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PubMed1999

Detection of human papillomavirus DNA on the fingers of patients with genital warts.

OBJECTIVE: To determine whether patients with genital warts carry human papillomavirus (HPV) DNA on their fingers. METHODS: 14 men and eight women with genital warts had cytobrush samples taken from genital lesions, finger tips, and tips of finger nails. Samples were examined for the presence of HPV DNA by the polymerase chain reaction. RESULTS: HPV DNA was detected in all female genital samples and in 13/14 male genital samples. HPV DNA was detected in the finger brush samples of three women and nine men. The same HPV type was identified in genital and hand samples in one woman and five men. CONCLUSION: This study has identified hand carriage of genital HPV types in patients with genital warts. Although sexual intercourse is considered the usual mode of transmitting genital HPV infection, our findings raise the possibility of transmission by finger-genital contact.

Condylomata Acuminata↗
PubMed2001

Sex determination genes control the development of the Drosophila genital disc, modulating the response to Hedgehog, Wingless and Decapentaplegic signals.

In both sexes, the Drosophila genital disc contains the female and male genital primordia. The sex determination gene doublesex controls which of these primordia will develop and which will be repressed. In females, the presence of Doublesex(F) product results in the development of the female genital primordium and repression of the male primordium. In males, the presence of Doublesex(M) product results in the development and repression of the male and female genital primordia, respectively. This report shows that Doublesex(F) prevents the induction of decapentaplegic by Hedgehog in the repressed male primordium of female genital discs, whereas Doublesex(M) blocks the Wingless pathway in the repressed female primordium of male genital discs. It is also shown that Doublesex(F) is continuously required during female larval development to prevent activation of decapentaplegic in the repressed male primordium, and during pupation for female genital cytodifferentiation. In males, however, it seems that Doublesex(M) is not continuously required during larval development for blocking the Wingless signaling pathway in the female genital primordium. Furthermore, Doublesex(M) does not appear to be needed during pupation for male genital cytodifferentiation. Using dachshund as a gene target for Decapentaplegic and Wingless signals, it was also found that Doublesex(M) and Doublesex(F) both positively and negatively control the response to these signals in male and female genitalia, respectively. A model is presented for the dimorphic sexual development of the genital primordium in which both Doublesex(M) and Doublesex(F) products play positive and negative roles.

Animals↗
PubMed2003

Sexual psychophysiology and effects of sildenafil citrate in oestrogenised women with acquired genital arousal disorder and impaired orgasm: a randomised controlled trial.

OBJECTIVE: Some postmenopausal women lose genital sexual responsivity despite preserved subjective sexual arousal from non-genital stimuli. When oestrogen replacement is without benefit, both the underlying pathophysiology and management of this acquired genital female sexual arousal disorder are unclear. We aimed to study the effect of sildenafil on sexual arousal and orgasmic functioning of such women. Secondly, we aimed to explore the concordance between a detailed historical assessment of genital response in real life, with laboratory vaginal photoplethysmographic assessment of genital vasocongestion. DESIGN: Session one consisted of a semi-structured clinical interview to assess real life sexual arousal. Session two employed vaginal pulse amplitude and self-report questionnaire assessment of erotica-induced sexual arousal. Sessions three and four were a randomised, double-blind, placebo-controlled crossover administration of sildenafil on orgasm latency, intensity, perception of genital congestion and subjective arousal to erotica plus clitoral vibrostimulation. SETTING: University associated Sexual Medicine Clinic and Psychophysiology Laboratory. SAMPLE: Volunteer sample of 34 oestrogenised postmenopausal women with acquired genital female sexual arousal disorder and impaired orgasm. METHODS: Sildenafil (50 mg) or placebo administered over two laboratory sessions. MAIN OUTCOME MEASURES: Orgasm latency and intensity during drug sessions; subjective and psychophysiological sexual arousal during photoplethysmography session. RESULTS: The erotic video significantly increased subjective sexual arousal in all women. Vaginal pulse amplitude responses varied from robust to absent. Although across all women, sildenafil improved neither arousal nor orgasm, subsequent analyses comparing high versus low vaginal pulse amplitude responders revealed significantly reduced latency to orgasm, and increased subjective sexual arousal and perception of genital arousal in the latter group of women. CONCLUSION: The data suggest that oestrogenised postmenopausal women with genital female sexual arousal disorder and orgasmic impairment based only on clinical assessment do not benefit from sildenafil. However, the photoplethysmograph had predictive value-those women showing low vaginal pulse amplitude response benefited from sildenafil compared with women with a higher response. Thus, oestrogenised women diagnosed with acquired genital female sexual arousal disorder may be a heterogeneous group and the photoplethysmograph might be useful in their further characterisation.

