivery for women with genital herpes infections during pregnancy declined significantly at our hospital as a result of the adoption of ACOG herpes guidelines, and there were no neonatal consequences, such as increased incidence of neonatal herpes simplex virus infection.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7824242&dopt=Abstract genital herpes



genital herpes
Frequency and reactivation of nongenital lesions among patients with genital herpes simplex virus.

Benedetti JK, Zeh J, Selke S, Corey L.

Department of Biostatistics, University of Washington, Seattle 98144.

OBJECTIVE: To determine the frequency, recurrence patterns, and host factors associated with nongenital herpes simplex virus lesions. PATIENTS AND METHODS: In this cohort study at a referral clinic, 457 patients with first episodes of genital herpes were prospectively observed to evaluate the anatomic sites of herpetic lesions at the first and subsequent visits. Of these patients, 73 had primary genital herpes simplex virus (HSV) type 1, 326 had primary first episode genital HSV-2, and 58 had HSV-1 infection prior to acquisition of genital HSV-2. The median follow-up was 63 weeks. RESULTS: Nongenital lesions at the time of acquisition of genital herpes were observed in 25%, 9%, and 2% of patients with primary HSV-1, primary HSV-2, and nonprimary HSV-2, respectively. Half of the patients with concurrent genital and nongenital lesions subsequently had recurrences at a nongenital site. Twenty patients (6.5%) whose primary genital HSV-2 infection involved only the genitalia subsequently developed nongenital recurrences, primarily on the buttocks (12) and legs (4). Nongenital recurrences, especially buttock recurrences, tended to be less frequent but of longer duration than genital recurrences. CONCLUSIONS: Overall, 21% of patients with primary genital herpes will have or will subsequently develop a nongenital recurrence. Among patients with HSV-1, nongenital lesions tended to occur more often on the hand and face, whereas HSV-2 lesions appeared more often on the buttocks. Buttock lesions due to HSV recur less frequently but last longer than genital lesions.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7872339&dopt=Abstract genital herpes



genital herpes
Recurrence rates in genital herpes after symptomatic first-episode infection.

Benedetti J, Corey L, Ashley R.

University of Washington, Seattle.

OBJECTIVE: To evaluate the frequency of reactivation of genital herpes infection and to identify predictors for recurrence. DESIGN: Prospective, observational cohort study. SETTING: Research clinic. PATIENTS: 457 consecutive patients who did not have acute-phase serum antibodies to herpes simplex virus type 2 (HSV-2) but who did have herpes simplex virus (HSV) isolated from genital lesions. RESULTS: Eighty-nine percent of patients with HSV-2 had at least one recurrence during follow-up (median, 391 days); the median monthly recurrence rate was 0.34. Thirty-eight percent had at least 6 recurrences during the first year and 20% had more than 10 recurrences. The median monthly recurrence rate was 0.43 for men and 0.33 for women (difference, 0.10 [95% CI, 0.03 to 0.19]; P < 0.01). Twenty-six percent of women and 8% of men had no or 1 recurrence in year 1 of follow-up, whereas 14% of women and 26% of men had more than 10 recurrences. Patients who had severe primary HSV-2 infection (duration, > or = 35 days) had recurrences nearly twice as often (0.66 compared with 0.36 recurrences per month [95% CI, 0.18 to 0.57]) and had a shorter time to first recurrence when compared with those who had shorter first episodes. CONCLUSIONS: Almost all persons with initially symptomatic HSV-2 infection have symptomatic recurrences. More than 35% of such patients have frequent recurrences. Recurrence rates are especially high in persons with an extended first episode of infection, regardless of whether they receive antiviral chemotherapy with acyclovir. Men with genital HSV-2 infection have about 20% more recurrences than do women, a factor that may contribute to the higher rate of HSV-2 transmission from men to women than from women to men and to the continuing epidemic of genital herpes in the United States.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7978697&dopt=Abstract genital herpes



genital herpes
Psychoeducational groups for young adults with genital herpes: training group facilitators.

Madrid E, Swanson J.

Holy Names College, Oakland, CA, USA.

Genital herpes is one of the sexually transmitted diseases that can have serious long-term psychological and physical consequences for young adults who contract the disease. Because of the chronic, reoccurring nature of genital herpes, these young adults need education about the transmission of the herpes virus and about safer sexual practices in addition to emotional support. Psychoeducational groups have shown to be a nursing intervention that can effectively provide this education and support. Yet community health nurses may not be knowledgeable about or comfortable with using this type of intervention. In this article we explain the process of training community health nurses to be nurse facilitators who conduct psychoeducational groups for young adults with genital herpes. The training consisted of a 1-day workshop and three follow-up sessions. The content and format of this training workshop and the follow-up sessions is presented in addition to recommendations to enhance this nursing intervention.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8558177&dopt=Abstract genital herpes



genital herpes
High cumulative incidence of genital herpes amongst HIV-1 seropositive heterosexuals in south London.

O'Farrell N, Tovey SJ.

Lloyd Clinic, Guy's Hospital, London, UK.

The cumulative incidence of sexually transmitted diseases (STD) in a cohort of 51 (35 female, 16 male) HIV-1 seropositive STD clinic attenders who had acquired HIV-1 infection via heterosexual transmission was investigated through a retrospective review of the case notes. The women were followed up for a mean 11.6 months and the men for 18 months. Thirty-one (88%) of the women and 13 (81%) of the men were of sub-Saharan African origin. Approximately half of the subjects were first diagnosed as HIV-1 positive with CD4 counts < 200 x 10(6)/1 and a quarter with CD4 counts < 50 x 10(6)/1. STDs detected in women were: genital herpes 15 (43%), candida 12 (34%), bacterial vaginosis 9 (25%), and in men: genital herpes 6 (38%), non-gonococcal urethritis 4 (25%). No cases of gonorrhoea were detected. At the time of first diagnosis of genital herpes at the clinic, the mean CD4 count in women was 275 x 10(6)/1 and in men 285 x 10(6)/1. Genital herpes was the AIDS defining diagnosis in 3 of the women. The recognized risk of HIV transmission via genital lesions should be stressed in HIV-1 positive subjects with genital herpes. The incidence of other STD was low--both knowledge of HIV status and safer sex counselling may limit unsafe sexual behaviour and should be evaluated further as a strategy for limiting the spread of HIV-1 infection.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7849119&dopt=Abstract genital herpes