genital herpes
Gender-specific predictors of genital herpes vaccine acceptance in a college population.

Auslander BA, Rosenthal SL, Succop PA, Mills LM, Stanberry LR, Bernstein DI.

Department of Pediatrics, University of Texas Medical Branch at Galveston, 301 Universtiy Boulevard, Galveston, TX 77555-0319, USA. baauslan utmb.edu

Vaccines represent one promising method for reducing the sexually transmitted disease (STD) epidemic. This study evaluated whether influences on the decision to accept a genital herpes vaccine differed by gender. In all, 518 college students completed a questionnaire on sexual history, health beliefs, and acceptance of a potential genital herpes vaccine. Each predictor variable plus a gender interaction term were analysed in separate logistic regression models. Follow-up analyses were performed by gender for outcomes that displayed significant interactions. Results indicated that a prior history of an STD and increased perception of risk for acquiring genital herpes were significant predictors of vaccine acceptance for men, while younger age and concerns about vaccine safety were significant predictors for women. Endorsement of a vaccine strategy targeting sexually experienced people was an influential factor for both genders, but was a much stronger one for women. Results suggest that gender-specific strategies may be crucial to genital herpes vaccine acceptance.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15705269&dopt=Abstract genital herpes



genital herpes
Topical microbicides for the prevention of genital herpes infection.

Keller MJ, Tuyama A, Carlucci MJ, Herold BC.

Departments of Medicine and Pediatrics, Division of Infectious Diseases, Mount Sinai School of Medicine, New York, NY, USA.

Genital herpes is one of the most prevalent sexually transmitted infections worldwide and is the most common cause of genital ulcers. Despite increased public awareness and the initiation of efforts to prevent transmission, the prevalence of herpes simplex virus (HSV) type 2 continues to increase. What makes HSV so difficult to control is that most sexual and perinatal transmission occurs during unrecognized or asymptomatic shedding. The impact of genital herpes as a public health threat is amplified because of its epidemiological synergy with HIV/AIDS. Thus, there is an urgent need for novel prophylactic methods, such as topical microbicides designed for genital application, to prevent both HSV and HIV transmission. Several candidate microbicides are being advanced to clinical trials based on in vitro activity and animal studies. These include compounds that inactivate virus directly, those that enhance innate immunity, and drugs that block viral binding and entry. A more vigorous evaluation of the safety of these and other candidate topical microbicides in development should include assessment of the impact of repeated application on innate host defences in the genital tract.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15743896&dopt=Abstract genital herpes



genital herpes
Comparison between virus isolation method, Papanicolaou stain, immunoperoxidase stain and polymerase chain reaction in the diagnosis of genital herpes.

Puthavathana P, Horthongkham N, Roongpisuthipong A, Maythangkul P, Kanyok R, Boonsirikhamchai P, Chaiyakul P.

Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Papanicolaou (Pap) stain, immunoperoxidase (IP) stain and polymerase chain reaction (PCR) were evaluated against the virus isolation method for their sensitivity and specificity in the diagnosis of herpes simplex virus (HSV) infection in 96 women who were suspected of genital herpes. The result showed that the sensitivity of PCR, IP and Pap stain was 100, 92.0 and 62.7%, respectively, while the specificity was 76.2, 66.7 and 81.0%, respectively. PCR was even more sensitive than the virus isolation technique. As Pap stain is the technique routinely performed for diagnosing genital herpes in most of the hospitals in Thailand, its low sensitivity should be taken into consideration. Based on the investigation by all four techniques together, HSV infection was diagnosed in 91.6% of the cases suspected of genital herpes which reflected higher precision of the clinical diagnosis over Pap stain.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10219899&dopt=Abstract genital herpes



genital herpes
Clinical course of patients with serologic evidence of recurrent genital herpes presenting with signs and symptoms of first episode disease.

Diamond C, Selke S, Ashley R, Benedetti J, Corey L.

Department of Medicine, University of Washington, Seattle, USA.

BACKGROUND AND OBJECTIVES: The care of patients with first episode and recurrent genital herpes differs with respect to therapy and source partner evaluation. Of 498 persons who presented with what appeared by history and symptoms to be a first episode of genital herpes, we identified 41 who had serologic evidence of remotely acquired herpes simplex virus 2 (HSV-2) infection. GOALS: To define the natural history of these individuals with previously unrecognized HSV-2 and to evaluate if any clinical or historical features could differentiate these people from persons with true first episode infection. STUDY DESIGN: Observational cohort study. RESULTS: Clinical overlap existed in the frequency of local symptoms, fever, and size of genital lesions between those with remotely acquired versus recently acquired genital herpes. The frequency of new sexual partners and recent sexual history were also similar in the two groups. However, on follow-up, the lesions of persons with remotely acquired HSV-2 healed more rapidly and subsequently recurred less frequently than those of true primary HSV-2. CONCLUSIONS: Even in a referral clinic with experienced clinicians, almost 10% of persons who are judged to have first episode genital herpes have evidence of remotely acquired HSV-2, suggesting that clinical differentiation of first episode genital herpes from previously acquired infection is difficult. Type-specific serologic testing assists the clinician in correctly classifying the infection and determining the potential source partner.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10225590&dopt=Abstract genital herpes



genital herpes
Prevalence of herpes simplex type 2 antibodies and a clinical history of herpes in three different populations in Campinas City, Brazil.