Adult↗
PubMed1995

HIV, sexually transmitted diseases and gynaecologic disorders in women: increased risk for genital herpes and warts among HIV-infected prostitutes in Amsterdam.

OBJECTIVES: To determine the incidence of sexually transmitted diseases (STD; gonorrhoea, early syphilis, Chlamydia trachomatis infection, trichomoniasis and primary genital herpes) and gynaecologic disorders (vaginal candidiasis, anaerobic vaginosis, genital ulcerations of unknown cause, pelvic inflammatory disease, recurrent genital herpes, recurrent genital warts) in a cohort of HIV-infected and non-infected drug-using prostitutes in Amsterdam between 1986 and 1992. DESIGN: A subgroup of 212 female drug users with a history of prostitution, who made at least one visit to a special STD clinic for drug-using prostitutes was selected from an ongoing cohort study of drug users in Amsterdam. METHODS: Using Poisson regression, the relative risk (RR) for each outcome was calculated for HIV-positive women compared with HIV-negative women. To determine potential causal relations with immune suppression, associations between disease incidence and immunologic markers (CD4 cell count and anti-CD3 response) were assessed in HIV-positive women. RESULTS: Adjusted for number of clients and frequency of condom use, HIV-positive women were at strong and significantly increased risk for primary genital herpes (RR, 7.64), recurrent herpes (RR, 8.33) and recurrent genital warts (RR, 15.93); moderately (significantly) increased risks were found for gonorrhoea (RR, 1.43), trichomoniasis (RR, 1.39), vaginal candidiasis (RR, 2.11) and genital ulcers of unknown aetiology (RR, 2.60). Of these HIV-related outcomes, the risk for recurrent genital herpes and genital warts were strongly associated with decreased CD4 cell counts. CONCLUSIONS: HIV-infected women experience an excess morbidity of STD and gynaecologic disorders. The strongly increased risk for genital herpes and warts in HIV-seropositive women indicates a causal relation with HIV. This study emphasizes the need for accessible medical care for drug-using prostitutes.

Adult↗
PubMed1998

High-grade dysplasia in genital warts from two patients infected with the human immunodeficiency virus.

Cancer-associated human papillomavirus (HPV) types are detected in genital warts removed from immunosuppressed individuals more commonly than from those occurring in otherwise healthy individuals. The prognosis of genital warts containing cancer-associated HPV types is not known. Because it is assumed that genital warts are benign lesions, they are usually treated by destructive therapies without prior knowledge of histopathology. The aim of the present study was to determine whether genital warts from individuals with or without human immunodeficiency virus (HIV) contain high-risk HPV types or areas of dysplasia. The study design was a nonrandomized analysis of genital warts removed by excision biopsy from 15 HIV-infected patients and 15 HIV-negative patients. The tissue was analyzed for HPV DNA by hybrid capture, and microscopic sections of each biopsy were examined for areas of dysplasia. Genital warts from HIV-infected patients contained cancer-associated ("high risk") HPV types in 9 of 15 cases, including 1 that contained only a high-risk type. High-grade dysplastic abnormalities were present in 2 of the 15 lesions from this group, both of which contained high-risk HPV types. Four genital warts removed from HIV-negative patients contained high-risk HPV types, but none contained dysplastic abnormalities. It is concluded that genital warts from HIV-infected patients often contain high-risk HPV types. Such lesions may exhibit dysplastic changes. The frequency of dysplastic changes in genital warts from HIV-infected patients is not known. Biopsy of genital warts may be indicated prior to additional therapy in HIV-infected patients, and surgical removal should be considered as a preferred treatment option in these patients.

