genital herpes
Antibody to herpes simplex virus type 2 as serological marker of sexual lifestyle in populations.

Cowan FM, Johnson AM, Ashley R, Corey L, Mindel A.

Academic Department of Genitourinary Medicine, University College, London Medical School.

OBJECTIVES--To examine the epidemiology of antibody to herpes simplex virus type 2 and to assess its suitability as a serological marker of sexual behaviour in populations with high and low prevalences. DESIGN--Cross sectional survey. SETTING--Department of genitourinary medicine and blood donation centre in central London. SUBJECTS--Representative sample of 869 patients attending department between November 1990 and December 1991, and 1494 consecutive blood donors attending for donation between February and April 1992. METHOD--Participants had a blood sample taken for antibody testing with a novel type specific assay and completed a questionnaire. RESULTS--Prevalence of antibody differed significantly between the two groups (188/833 (22.7%) clinic attenders; 102/1347 (7.6%) blood donors). In both populations antibody was strongly associated with sex, sexual orientation, years of sexual activity, number of lifetime sexual partners, and past infection with sexually transmitted diseases after other factors were controlled for. Only 130 (45%) of all those with antibody had symptoms suggestive of genital herpes, and 79 (27.4%) had had genital herpes diagnosed. Of those without antibody to herpes simplex viruses type 1 and 2, 8.0% reported genital blisters or sores and 1.1% had had genital herpes diagnosed by a doctor. CONCLUSIONS--The strong relation between herpes simplex virus type 2 and sexual lifestyle suggests that the presence of antibody to the virus may be suitable for use as an objective, serological marker of patterns of sexual behaviour in different populations. These data show that only a minority of those infected with herpes simplex virus type 2 have a diagnosis of genital herpes or express clinical symptoms, making serological determinants of infection essential for epidemiological studies.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7866079&dopt=Abstract genital herpes



genital herpes
Isolation of herpes simplex virus from sexually transmitted disease patients in Ibadan, Nigeria.

Oni AA, Adu FD, Ekweozor CC.

Department of Virology, College of Medicine, University College Hospital, Ibadan, Nigeria.

BACKGROUND AND OBJECTIVES: Despite the public health importance of herpes simplex virus infection in Nigeria, attempts have not been made to isolate and identify the virus. GOAL OF THE STUDY: To isolate, identify, and type the virus from patients attending a sexually transmitted disease (STD) clinic in Ibadan, Nigeria. STUDY DESIGN: One hundred fifty-three clinical samples from 116 patients were taken and inoculated into tissue culture for virus isolation. The isolates were identified and typed using chloroform sensitivity test, histocytological study, Complement Fixation Test (CFT), and indirect immunofluorescent antibody technique (IFAT). RESULT: Virus was isolated from seven of the 153 samples. Two of the seven were HSV-1, and five were HSV-2. CONCLUSION: This is the first documented isolation of the herpes simplex virus in Nigeria. The study has provided baseline data for future studies on genital herpes in Nigeria. These results may have interesting implications with respect of HIV transmission and other related sexually transmitted diseases in Nigeria.

PIP: In Nigeria, the sexually transmitted disease clinic staff at the hospital of the University of Ibadan collected 153 urethral, vaginal, and endocervical samples from 116 patients between November, 1991, and November, 1992, so researchers could isolate, identify, and type the herpes simplex virus (HSV). They used the complete fixation test and the indirect immunofluorescent antibody technique to confirm HSV. The patients also had genital herpes (31.6%), Neisseria gonorrhoeae urethritis (15.8%), nonspecific urethritis (15.8%), candidiasis (21%), genital warts (10.5%), and trichomoniasis (1%). No one had syphilis. The laboratory staff isolated HSV from only 7 samples (4.6% of all samples). All 7 isolates were from males (genital ulcer and urethral samples). Five of the isolates were HSV-2 and 2 were HSV-1. This study was the first documented isolation of HSV in Nigeria. These findings provide baseline data on genital herpes for projected studies. Further research should examine the significance of these findings for other areas, particularly HIV transmission and immunocompromised patients.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7974067&dopt=Abstract genital herpes



genital herpes
Male circumcision and common sexually transmissible diseases in a developed nation setting.

