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PubMed2004

Rate and predictors of new genital warts claims and genital warts-related healthcare utilization among privately insured patients in the United States.

BACKGROUND: Little non-clinic-based data are available on incident genital warts rates and related healthcare use. GOAL: : The goal of this study was to describe the incidence and predictors of genital warts and associated healthcare utilization patterns among a group of privately insured patients in the United States. STUDY: Health claims were evaluated prospectively from 5,914,107 privately insured individuals. RESULTS: The rate of new genital warts claims per 100,000 person-years at risk, age-standardized to the 2001 U.S. privately insured population, increased from 117.8 in 1998 to 205.0 in 2001. The highest rates were among 20- to 29-year-olds. The majority of claims came from dermatology and obstetrics/gynecology. CONCLUSIONS: The incidence of genital warts, as measured by the rate of new claims, appears to be rising. Age associations with the rate of new genital warts claims differed by gender; these associations may be influenced by changes in health-seeking behavior, potentially driven by health awareness.

Adolescent↗
PubMed1991

Rising trend of reported primary genital syphilis and genital ulcer disease in Burkina Faso.

Recent trends in reported primary genital syphilis and genital ulcer disease (GUD) were assessed in Burkina Faso using incidence data reported to the Ministry of Health. From 1978 to 1983 the yearly reports of genital syphilis and GUD rose by 42%. A single period moving average was calculated for each consecutive 13-week period from 1978 to 1983, documenting an average 7% rise per year. Severe limitations in the Ministry of Health of personnel and other resources for surveillance were noted and no improvements in surveillance methods were evident during this study. The rising trend suggests a growing problem of ulcerative sexually transmitted diseases, which may, in turn, facilitate infection with sexually acquired human immunodeficiency virus, coincident with the expansion of this epidemic in Africa. Syphilis complications are also almost certain to include adverse pregnancy outcome due to maternal syphilis. The rising trend in genital syphilis and GUD, and the probable increase in associated adverse sequellae, require that prevention and control of sexually transmitted diseases should be made a high priority.

Burkina Faso↗
PubMed1988

Genital warts, papillomaviruses, and genital malignancies.

Human papillomavirus (HPV) infections of the genital tract are widespread and often subclinical. Of about a dozen genital tract HPVs, types 16 and 18 are strongly associated with squamous cell carcinoma of the cervix and of other sites in the lower genital tract. In invasive cervical cancers, the viral genomes are often integrated into the cellular DNA and are transcriptionally active. These viruses, with additional cofactors, play a role in genital tract malignancies.

Carcinoma, Squamous Cell↗
PubMed1999

Colonization of the respiratory and genital tracts of female mice with Mycoplasma pneumoniae and protection afforded to the genital tract by prior respiratory colonization.

Mycoplasma pneumoniae, strain MY 12763, colonized the throats of 6 BALB/c female mice for at least 18 days after intranasal inoculation. The same strain colonized, in high titre, the vagina of 9 of 10 progesterone-treated BALB/c mice for at least 35 days, but none of 10 oestradiol-treated mice. Mice were less susceptible to genital-tract colonization with the multiple broth-passed FH strain of M. pneumoniae, only 3 of 10 becoming colonized. The 6 mice inoculated intranasally with strain MY 12763 were immune to genital-tract colonization with the same strain, whereas 10 mice without respiratory-tract colonization were susceptible. Protection of the genital tract in this way was at least as effective as that afforded by previous genital-tract colonization. In a further experiment, 26 immunocompetent BALB/c mice colonized previously in the respiratory tract were resistant to vaginal colonization, whereas 20 BALB/c nude mice, similarly colonized in the respiratory tract, were susceptible in the vagina, illustrating the importance of cell-mediated immunity. The possible relevance of the findings to the human situation is discussed.

Animals↗
PubMed2005

Counseling the patient who has genital herpes or genital human papillomavirus infection.

Educational counseling has an important role in managing patients who have viral STIs, such as genital herpes and genital HPV infections. Given the lack of a curative therapy for both, patients may require long-term management and may need to be attentive to recurring symptoms. In addition, both diagnoses may raise issues of persisting infectiousness along with a need for patient counseling about the potential risk to partners and risk reduction strategies. Lastly, dozens of published papers over the years describe potential psychosocial sequelae for patients who have genital herpes, and there is a growing psychosocial literature on genital HPV as well. Clinicians can make a significant difference in patient adjustment to the diagnosis of an STI, and addressing these challenging issues will benefit patients greatly.

Adult↗
PubMed2003

Study of knowledge of genital herpes infection and attitudes to testing for genital herpes among antenatal clinic attendees.