Anus Diseases↗
PubMed1987

Condylomata acuminata (genital warts). An epidemiologic view.

The understanding of condylomata acuminata (genital warts) has been enhanced by the recent development of diagnostic methods. Forty-two types of human papillomavirus were identified up to 1985, and at least sixteen types were involved in genital warts. The incidence of genital warts is around 0.1% in the general population and more than 0.5% in young persons. The incidence is known to be increasing rapidly and exceeding the incidence of genital herpes. Females are more prone to be affected. The epidemiologic evidence supporting the relationship between genital warts and genital cancer is overwhelming. The evidence also speaks for a strong correlation between genital warts and verrucous carcinoma of the genitalia, bowenoid papulosis, and laryngeal papilloma. The person having genital warts may also have other cutaneous warts. This observation is compatible with the finding that types of human papillomavirus involved in other cutaneous warts were found in genital warts. In view of the never and easier ways of diagnosing nonconspicuous condyloma acuminatum and the potential for malignant transformation of condyloma acuminatum, it is strongly recommended that patients should be followed up periodically for early detection of neoplasia.

Age Factors↗
PubMed2001

Genital squamous cell carcinoma in men treated by photochemotherapy. A cancer registry-based study from 1978 to 1998.

BACKGROUND: One single report from the U.S. 16-centre-trial indicated that psoralen and ultraviolet A radiation (PUVA) therapy may induce an increased risk of genital tumours in men, and protection of the genital area is, therefore, recommended. OBJECTIVES: To evaluate the relevance of this risk in routine clinical practice. METHODS: Two groups of patients were included in a 1978-98 retrospective study. Case records of men with genital squamous cell carcinoma (SCC) identified from the Cancer Registry of the Doubs area of France were examined for a history of PUVA therapy, topical tar treatment, psoriasis, human papillomavirus infection or genital dermatitis. In addition, all the dermatologists of the Doubs area (in public and private practice) using PUVA therapy were asked to provide information on the number of patients having received PUVA therapy and whether the genital area was exposed during treatment. RESULTS: Between 1978 and 1998, among the 48 men who had developed a genital SCC in the Doubs area, only one had a history of intensive PUVA therapy. About 150,000 treatments with PUVA therapy had been performed by 15 dermatologists in the Doubs area for 5400 patients since 1978. No case of genital SCC had been reported, despite the fact that the genital area had not been protected during UVA exposure. CONCLUSIONS: Although retrospective, our study demonstrates that the occurrence of genital SCC in men treated with PUVA therapy is a very rare event in common dermatological practice.

Adult↗
PubMed2003

Female genital tract graft-versus-host disease following allogeneic bone marrow transplantation.

BACKGROUND AND OBJECTIVES: Graft-versus-host disease (GVHD) is a complex syndrome observed after bone marrow transplantation (BMT) affecting several organs including the lower genital female tract. We tried to evaluate the incidence of genital tract involvement and whether there are specific risk factors. DESIGN AND METHODS: A retrospective study was conducted in order to describe genital manifestations of GVHD and evaluate its incidence, severity and remission among 213 females who underwent BMT. The risk factors studied were previous pregnancies, vaginal cultures just before BMT and hormonal replacement therapy (HRT). RESULTS: Genital lesions considered as expression of GVHD were found in 53 patients (24.9%). They appeared in the first 100 days after BMT in 12 women and beyond in 41 cases. Seventy-three percent of patients with such lesions showed some evidence of chronic GVHD elsewhere. The proposed grading, the first attempt of its kind, showed that genital chronic GVHD was minimal in 66%, moderate in 22% and severe in 12% of patients. Vaginal fibrosis, sometimes with complete obstruction, was seen in this last form. This occurred in 86.8% of patients after 2-157 months (median 22) while persistent GVHD was observed in 7 of them. In our sample no significant association was found between genital GVHD and previous pregnancies or vaginal infections at BMT, while HRT seems poorly associated with gynecological manifestations of GVHD (p=0.049). INTERPRETATION AND CONCLUSIONS: Genital GVHD is not unusual after BMT. It can seriously affect female sexuality and the overall quality of life. We suggest stressing the importance of early detection of genital involvement in order to prevent the most serious lesions. Further studies are needed to identify the triggering factors associated with the development of genital GVHD.