Donovan B, Bassett I, Bodsworth NJ.

Sydney Sexual Health Centre, Sydney Hospital, NSW, Australia.

OBJECTIVE--To determine whether the circumcision status of men affected their likelihood of acquiring sexually transmissible diseases (STDs). DESIGN--A cross-sectional study employing an anonymous questionnaire, clinical examination and type specific serology for herpes simplex virus type 2 (HSV-2). SETTING--A public STD clinic in Sydney, Australia. SUBJECTS--300 consecutive heterosexual male patients. MAIN OUTCOME MEASURES--Associations between circumcision status and past or present diagnoses of STDs including HSV-2 serology and clinical pattern of genital herpes. RESULTS--185 (62%) of the men were circumcised and they reported similar ages, education levels and lifetime partner numbers as men who were uncircumcised. There were no significant associations between the presence or absence of the male prepuce and the number diagnosed with genital herpes, genital warts and non-gonococcal urethritis. Men who were uncircumcised were no more likely to be seropositive for HSV-2 and reported symptomatic genital herpes outbreaks of the same frequency and severity as men who were circumcised. Gonorrhoea, syphilis and acute hepatitis B were reported too infrequently to reliably exclude any association with circumcision status. Human immunodeficiency virus infection (rare among heterosexual men in the clinic) was an exclusion criterion. CONCLUSIONS--From the findings of this study, circumcision of men has no significant effect on the incidence of common STDs in this developed nation setting. However, these findings may not necessarily extend to other setting where hygiene is poorer and the spectrum of common STDs is different.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8001942&dopt=Abstract genital herpes



genital herpes
Follow-up of pregnant women at high risk of transmitting herpes simplex virus.

Schultz R, Suarez M, Saavedra T.

Universidad de Chile, Departamento de Microbiologia y Parasitologia, Correo Central, Santiago.

Prospects for neonatal herpes transmission were studied in a group of pregnant Chilean women at high herpetic risk--including 59 with a history of genital herpes, 11 with a first genital herpes episode during the observed pregnancy, and 16 whose sexual partners had a history of genital herpes. Each woman completed a survey questionnaire, provided serologic samples for detection of herpes simplex virus (HSV), and provided periodic samples taken with cotton swabs for HSV isolation. The 86 women who completed the study had an average age of 28 years; most (58.8%) were primiparas. Only 21 of the 86 subjects yielded HSV isolates (predominantly HSV-2) from weekly cotton swab samples taken from the 34th week of pregnancy onward. HSV-2 predominance was found both in the symptomatic cases and in the three asymptomatic ones. Of six subjects found to be shedding HSV at the time of delivery, only one exhibited asymptomatic shedding. These findings are consistent with the following conclusions derived from studies in developed countries: (1) Isolation of HSV in pregnancy does not define a greater risk of shedding HSV during childbirth. (2) In nearly all (five of six) cases, HSV shedding during childbirth involved symptomatic episodes of herpes that clearly defined the steps to be taken by the physician. (3) Despite this, the finding of one asymptomatic case demonstrates that the physician should request a test for HSV isolation at the time of delivery by a woman at high herpetic risk.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8069336&dopt=Abstract genital herpes



genital herpes
Passive immunization of the vagina protects mice against vaginal transmission of genital herpes infections.

Whaley KJ, Zeitlin L, Barratt RA, Hoen TE, Cone RA.

Department of Biophysics, Johns Hopkins University, Baltimore, Maryland 21218.

