Recurrent genital herpes: clinical and virological features in men and women.

Mindel, Adrian; Coker, D M; Faherty, A.; Williams, P. C.

doi:10.1136/sti.64.2.103

Cited by 9 publications

(4 citation statements)

References 9 publications

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“…Our results are consistent with the previously established association between longer lesion duration in men 13 and HIV infected individuals. 2 In summary, we found that in the United States, recurrent genital HSV-1 is relatively rare in the general STD and HIV clinic setting, especially among black people.…”

Section: Discussionsupporting

confidence: 93%

Epidemiology of recurrent genital herpes simplex virus types 1 and 2

Solomon

2003

Sexually Transmitted Infections

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Objectives: To describe the epidemiology of type specific recurrent genital herpes, and to compare the duration of recurrent genital lesions caused by herpes simplex virus (HSV) types 1 and 2. Methods: Participants were enrolled at clinics across the United States. Adults suspected of having active genital herpes were eligible. Lesions were cultured for HSV and typed. Data from 940 participants with recurrent culture positive HSV lesions were analysed. Pearson's x 2 and Fisher's exact tests, multivariate logistic regression models, and a stratified Cox proportional hazards model were used to compare epidemiological characteristics and lesion duration of HSV-1 and HSV-2. Results: HSV-1 was present in 4.2% of the recurrent HSV culture positive lesions. HSV-1 was most prevalent among whites (6.5%) and individuals with 0-2 recurrences in the previous year (9.1%) and, among men, in those with rectal/ perirectal lesions (13.2%). Longer lesion duration was not significantly associated with virus type (hazard ratio (HR) 0.95, 95% confidence interval (CI) 0.65 to 1.38, p = 0.79), but was associated with male sex (HR 0.85, 95% CI 0.74 to 0.99, p = 0.04), and HIV seropositivity (HR 0.62, 95% CI 0.48 to 0.81, p,0.01). Conclusions:The authors found that, in the United States, recurrent genital HSV-1 is relatively rare in the STD and HIV clinic setting, especially among black people. Among men, rectal/perirectal recurrent lesions are more likely to be caused by HSV-1 than are penile lesions. In addition, lesion duration depends on sex and HIV status but not virus type. These findings shed new light on the type specific epidemiology of recurrent genital HSV, and suggest that type specific testing can inform the prognosis and management of genital herpes.G enital herpes, a disease marked by recurrent ulcerative lesions, is one of the most prevalent sexually transmitted diseases (STDs).1 2 Herpes simplex virus type 2 (HSV-2) is the most common cause, but recent reports suggest that an increasing share of genital herpes is caused by herpes simplex virus type 1 (HSV-1). 4Although primary disease is similar for both genital HSV-1 and HSV-2, 5 primary genital HSV-1 infection is less likely than HSV-2 infection to result in recurrent disease, 6 7 and the risk of asymptomatic viral shedding is less for patients with genital HSV-1. 8Little is known, however, about other epidemiological and clinical differences between recurrent genital HSV-1 and HSV-2.The objective of this study was to describe the epidemiology of type specific recurrent genital herpes in a large, geographically diverse sample, and to compare the duration of recurrent genital HSV-1 and HSV-2 lesions. METHODS Study designData were collected as part of a cross sectional surveillance study to assess the prevalence of aciclovir resistance in genital herpes.9 Participants were enrolled at 22 STD and HIV clinics in seven urban areas across the United States from October 1996 to April 1998. Eligible participants were 18 years and older and were suspected of having active geni...

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Section: Discussionsupporting

confidence: 93%

Epidemiology of recurrent genital herpes simplex virus types 1 and 2

Solomon

2003

Sexually Transmitted Infections

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“…Viral culture is most sensitive when early vesicular lesions are present. However, diagnostic yield declines as lesions ulcerate and by the time lesions have crusted, sensitivity has dropped to 27% 12,25 . These temporal requirements and high rates of false negatives limit the diagnostic utility of viral culture as a screening test for genital herpes infection.…”

Section: Pcr: the New Diagnostic Gold Standardmentioning

confidence: 99%

Review: Identifying potential pitfalls in conventional herpes simplex virus management

Nguyen¹,

Burkhart²,

Burkhart³

2010

Int J Dermatology

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In recent years, it has become increasingly clear that genital ulcers from herpes simplex virus (HSV) are associated with HIV acquisition. In light of this evolving synergy in transmission and the availability of effective antiviral therapy, proper diagnosis and management of HSV becomes increasingly important. Unfortunately, conventional HSV management is founded on several popular misconceptions. Herein, we hope to dispel these common misconceptions and expand the current model of herpetic reactivation. By doing so, we aimed to unveil potential pitfalls in current herpetic management.

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“…In humans, recurrences may be triggered by menstruation [179][180][181][182] and pregnancy has been reported to increase the frequency of recurrences in some women. 179 183 Studies in mice also suggest a hormonal influence of pregnancy on HSV infection with pregnant animals proving more susceptible than non-pregnant mice to infection.…”

Section: Genital Herpes Simplex Virus Infectionmentioning

confidence: 99%

Influence of ovarian hormones on urogenital infection

Sonnex

1998

Sexually Transmitted Infections

105

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Influence of ovarian hormones on urogenital infection C SonnexNumerous studies have examined the influence of hormones on infectious diseases and there is now a wealth of data relating to the more specific eVect of the sex hormones, oestrogen and progesterone, on urogenital infections. The interaction between these hormones and the immune system is complex and the variation of hormonal eVect between species further complicates the true picture as related to humans. Although it is diYcult therefore to draw general conclusions regarding predominant eVects of specific hormones, there is the suggestion that oestrogen enhances the pathogenicity of many urogenital micro-organisms. Our understanding of the influential role played by sex hormones in disease pathogenesis is at an early stage and illustrates well the importance of drawing together and interpreting as a whole both epidemiological and molecular studies. (Sex Transm Inf 1998;74:11-19)

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Recurrent genital herpes: clinical and virological features in men and women.

Cited by 9 publications

References 9 publications

Epidemiology of recurrent genital herpes simplex virus types 1 and 2

Epidemiology of recurrent genital herpes simplex virus types 1 and 2

Review: Identifying potential pitfalls in conventional herpes simplex virus management

Influence of ovarian hormones on urogenital infection

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