Adolescent↗
PubMed1982

Double-blind controlled trial of topical acyclovir in genital herpes simplex virus infections.

Sixty-nine patients with first episodes and 111 with recurrent episodes of genital herpes simplex virus (HSV) infection were enrolled in a double-blind trial comparing a 5 percent topical acyclovir ointment versus placebo, polyethylene glycol (PEG). Among acyclovir recipients with first episodes of genital herpes, the mean duration of viral shedding from genital lesions, 2.0 days, mean duration of local pain or itching, 3.6 days, and mean time to healing of lesions, 11.2 days, were less than in placebo recipients 4.6, 6.7, and 15.8 days, respectively (p less than 0.05 for each comparison). Among patients with recurrent genital herpes, the mean duration of viral shedding from genital lesions was 0.8 days in acyclovir recipients compared with 1.7 days in placebo recipients (p less than 0.001). Among men with recurrent genital herpes, the mean time to crusting and healing of lesions was 3.5 and 7.5 days in acyclovir recipients compared with 5.0 and 9.7 days in placebo recipients, p = 0.03 and 0.07, respectively. No significant differences in the duration of symptoms or healing times were noted between acyclovir- and placebo-treated women with recurrent genital herpes. Acyclovir therapy was not associated with a decrease in frequency of clinical recurrences or an increase in the time of the next recurrence in patients with either first or recurrent genital herpes. Topical acyclovir appears effective in shortening some of the clinical manifestations of genital HSV infections.

Acyclovir↗
PubMed1993

Effect of stage of oestrous cycle on tylosin disposition in genital tract secretions of cows.

The influence of physiological state (oestrous or luteal phase) on tylosin disposition in genital secretions was examined after intravenous administration of tylosin to cows. Six healthy, cyclic and non-lactating dairy cows with controlled oestrous cycles were given a single slow intravenous injection of tylosin, at a dose of 10 mg kg-1. Plasma and genital fluid were regularly sampled up to 48 hours after injection. Tylosin diffused from blood to the genital tract and accumulated in genital secretions whatever the stage of the oestrous cycle: the secretion to plasma ratio was 3.45 +/- 2.54 during oestrous and 4.75 +/- 3.24 during the luteal phase. The area under the concentration-time curve (AUC) and the mean residence time (MRT) were significantly higher in genital secretions than in plasma. The AUC and the MRT in genital secretions showed no significant differences during the oestrous cycle. The minimal inhibitory concentrations (MIC) of tylosin for 25 strains of Actinomyces pyogenes were between 0.032 (12 strains) and 0.063 micrograms ml-1 (13 strains). Simulations based on the mean values of pharmacokinetic parameters determined in genital secretions, gave tylosin concentrations higher than the MIC for at least 36 hours. It was concluded that after an intravenous administration of tylosin, effective concentrations were achieved in genital secretions of the cyclic cow whatever its hormonal status which supported its use for the treatment of genital tract infections.

Actinomyces↗
PubMed1981

A comparison of phosphonoacetic acid and phosphonoformic acid activity in genital herpes simplex virus type 1 and type 2 infections of mice.

