genital herpes
Are reported stress and coping style associated with frequent recurrence of genital herpes?

Cassidy L, Meadows J, Catalan J, Barton S.

HIV/GUM Directorate, Chelsea.

OBJECTIVES: This paper reports on the cross sectional data from the longitudinal study examining the impact of genital herpes simplex virus (HSV) infection on quality of life. In particular the report sought to study the relation between recurrence of genital HSV and coping style, mood, personality, and quality of life, among other factors. SETTING AND SUBJECTS: 116 patients with a known history of genital herpes simplex infection attending the Department of Genitourinary Medicine at Chelsea and Westminster Hospital. METHODS: Psychosocial factors (stress, anxiety, depression, health locus of control, personality, social support, coping skills, and quality of life) and the reported frequency of genital herpes episodes were measured using self administered questionnaires designed to examine the relation between psychosocial status and the frequency of genital HSV episodes. RESULTS: The number of recurrences reported by patients was significantly related to the style of coping skills used. Higher recurrences were less likely to use problem focused coping skills of planning and active coping, and the emotion focused coping skills of positive reinterpretation and growth. There was a significant difference in the number of patients who believed that psychological stress was related to the number of recurrences they experienced. This belief was related to neuroticism on the Eysenck Personality Questionnaire scale, and not to any of the other measures investigated. CONCLUSION: The findings suggest that it is the way individuals cope, and their personality characteristics rather than actual levels of psychological stress, that influence their belief in a link between recurrent genital HSV and stress. HSV may become the focus of existing concerns and be viewed as the physical manifestation of stress.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9389946&dopt=Abstract genital herpes



genital herpes
Prevalence of herpes simplex virus type 1- and 2- specific antibodies among the acute, recurrent, and provoked types of female genital herpes.

Hashido M, Lee FK, Nahmias AJ, Kawana T.

Infectious Diseases Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan. mdkhsd nih.go.jp

Sixty-eight sera from the acute, recurrent, and provoked types of female genital herpes were compared for the seroprevalence of herpes simplex virus (HSV) types 1 and 2 by immunodot assay using HSV glycoprotein G. In the HSV-1-isolated patients, no HSV-2 antibodies were detected, whereas in the HSV-2-isolated patients, HSV-1 seroprevalence was 9% for the acute type, 89% for the provoked type (P < 0.005), and 55% for the recurrent type (P < 0.05). The natural history of female genital herpes and the possible protective role of pre-existing antibodies in preventing the acquisition or clinical manifestation of a subsequent HSV infection are discussed.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9403510&dopt=Abstract genital herpes



genital herpes
Antenatal serum screening for genital herpes: a study of knowledge and attitudes of women at a central London hospital.

Vonau B, Low-Beer N, Barton SE, Smith JR.

Department of Genitourinary Medicine, Chelsea and Westminster Hospital, London.

OBJECTIVE: To evaluate the knowledge and attitudes of women regarding genital herpes and specifically serum screening for prevention of vertical transmission. SETTING: Antenatal clinic at the Chelsea and Westminster Hospital, London. POPULATION: Randomly selected women at their first antenatal visit. METHODS: A questionnaire focussing on the women's knowledge of, and their attitudes about, genital herpes was completed. The results were analysed using the Statistical Package for Social Sciences (SPSS). RESULTS: One hundred women were surveyed over six weeks. The majority (80%) were aware that genital herpes was a sexually transmitted disease and 60% were aware that it can be transmitted to the baby in pregnancy. Only 34% thought that genital herpes is always symptomatic and 56% believed that they would know for certain if they had herpes. Sixty percent thought they would know whether their partners had ever been infected. Eighty percent of our sample population were prepared to be screened, and 76% would also encourage their sexual partner to have a blood test. CONCLUSION: This study shows that the study population had a good knowledge about genital herpes and that there would be acceptance of antenatal testing. Whether serum screening is cost-effective must still be evaluated. The impact of such a screening on a couple's relationship is potentially deleterious and needs to be assessed carefully before a screening programme for genital herpes is actually introduced. The next phase of our study will address this issue.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9091014&dopt=Abstract genital herpes



genital herpes
Genital herpes in a primary care clinic. Demographic and sexual correlates of herpes simplex type 2 infections.