A descriptive survey of knowledge of genital herpes and attitudes to testing was conducted among antenatal clinic attendees at the Gold Coast Hospital, Australia. The study subjects showed a good knowledge of genital herpes, to a level that appears sufficient for an informed choice regarding herpes serology testing to be made. A preference for testing for genital herpes was suggested. Although serological testing is not routinely required, the results of the study indicate that discussion of genital herpes should be considered in the antenatal clinic setting.

Adult↗
PubMed2003

Genital self-image as a component of sexual health: relationship between genital self-image, female sexual function, and quality of life measures.

Thirty-one patients completed a Genital Self-Image Scale along with the Female Sexual Function Index (FSFI; Rosen et al., 2000), Sexual Distress Scale (Derogatis et al., 2001), Perceived Stress Scale (Cohen et al., 1983), Golombok Rust Inventory of Marital State (Rust et al., 1986) Questionnaire, and Beck's Depression Inventory (Beck et al., 1988). A positive genital self-image correlated negatively with amount of sexual distress and depression but not with marital state, perceived stress, or overall sexual function. A positive genital self-image was associated with higher desire but not with arousal, lubrication, orgasm, satisfaction, or absence of pain on the FSFI. Although not correlated directly with sexual function, genital self-image appears to be associated with parameters of the overall sexual experience.

Adult↗
PubMed2002

Do condoms prevent genital HPV infection, external genital warts, or cervical neoplasia? A meta-analysis.

BACKGROUND: Although condoms most likely prevent HIV infection, evidence of their effectiveness against other sexually transmitted diseases is mixed. GOAL: The goal of the study was to determine whether condom use prevents genital human papillomavirus (HPV) infection and HPV-related conditions. STUDY DESIGN: We conducted a literature review and meta-analysis of the effect of condom use on the prevention of genital warts, subclinical HPV infection, cervical intraepithelial neoplasia (CIN), and invasive cervical cancer (ICC). RESULTS: Among 27 estimates from 20 studies, there was no consistent evidence that condom use reduces the risk of becoming HPV DNA-positive. However, risk for genital warts, CIN of grade II or III (CIN II or III), and ICC was somewhat reduced. CONCLUSIONS: Available data are too inconsistent to provide precise estimates. However, they suggest that while condoms may not prevent HPV infection, they may protect against genital warts, CIN II or III, and ICC.

Condoms↗
PubMed1991

Increased incidence of cervical cytological abnormalities in women with genital warts or contact with genital warts: a need for increased vigilance?

OBJECTIVE: To determine whether women who have a history of genital warts or whose sexual partners have such a history were more likely to have borderline or dyskaryotic cervical smears than other women. DESIGN: Prospective study conducted over a five month period. SETTING: A genitourinary medicine clinic in Cambridge, UK. PATIENTS: One hundred and eighty five women who attended the clinic during the study period, on whom cervical cytology was performed. Ninety-seven had a history of genital warts and twenty had partners with genital warts. METHODS: Cervical cytology taken by standard methods. Demographic data and sexual history obtained by questionnaire. Colposcopy was performed on patients with a history of warts or wart contact. OUTCOME MEASURED: Relative incidence of cytological abnormalities in the various groups of patients. RESULTS: "Borderline" nuclear change was the most frequent abnormality reported in the wart contact group (six cases) whereas mild dyskaryosis was the most frequent abnormal finding in those women with a history of warts (21 cases). CONCLUSIONS: Women with warts or contact with genital warts were more likely to have borderline or dyskaryotic cervical smears than women without such a history. Recommendations for follow-up of these patients are made.

Adult↗
PubMed1999

Prevalence of type specific Epstein-Barr virus in the genital tract of genital herpes suspected patients.

A total of 62 clinical specimens from the genital tract of patients who were suspected of contracting genital herpes were investigated for HSV infection by the virus isolation method, and also investigated for the co-infection with EBV infection by detecting EBV DNA using nested PCR. HSV infection was diagnosed in 30 (48.4%) of the study cases, and so was EBV. EBV DNA was present in 17 (56.7%) of the 30 HSV positive samples. No correlation was found between the co-existence of these two viruses together. EBV DNA was detected in genital specimens of cervical, vaginal, urethral, and anal swabs. Ninety per cent of EBV belonged to type 1, and the remainder belonged to type 2 and mixed types. The role of EBV in genital tract infection needs to be further investigated.

Anal Canal↗
PubMed1997

Oral famciclovir for suppression of recurrent genital herpes simplex virus infection in women. A multicenter, double-blind, placebo-controlled trial. Collaborative Famciclovir Genital Herpes Research Group.