The activity of phosphonoacetic acid (PAA) and phosphonoformic acid (PFA) against four strains of herpes simplex virus type 1 (HSV-1) and four strains of HSV-2 were compared in tissue culture and in a murine model of genital herpes. In mouse embryo fibroblast cells, both drugs were three-fold more active against the HSV-1 strains than against the HSV-2 strains. In contrast, in the animal model infections, PAA appeared to be more active against the HSV-2 strains, while PFA was equally effective against both HSV types. In mice infected intravaginally with HSV-2 and treated with intravaginal 5% PAA, none of the treated mice became infected, replication of virus in the genital tract was completely inhibited, none of the infected mice died from encephalitis, and latent infection in lumbosacral ganglia of surviving animals was completely prevented. In HSV-1 genital infection treated with PAA, 20-60% of mice became infected, replication of virus in the genital tract was strikingly reduced, none of the infected mice died, and latent infection was completely prevented. In both HSV-2 and HSV-1 genital infections, 20-70% of animals treated with 8% PFA became infected, growth of virus in the genital tract was reduced significantly but not completely suppressed, mortality was variably altered, and there was a trend towards reduction in the frequently of latent infection. These results indicate that HSV-1 strains are more sensitive to PAA and PFA in tissue culture, but the HSV-2 strains are generally more amenable to therapy in the murine model of genital herpes. Although PAA appeared to be more active that PFA in the genital infection, both drugs significantly altered the course of the infection. Since dermal toxicity associated with PAA precludes its use in humans and since PFA is already undergoing trials in patients with recurrent herpes labialis, the current results suggest that topical PFA deserved further evaluation in the treatment of mucocutaneous HSV infections, including genital herpes.

Animals↗
PubMed2005

The VCUAM (Vagina Cervix Uterus Adnex-associated Malformation) classification: a new classification for genital malformations.

OBJECTIVE: With an incidence of up to 5% in the general population, genital malformations are a frequent clinical occurrence. However, using the existing published classifications of malformations, difficulties arise in classifying genital malformations appropriately. The aim of the present study was to produce a simple, systematic, and reproducible classification system. DESIGN: A systematic arrangement of genital and associated malformaltions, using a structure similar to that in the TNM classification of oncological tumors, was developed and validated. SETTING: Patients with genital malformations in a university hospital. PATIENT(S): Ninty-nine premenopausal patients with genital malformations. INTERVENTION(S): Patients were diagnosed for genital malformation using laparoscopy or magnetic resonance imaging. MAIN OUTCOME MEASURE(S): A new classification (VCUAM) is presented to evaluate patients with different genital malformations. RESULT(S): The external and internal female genital organs were divided into the following subgroups in accordance with the anatomy: vagina (V), cervix (C), uterus (U), and adnexa (A). Associated malformations were assigned to a subgroup (M) relative to each specific organ. The classification was validated in a group of 99 patients with genital malformations. CONCLUSION(S): The VCUAM classification for the first time makes it possible to reflect even complex malformations in a precise and individual fashion, taking associated malformations into account. The classification makes it easier to provide appropriate clinical care for the affected patients.

Abnormalities, Multiple↗
PubMed1990

Genital herpes simplex virus infections.

There has been a dramatic increase in patient visits to physicians for evaluation and treatment of genital herpes infections. This has resulted in part from an increase in genital herpes infections, particularly severe, first-episode genital herpes infections in adults without prior HSV-1 infection. Virus culture remains the most sensitive and specific method for diagnosis, and use of viral cultures is encouraged. Type-specific antibody tests have been employed in studies documenting the role of asymptomatic shedding of HSV in transmission of genital infections, the role of genital HSV in transmission of HIV, the predominance of asymptomatic and unrecognized infections in those infected with HSV-2, and the presence of past asymptomatic or unrecognized acquisition of HSV-2 in 25% of persons presenting with first-episode genital herpes. Unfortunately, commercially available serologic tests do not reliably differentiate between antibody to HSV-1 and HSV-2. Recent studies suggest that the annual risk of transmission from a sexual partner with genital herpes is about 10% in heterosexual couples. Currently, promotion of "safe sex" is the only available approach for prevention of transmission. However, ongoing research is focused on the development of an effective vaccine. Acyclovir should be used routinely in persons with first-episode genital herpes, but careful evaluation is needed in persons with recurrent genital herpes to determine whether episodic or suppressive treatment is indicated. Acyclovir should also be used routinely for episodic or suppressive treatment of HSV infections in persons with AIDS. Additional antiviral agents are needed for more effective suppressive therapy and for treatment of ACV-resistant HSV infections in the immunocompromised host.