Wald A, Koutsky L, Ashley RL, Corey L.

Department of Medicine, School of Medicine, University of Washington, Seattle 98144, USA.

BACKGROUND AND OBJECTIVES: Genital herpes remains one of the most prevalent sexually transmitted diseases (STDs). The sexual behavioral correlates of herpes simplex virus type 2 (HSV-2) infection in the general population have not been well characterized. GOALS: To assess demographic and sexual behavioral correlates of symptomatic and subclinical HSV-2 infection. STUDY DESIGN: Cross-sectional survey of 922 randomly chosen patients and 78 of their partners (1,000 total) in a family practice. Sexual behavior information was collected in 492 people. RESULTS: Two hundred twenty-five (23%) heterosexual people had HSV-2 infection, but only 59 (26%) reported a history of genital herpes. HSV-2 seroprevalence was 63% in African-American women, 27% in white women, 40% in African-American men, and 12% in white men. In multivariate analyses of risk factors for HSV-2 infection among men, 10 or more sexual partners and a prior STD were statistically significantly associated with HSV-2 infection. Among white women, number of sexual partners, a prior STD, marriage or cohabitation, and less than a college education were predictive of HSV-2 infection. A history of oral sex was the only statistically significant predictor of HSV-2 infection in African-American women. CONCLUSIONS: Risk factors for HSV-2 infection differ by gender and ethnic group. Traditionally recognized behavioral correlates of STD acquisition may not identify people in communities with high prevalence of HSV-2 infection.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9132981&dopt=Abstract genital herpes



genital herpes
Genital herpes during pregnancy: inability to distinguish primary and recurrent infections clinically.

Hensleigh PA, Andrews WW, Brown Z, Greenspoon J, Yasukawa L, Prober CG.

Department of Obstetrics and Gynecology, Santa Clara Valley Medical Center, San Jose, California, USA.

OBJECTIVE: To determine if the signs and symptoms of genital herpes in pregnancy accurately identify primary genital herpes infections using serologic testing for final classification. METHODS: Twenty-three women with clinical signs and symptoms suggestive of primary genital herpes infections in the second and third trimesters of pregnancy were subsequently cultured and tested serologically (for herpes simplex virus type 1 and herpes simplex virus type 2 antibodies) and classified as having true primary (no herpes simplex virus type 1 or type 2 antibodies), nonprimary (heterologous herpes simplex virus antibodies present), or recurrent (homologous antibodies present) infections. RESULTS: Only one of 23 women with clinical illnesses consistent with primary genital herpes virus simplex infections had serologically-verified primary infection. This primary infection was caused by herpes simplex virus type 1. Three women had nonprimary type 2 infections, and 19 women had recurrent infections. Among culture-proven recurrent infections, 12 were caused by herpes simplex virus type 2 and three by herpes simplex virus type 1. Only one infant was born preterm, and no clinically significant perinatal morbidity was observed. CONCLUSION: Correct classification of gestational genital herpes infections can be accomplished only when clinical evaluation is correlated with viral isolation and serologic testing using a type-specific assay. Severe first episodes of genital herpes infections among women in the second and third trimesters of pregnancy are not usually primary infections and are not commonly associated with perinatal morbidity.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9170460&dopt=Abstract genital herpes



genital herpes
Differentiation of primary from nonprimary genital herpes infections by a herpes simplex virus-specific immunoglobulin G avidity assay.

Hashido M, Inouye S, Kawana T.

Department of Epidemiology, National Institute of Health, Shinjuku-ku, Tokyo, Japan.