OBJECTIVE: To evaluate the efficacy and safety of oral famciclovir in the suppression of genital herpes. METHODS: In this randomized, double-blind, placebo-controlled trial that was performed at 11 university and 9 private ambulatory care referral centers, 375 women who were 18 years of age or older and had a history of 6 or more episodes of genital herpes during 12 of the last 24 months in the absence of suppressive therapy were treated for 4 months with oral famciclovir, 125 mg once daily or twice daily, 250 mg once daily or twice daily, 500 mg once daily, or placebo. The primary outcome measures included the time to first clinically and virologically confirmed recurrences, and safety as measured by clinical laboratory tests and adverse experiences. RESULTS: The median time to first recurrence was 82 days in the placebo group, 114 days in those receiving famciclovir, 125 mg once daily, and more than 120 days in the other treatment groups. When compared with placebo recipients, the time to the first clinical recurrence was significantly prolonged in subjects who received famciclovir, 125 mg twice daily (hazard ratio, 1.8; 95% confidence interval, 1.0-3.0; P = .03), and in those who received famciclovir, 250 mg twice daily (hazard ratio, 3.6; 95% confidence interval, 1.9-6.9; P < .001). Treatment was well tolerated, and there was no evidence of emergence of resistance during or after suppressive famciclovir therapy. CONCLUSIONS: Oral famciclovir, 250 mg, given twice daily for 4 months is an effective, well-tolerated treatment for the suppression of genital herpes in women with frequent recurrences, but single daily doses produced less complete suppression of genital herpes.

2-Aminopurine↗
PubMed1989

Molluscum contagiosum virus types in genital and non-genital lesions.

The endonuclease digest patterns of viral DNA from 48 genital and 45 non-genital molluscum contagiosum virus (MCV) lesions were examined. The overall ratio of MCVI to MCVII was 3.23:1. There was no predominance of either MCV type in genital lesions. No obvious morphological differences were seen between MCVI and MCVII lesions. MCVII was not found in any patient under 15 years old.

Adolescent↗
PubMed1990

Two new human papillomavirus types (HPV54 and 55) characterized from genital tumours illustrate the plurality of genital HPVs.

The genomes of two new human papillomavirus (HPV) types, named HPV54 and HPV55, were cloned from penile lesions of 2 patients. HPV54 was isolated from a verrucous carcinoma (Buschke-Löwenstein tumour) together with full-length HPV6 genomes and HPV6 DNA molecules with a deletion of about 0.3 kb located in the non-coding region. HPV55 was isolated from a condyloma acuminatum. No cross-hybridization was observed between HPV54 DNA and the DNAs of the known cutaneous and genital HPVs by blot hybridization experiments performed under stringent conditions. In contrast, significant cross-hybridization was detected between HPV55 DNA and the DNA of HPV13, associated with benign oral lesions, and, to a lesser extent, with the DNAs of HPV6, 11, and 44, associated with benign genital proliferative lesions. The DNA sequence homology between HPV55 and HPV6, 11, and 13 was estimated at 12%, 12%, and 20%, respectively, by hybridization in liquid phase at saturation, followed by nuclease S1 analysis. The physical maps of HPV54 and 55 were aligned with the genetic maps of HPV16 and 11, respectively, by heteroduplex mapping and partial DNA sequencing. HPV54 is thus only weakly related to the known HPVs, while HPV55 represents an additional HPV6-related HPV type. HPV54 and HPV55 are uncommon genital HPV types since, in a survey of a large series of specimens of benign, pre-malignant or malignant anogenital and orolaryngeal tumours, HPV54 was not detected, and HPV55 was found in another case of condyloma acuminatum.

Adult↗
PubMed1995

Protective efficacy of a parenterally administered MOMP-derived synthetic oligopeptide vaccine in a murine model of Chlamydia trachomatis genital tract infection: serum neutralizing IgG antibodies do not protect against chlamydial genital tract infection.