Acyclovir↗
PubMed2003

Emergence of herpes simplex type 1 as the main cause of recurrent genital ulcerative disease in women in Northern Ireland.

BACKGROUND: Genital herpes is a common infection affecting some 20% of sexually active people. Although herpes simplex virus (HSV) types 1 and 2 can both establish genital latency, reactivation from the sacral ganglia favours HSV-2. Over the past decade the incidence of type 1 genital infection in women has greatly increased. OBJECTIVES: To determine whether the increased prevalence of HSV-1 genital infection was benign or influencing the pattern of virus recovery in recurrent infection. STUDY DESIGN: A retrospective analysis of laboratory computer records was undertaken. Patients attending six genitourinary medicine (GUM) departments, over an 80 months period, were identified. Recurrent infection was confirmed where virus was recovered from at least two separate episodes of genital ulceration that were separated by an interval of 12 or more weeks. Episodes were further analysed for frequency, age, gender and virus type. RESULTS: Sixty nine patients with recurrent genital herpetic infection were identified. HSV-1 and HSV-2 were predominantly recovered from recurrent genital infections in females (34 HSV-1 vs. ten HSV-2) and males (one HSV-1 vs. 24 HSV-2), respectively (P>0.001). The mean age of females and males, at the initial diagnosis, was 26 and 39 years. There was no difference in the recurrence rate by type. CONCLUSIONS: HSV-1 has become the commonest cause of recurrent genital ulceration in Northern Ireland, almost entirely due its recent increased prevalence in women over the last decade. Women are experiencing genital herpetic infections at an earlier age than men.

Adolescent↗
PubMed2002

Current opinion on the classification and definition of genital tract prolapse.

PURPOSE OF REVIEW: There are few issues in obstetrics and gynecology that seem so readily apparent but are in actuality replete with confusion than the diagnosis of genital tract prolapse. This stems from the difficulties in defining genital tract prolapse and from the long history of turmoil regarding how to classify and describe it. In the past 5-10 years our specialty has begun to make inroads into these issues. Finally, there is an accepted classification system and because of this we are beginning to recognize what represents normal vaginal support versus genital tract prolapse. RECENT FINDINGS: In 1993 the confusion regarding the classification of genital tract prolapse was documented by a very thorough review of the literature; in response, the Pelvic Organ Prolapse Quantification system was developed. Subsequent to this, several articles have begun to define the epidemiology of genital tract prolapse and this is providing a glimpse of what differentiates pathologic genital tract prolapse from normal support. SUMMARY: We can now reliably classify and describe genital tract relaxation and imply what is normal support versus pathological genital tract prolapse. However, we still have not defined genital tract prolapse, determined its prevalence or provided the clinician with a simple and reliable means of testing for its presence or absence.

Female↗
PubMed2005

Awareness of genital health in young male athletes.

OBJECTIVE: To assess young male athletes' understanding of the need for a genital examination during the sports physical, their knowledge of signs and symptoms of serious testicular pathology, and the type of genital protection they wear for specific sports. Additionally, to identify common sport-specific genital injuries requiring emergency department treatment. DESIGN: Descriptive survey. SETTING: Station-based mass screening preparticipation physical exams performed in northeastern Ohio. PARTICIPANTS: A total of 755 male athletes at the junior high school, high school, and collegiate levels (age 12-25 years). MAIN OUTCOME MEASUREMENTS: Participants' answers to a 5-question survey. Male genital injury occurring in common contact and collision sports identified from the National Electronic Injury Surveillance System. RESULTS: Fifty percent did not understand why the genital examination is done. Forty-seven percent did not wear genital protection during sports. Most were unaware of the risk of testicular cancer and did not appreciate the difference in urgency of seeking medical treatment of painless versus painful testicular swelling. Approximately 20% of emergency department visits for sports-related genital trauma had a risk of permanent injury, and up to 7% resulted in hospitalization or transfer. CONCLUSIONS: Young male athletes are unaware of testicular pathology that affects their age group, and many do not wear genital protection during sports. Better education of young males regarding genital health and protection is necessary.