Carvalho M, de Carvalho S, Pannuti CS, Sumita LM, de Souza VA.

Laboratory of Virology (LIM52-HCFMUSP), Instituto de Medicina Tropical de Sao Paulo, Department of Infectious Diseases, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.

OBJECTIVES: To determine the seroprevalence of herpes simplex virus type 2 (HSV-2) antibodies and the relation between the history of clinical herpes and the presence of type-specific HSV-2 antibodies in three different populations from the city of Campinas City, Brazil. POPULATION AND METHODS: One hundred and one college students, 96 patients with sexually transmitted diseases (STD), and 102 women at delivery were interviewed and blood samples were collected. Total HSV (HSV-1 and HSV-2) antibodies were screened by enzyme-linked immunosorbent assay (ELISA) and type-specific HSV-2 antibodies were detected by Western blot assay. RESULTS: Herpes simplex virus antibodies were detected in 66.3% of the students, 97.1% of the women at delivery, and 99.0% of the STD patients. Type-specific HSV-2 antibodies were detected in 6.9% of the students, 22.6% of the women at delivery, and in 53.1% of the STD patients. History of genital herpes was reported by none of the students, by one of the women at delivery, and by 11 of 51 (21.6%) STD patients who were HSV-2 seropositive. Four of the 45 (8.9%) seronegative STD patients reported a history of genital herpes. CONCLUSION: The prevalence of HSV-2 infection in Campinas City can be significantly affected by the characteristics of the population studied, as was shown in previous studies. The sensitivity of the history of genital herpes was low in the present series, stressing that prophylactic measures for vertical and horizontal transmission of HSV-2 should not be based only on a positive history of genital ulcers.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10225987&dopt=Abstract genital herpes



genital herpes
Historical findings in subjects from a high socioeconomic group who have genital infections with herpes simplex virus.

Knox SR, Corey L, Blough HA, Lerner AM.

HELP Scientific and Medical Advisory Board, American Social Health Association, Palo Alto, California, USA.

A highly motivated, self-selected group of 1,535 men and 1,607 women of middle-to-high socioeconomic class who had recurring genital herpes were surveyed in an assessment of the historical characteristics of these subjects and their disease. All subjects lived in the continental United States and were members of the national herpes organization, HELP, sponsored by the American Social Health Association. Subjects were predominantly well-educated white persons (mean educational level, 15.2 years) earning > $20,000 per year. The mean ages of acquisition of genital herpes were 26.9 years for women and 30.8 years for men. The mean durations of infection were 3.9 years for women and 5.1 years for men. Women usually acquired genital herpes between the ages of 20 and 29 years, whereas substantial numbers of men experienced their initial episodes of infection when they were in their thirties. The population studied was predominantly heterosexual. Many of the subjects, especially the men, had experienced other sexually transmitted diseases such as gonococcal or nongonococcal urethritis. Over two-thirds of the subjects experienced more than five relapses every year, and the percentage of subjects with more than five recurrences yearly did not decrease with time.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10328018&dopt=Abstract genital herpes



genital herpes
Clinical reactivation of genital herpes simplex virus infection decreases in frequency over time.

Benedetti JK, Zeh J, Corey L.

University of Washington, Department of Biostatistics, Seattle 98195, USA.

BACKGROUND: Visits to physicians for genital herpes simplex virus (HSV) infection continue to increase. Most patients with symptomatic infections have recurrences, but no studies of the long-term clinical course of genital herpes are available. OBJECTIVE: To determine whether the frequency of HSV recurrences decreases over time. DESIGN: Observational cohort study. SETTING: University-based research clinic. PATIENTS: 664 persons with genital herpes followed for at least 14 months. MEASUREMENTS: Patients were classified as having initial or recurrent HSV-1 or HSV-2 infection. Patient-reported recurrences and observed recurrences were recorded in a database; more than 12,000 recurrences were analyzed. RESULTS: Median recurrence rates in the first year of follow-up were one and five per year in patients with newly acquired HSV-1 and HSV-2 infection, respectively; second-year rates were significantly lower in both groups. Patients presenting with recurrent HSV-2 infection had higher rates of recurrence in the first and second years and no significant decrease; significant decreases were detected with longer follow-up. One third of all patients experienced a decrease of two or more recurrences per year between years 1 and 2. Patients infected with HSV-2 who were followed for more than 4 years had a median decrease of two recurrences between years 1 and 5. However, 25% of these patients had an increase of at least one recurrence in year 5, illustrating the variability among HSV-infected persons. Decreases over time among patients who never received suppressive therapy were similar to decreases during untreated periods in patients who received suppressive therapy. CONCLUSIONS: Herpes simplex virus type 2 infection continues to be a chronic remitting illness. Over time, however, clinically significant reductions occur in a majority of patients. Physicians may wish to periodically assess the need for continued treatment with daily suppressive antiviral chemotherapy.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10391810&dopt=Abstract genital herpes