The protective efficacy of an alum-adsorbed, parenterally administered synthetic oligopeptide immunogen corresponding to antigenically common T-helper and neutralizing B-cell epitopes of the Chlamydia trachomatis major outer membrane protein was studied in a murine model of chlamydial genital tract infection. Mice produced high levels of anti-chlamydial serum IgG neutralizing antibodies following subcutaneous immunization with the alum-adsorbed oligopeptide. Lower but detectable levels of chlamydial specific IgG antibodies were found in vaginal washes. IgG1 was the predominant isotype present in sera and vaginal washes. Chlamydial-specific IgA was not present in either the sera or vaginal washes of immunized mice. Vaccinated and control mice were challenged intravaginally or intrauterinally with low, medium, or high doses of C. trachomatis serovar D challenge inocula. Protection was assessed by performing quantitative chlamydial cervico-vaginal cultures over the course of the infection period. There were no statistically significant differences between groups of immunized and control mice in either colonization, shedding, or duration of infection. These findings demonstrate that parenteral immunization with the oligopeptide (serum-neutralizing antibodies) is ineffective in preventing chlamydial genital tract infection. It is possible, since chlamydial infection is restricted to the genital tract mucosae, that a more accurate evaluation of the oligopeptide vaccine potential will require local rather than systemic immunization.

Administration, Intravaginal↗
PubMed2006

Lactobacilli in the female genital tract in relation to other genital microbes and vaginal pH.

BACKGROUND: The relationship between lactobacilli and other microbes and the association with vaginal pH in the female genital tract were examined. The study also included evaluation of the possibility of supplying probiotics to the genital tract by using panty liners impregnated with the probiotic strain Lactobacillus plantarum LB931. METHODS: This was a randomized, placebo-controlled, double-blind, multicenter study involving 191 healthy fertile women. Specified microbes were counted and vaginal pH was measured once a month for five consecutive months. RESULTS: Major individual variations in the genital microflora composition and the vaginal pH were found among the women. The number of lactobacilli was significantly related to vaginal pH (p<0.001) and approximately 70% of the women were permanent carriers of individual lactobacilli strains. Women with high numbers of lactobacilli were less prevalent with Group B streptococci than women with low numbers (p=0.036), and these women had a lower mean vaginal pH. The number of lactobacilli also correlated with the prevalence of yeast. LB931 could be found in 86% of the labial samples and 54% of the vaginal samples. CONCLUSIONS: High numbers of lactobacilli may contribute to a low vaginal pH and seem to have a negative influence on Group B streptococci. LB931 could be transferred from the panty liners to both the vagina and the labial fold.

Absorbent Pads↗
PubMed1993

Risk of acquisition of genital herpes simplex virus type 2 in sex partners of persons with genital herpes: a prospective couple study.

In a prospective study of factors associated with genital herpes simplex virus (HSV) type 2 transmission in couples in whom 1 partner had clinical genital HSV and the other did not, 11 (19%) of the 57 history-negative partners had HSV-2 antibody by Western blot at entry. In follow-up (mean, 16 months) of 29 HSV-2-seronegative partners, overall 4 (14%) seroconverted compared with 3 (23%) of 13 HSV-1- and -2-seronegative partners and 1 (6%) of 16 HSV-1-seropositive partners. Since all seroconverters were women, the risk of transmission may be higher in HSV-seronegative women. No significant differences were found between HSV-2-seronegative partners and seroconverters regarding duration of relationships, number of partner recurrences, intercourse frequency, or contraceptive method. However, 2 seroconverters were exposed to lesions without barrier contraception. This study suggests that infection is commonly asymptomatic and that although the overall risk of genital HSV transmission in couples is low (10%/year), the risk may be significantly increased in women and in seronegative individuals.

Adult↗
PubMed2004

Female genital mutilation in the West: traditional circumcision versus genital cosmetic surgery.

This article intends to present the Scandinavian legislation on female genital mutilation and explore the implications of the laws. Juxtaposing trends of plastic genital surgery in the West with claims that female circumcision may be a practice generally abandoned in Scandinavia, we highlight the double morality inherent in current public discussions. Finally, we pose the question: Is the legal principle of equality before the law regarded when it comes to alterations of the female genitals?

Africa↗
PubMed1998

Rabbit genital tissue is susceptible to infection by rabbit oral papillomavirus: an animal model for a genital tissue-targeting papillomavirus.

Rabbit oral papillomavirus (ROPV) is a mucosatropic papillomavirus which naturally infects oral mucosal sites of domestic rabbits. In this study, we tested the hypothesis that rabbit genital mucosa is also susceptible to ROPV infection by using the athymic mouse xenograft system and adult immunocompetent rabbits. Subrenal xenografts of ROPV-infected rabbit vulvar and penile sheath tissues were strongly positive for ROPV infection by histologic, in situ hybridization, and Southern analyses. Direct inoculation of adult rabbit penises with infectious ROPV produced small raised lesions of approximately 1 by 1 by 1 mm that were ROPV positive by both in situ hybridization and Southern analyses and were also viral capsid antigen positive by immunohistological staining. Infection of rabbit genital tissues with ROPV may be a useful animal model for the study of genital tissue-targeting papillomaviruses.

Animals↗