Adolescent↗
PubMed2005

Genital herpes simplex virus infection and perinatal transmission of human immunodeficiency virus.

OBJECTIVE: To assess the risk of perinatal human immunodeficiency virus (HIV) transmission in HIV-infected women clinically diagnosed with genital herpes simplex virus (HSV) infection during pregnancy. METHODS: This retrospective analysis included 402 HIV-infected pregnant women who enrolled from 1994-1999 in a multicenter prospective cohort study in New York City, who delivered a liveborn singleton infant with known HIV infection status, and who had information on diagnosis of genital HSV infection during pregnancy. Study participants were determined to have genital HSV infection during pregnancy by documentation of clinical diagnosis. RESULTS: Forty-six (11.4%) of the study participants delivered HIV-infected infants. Twenty-one (5.2%) had clinical diagnosis of genital HSV infection in pregnancy. Six (28.6%) of the 21 HIV-infected women with a clinical diagnosis of genital HSV infection delivered an HIV-infected infant. In univariate analyses, HIV-infected pregnant women with clinical diagnosis of genital HSV infection during pregnancy had a significantly increased risk of perinatal HIV transmission (odds ratio 3.4, 95% confidence interval 1.3-9.3; P = .02). When other factors associated with perinatal HIV transmission were included in a logistic regression model (lack of zidovudine therapy during pregnancy or delivery, prolonged rupture of membranes, and preterm delivery), clinical diagnosis of genital HSV infection during pregnancy remained a significant independent predictor of perinatal HIV transmission (adjusted odds ratio 4.8, 95% confidence interval 1.3-17.0; P = .02). CONCLUSION: Clinical diagnosis of genital HSV infection during pregnancy in HIV-infected women may be a risk factor for perinatal HIV transmission. If future studies confirm this association, therapy to suppress genital HSV reactivation during pregnancy may be a strategy to reduce perinatal HIV transmission.

Adult↗
PubMed2003

Herpes simplex virus type 1 is the prevailing cause of genital herpes in the Tel Aviv area, Israel.

BACKGROUND AND GOAL: The changing epidemiology of genital herpes with the increasing importance of herpes simplex virus (HSV) type 1 prompted a study on the relative prevalence of HSV-1 and HSV-2 among cases of genital herpes in the Tel Aviv area, Israel. STUDY DESIGN: A retrospective laboratory-based study of positive genital and nongenital herpes cultures performed at the Beilinson Medical Center between 1993 and 2002. Data regarding the number of isolates of each type and the age and sex of patients with genital lesions were retrieved from the database. Cultures were performed using Vero cells, and positive results were confirmed and typed by immunofluorescence. RESULTS: A total of 285 positive genital cultures and 659 positive nongenital cultures were recorded. HSV-1 was identified in 189 (66.3%) of the positive genital specimens and in 656 (99.55%) of the nongenital specimens. HSV-1 was isolated in 174 of 262 (66.4%) female subjects and 15 of 23 (65.2%) male subjects. The proportion of HSV-1 genital isolates was 72.7% in patients 15 to 24 years of age, 62% in those 25 to 44 years, and 46% in those aged 45 years or older. Overall, the annual isolation rate of genital HSV-1 has not changed markedly over the years. CONCLUSION: Herpes simplex virus type 1 has clearly been the predominant HSV type isolated from genital specimens in the Tel Aviv area over the last decade.

Adolescent↗