Vaginal application of human herpes simplex virus (HSV) antiserum, complement-inactivated antiserum, or IgG purified from antiserum protected mice (P < .001, P < .001, and P < .01, respectively) from visible signs of genital HSV-2 infection after subsequent vaginal inoculation with HSV-2 (10 ID50). Vaginal application of an anti-HSV-2 monoclonal antibody (MAb III-174) also protected mice against infection. This MAb, a neutralizing mouse IgG2A against glycoprotein D, prevented infection as determined by viral shedding from the vagina (P < .05), blocked 50% of visible signs of genital herpes infection at a vaginal dose of approximately 10 ng, and blocked 100% of visible signs of infection at a vaginal dose of 1 microgram (P < .001). These results suggest that vaginal applications of anti-HSV antibodies may help prevent sexual transmission of genital herpes infection.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8158042&dopt=Abstract genital herpes



genital herpes
Quantity of latency-associated transcript produced by herpes simplex virus is not predictive of the frequency of experimental recurrent genital herpes.

Bourne N, Stanberry LR, Connelly BL, Kurawadwala J, Straus SE, Krause PR.

Division of Infectious Diseases, Children's Hospital Research Foundation, Cincinnati, OH 45229-3039.

The role of the latency-associated transcript (LAT) in control of recurrent herpes simplex virus type 2 (HSV-2) infection was investigated by examining whether LAT concentration in vitro during productive infection or in ganglia during latency correlated with frequency of recurrent genital herpes. Clinical HSV-2 isolates from frequent or infrequent recurrent genital disease produced comparable amounts of glycoprotein D and infected cell polypeptide 0 RNA, but the isolate from frequent disease produced about seven times more LAT. The guinea pig model of genital herpes was used to determine whether the quantity of LAT produced during acute infection in vitro correlated with recurrence phenotype; the frequency of recurrent disease was similar for the 2 clinical isolates. Likewise, there was no correlation between the recurrence phenotype of individual animals and LAT concentration in their ganglia. Thus, while absence of LAT may impair HSV reactivation and recurrence, once a threshold concentration is exceeded, LAT has no further effect on recurrence frequency.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8169396&dopt=Abstract genital herpes



genital herpes
Herpes simplex virus type 2 infection of heterosexual men attending a sexual health centre.

Bassett I, Donovan B, Bodsworth NJ, Field PR, Ho DW, Jeansson S, Cunningham AL.

Sydney Sexual Health Centre, Sydney Hospital, NSW.

OBJECTIVE: To identify risk factors, particularly circumcision status, associated with serological evidence of herpes simplex virus type 2 (HSV-2) infection of heterosexual men. DESIGN: A cross-sectional case-control study employing an anonymous delinked interviewer-administered questionnaire, clinical examination, and a type-specific serological test for HSV-2. PARTICIPANTS AND SETTING: Three hundred consecutive heterosexual male patients at a public sexually transmissible diseases (STD) clinic in Sydney, Australia. MAIN OUTCOME MEASURES: Associations between serological evidence of HSV-2 infection and history of genital herpes or contact with genital herpes, history of other common STDs, and demographic and behavioural factors such as age, education level, number of sexual partners and lack of circumcision. RESULTS: One hundred and ninety-four patients (64.7%) had antibodies to HSV-2 but only 24% of these gave a history of genital herpes. A history of genital herpes or sexual contact with genital herpes, reported total lifetime number of sexual partners, failure to complete high school and a history of non-gonococcal urethritis or genital warts were associated with serological evidence of HSV-2 infection at the univariate level. Neither increasing age nor lack of circumcision was associated with HSV-2 infection. Following multivariate analysis only the lifetime number of partners and failure to finish high school were significantly strong predictors of HSV-2 infection. CONCLUSION: This is the highest prevalence of HSV-2 infection ever detected in an Australian population and one of the highest recorded globally. As younger men were as commonly infected as older men, and an earlier (1985) study involving the same clinic yielded a lower prevalence, it appears that a high level of ongoing HSV-2 transmission is occurring among Sydney heterosexuals. Increased awareness of this fact could enhance safer sex campaigns.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8202004&dopt=Abstract genital herpes