An immunoglobulin G (IgG) antibody avidity assay which uses protein-denaturing agents and a modification of an enzyme-linked immunosorbent assay have been investigated for their usefulness in distinguishing primary genital herpes simplex virus (HSV) infections from nonprimary infections. Forty-nine serum specimens from patients with primary, recurrent, and nonprimary first-episode genital herpes were studied. The clearest separation was obtained with 6 M urea treatment, giving mean avidity indices of 0.398 for sera < or = 100 days after the infection and 0.879 for sera > 100 days after the infection (P < 0.001). No significant difference in avidity indices was observed between the recurrent and nonprimary first-episode infections. Determination of the avidity of HSV-specific IgG will improve the diagnostic potential of HSV serology.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9196189&dopt=Abstract genital herpes



genital herpes
Herpes simplex virus type 2 in Brazil: seroepidemiologic survey.

Da Rosa-Santos OL, Goncalves Da Silva A, Pereira AC Jr.

Department of Medical Clinics (Dermatology), Clementino Fraga Filho University Hospital, Rio de Janeiro, Brazil.

BACKGROUND: The incidence of genital herpes is increasing worldwide. Herpes simplex virus type 2 (HSV-2) is the most common cause of genital ulcerations among the sexually transmitted diseases (STDS). In order to investigate the sexual transmission of genital herpes infection in Brazil, the prevalence of specific antibodies to HSV-2, in populations of high and low risk for STDS was evaluated. METHODS: The population at low risk for STDS was composed of 155 voluntary blood donors at the University Hospitals between February and August, 1994. The population at high risk for STDS was composed of 85 HIV-seropositive persons, consisting of homosexual and promiscuous heterosexual men. A group of 20 highly active prostitutes was also studied between May and July, 1994. All blood samples were screened using an enzyme-linked immunosorbent assay (ELISA) that detects type-specific antibodies to HSV-2 glycoprotein G. Before donating blood, all persons in the study group were given a questionnaire concerning risk factors for acquisition of STDS and suitable to show the socioepidemiologic characteristics of the subjects. RESULTS: The prevalence of ELISA showing HSV-2 infections among HIV-seroposite persons, was 73% (P < 0.01). In the whole group at high risk for STDS, the prevalence was 72% (P < 0.05). Infection with HSV-2, as determined by seroprevalence, was significantly and independently associated with years of sexual activity, history of previous STDS, number of sexual partners in the previous month, number of pregnancies, and previous induced abortions, as well as the percentage of sexual acts involving receptive anal intercourse. CONCLUSIONS: The current strategy for diagnosing genital HSV-2 infection misses many cases. Newly developed type-specific serologic methods can identify cases of unrecognized or subclinical infection. With the high seroprevalence rates detected, routine screening for HSV-2-specific antibodies should be considered in populations at high risk for STDS.

PIP: The incidence of genital herpes is increasing worldwide and herpes simplex virus type 2 (HSV-2) is the most common cause of genital ulcerations among sexually transmitted diseases (STDs). Findings are reported from an assessment of the prevalence of antibodies to HSV-2 in low- and high-risk populations in Brazil. 155 voluntary blood donors and 85 HIV-seropositive homosexual and promiscuous heterosexual men were screened with ELISA for infection with HSV-2 during February-August 1994. 20 highly active prostitutes were also studied during May-July 1994. The subjects were of mean age 30 years, 70% were sexually active at the time of the study, and 6.55% used condoms. Antibodies to HSV-2 were detected in 29.1% of the blood donors, 73% of the HIV-seropositive men, and 72% of the overall high-risk group. Only 10%, however, admitted to ever having episodes of genital herpes. HSV-2 infection was significantly and independently associated with years of sexual activity, history of previous STDs, number of sex partners in the previous month, number of pregnancies, number of induced abortions, and the percentage of sex acts involving receptive anal intercourse. Routine screening for HSV-2 infection should be considered in populations at high risk for STDs.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8915732&dopt=Abstract genital herpes