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PubMedDate not supplied

High cumulative incidence of genital herpes amongst HIV-1 seropositive heterosexuals in south London.

The cumulative incidence of sexually transmitted diseases (STD) in a cohort of 51 (35 female, 16 male) HIV-1 seropositive STD clinic attenders who had acquired HIV-1 infection via heterosexual transmission was investigated through a retrospective review of the case notes. The women were followed up for a mean 11.6 months and the men for 18 months. Thirty-one (88%) of the women and 13 (81%) of the men were of sub-Saharan African origin. Approximately half of the subjects were first diagnosed as HIV-1 positive with CD4 counts < 200 x 10(6)/1 and a quarter with CD4 counts < 50 x 10(6)/1. STDs detected in women were: genital herpes 15 (43%), candida 12 (34%), bacterial vaginosis 9 (25%), and in men: genital herpes 6 (38%), non-gonococcal urethritis 4 (25%). No cases of gonorrhoea were detected. At the time of first diagnosis of genital herpes at the clinic, the mean CD4 count in women was 275 x 10(6)/1 and in men 285 x 10(6)/1. Genital herpes was the AIDS defining diagnosis in 3 of the women. The recognized risk of HIV transmission via genital lesions should be stressed in HIV-1 positive subjects with genital herpes. The incidence of other STD was low--both knowledge of HIV status and safer sex counselling may limit unsafe sexual behaviour and should be evaluated further as a strategy for limiting the spread of HIV-1 infection.

Female↗
PubMed1983

Diethylstilbestrol metabolism by the fetal genital tract.

Oxidative metabolism of diethylstilbestrol (DES) was measured in both the male and female genital tracts of the fetal mouse in organ culture. The major oxidative metabolite formed was Z,Z-dienestrol, whose formation appeared to be time dependent in the isolated fetal genital tract of both sexes. This peroxidative metabolite, which has been previously linked to bioactivation of DES in adult target tissues, was not detected in the fetal liver cultures. In addition, fetal genital tracts were capable of O-methylation of DES. In fact, a new metabolite, 4'-O-methyl-DES, was formed in fetal genital tissues but not in liver cultures. On the other hand, conjugation of DES occurred extensively in the fetal liver and placenta but not in the fetal genital tissues; conjugated DES was found primarily in the media. Thus, the fetal genital tract, which is the primary target for the transplacental carcinogenicity of DES, has the capacity to metabolize this compound.

Animals↗
PubMed2003

Development of the Drosophila genital disc requires interactions between its segmental primordia.

In both sexes, the Drosophila genital disc comprises three segmental primordia: the female genital primordium derived from segment A8, the male genital primordium derived from segment A9 and the anal primordium derived from segments A10-11. Each segmental primordium has an anterior (A) and a posterior (P) compartment, the P cells of the three segments being contiguous at the lateral edges of the disc. We show that Hedgehog (Hh) expressed in the P compartment differentially signals A cells at the AP compartment border and A cells at the segmental border. As in the wing imaginal disc, cell lineage restriction of the AP compartment border is defined by Hh signalling. There is also a lineage restriction barrier at the segmental borders, even though the P compartment cells of the three segments converge in the lateral areas of the disc. Lineage restriction between segments A9 and A10-11 depends on factors other than the Hh, En and Hox genes. The segmental borders, however, can be permeable to some morphogenetic signals. Furthermore, cell ablation experiments show that the presence of all primordia (either the anal or the genital primordium) during development are required for normal development of genital disc. Collectively, these findings suggest that interaction between segmental primordia is required for the normal development of the genital disc.

Animals↗
PubMed2001

Continuing medical ignorance: modern myths in the management of genital warts.

Genital warts are the most common sexually transmitted disease (STD) in industrialized countries. Since they also often respond poorly to current treatments, they account for substantial morbidity. Human papillomavirus (HPV) typing methods have shown that HPV 6 and 11, the most common types found in genital warts, are not found in cancer of the cervix. These types, however, do cause minor degrees of cervical dysplasia which also results in morbidity both through fear and through over-treatment. The sexual nature of transmission of genital warts has been known from ancient times; there is also good evidence of vertical transmission and transmission through non-genital contact. Barrier contractive methods do not completely prevent transmission of genital warts and may give little worthwhile protection. These facts, together with the established persistence of HPV contribute to the associated psychological morbidity. There are a number of treatments for genital (and other) warts. This attests to the fact that no one of these is clearly superior to the others. Until better treatments are developed much of the management of this condition must consist of using such treatments that are available to maximize efficacy while trying to reduce unnecessary costs, inconvenience and potential injury and sustaining morale through what may be a long and demoralizing course.

Condylomata Acuminata↗
PubMed2006

Genital shedding of herpes simplex virus type 2 in childbearing-aged and pregnant women living in Gabon.

The prevalence of genital shedding of herpes simplex virus (HSV)-2 and related risk factors was evaluated in a prospective population of 355 women attending the Maternity Joséphine Bongo, in Libreville, Gabon. We found a high prevalence (66%) of HSV-2 seropositivity, with a high proportion, 14%, of women harbouring HSV-2 DNA shedding in their genital secretions. HSV-2 genital shedding was positively associated with previous episodes of genital blisters, current genital ulcer, current genital blister, HIV seropositivity and HSV-2 seropositivity. The high prevalence of HSV-2 in childbearing-aged population indicates that young women living in Gabon are at high risk for HIV acquisition in HIV-seronegative women sexually exposed to HIV, for HIV transmission in HIV-infected women co-infected by HSV-2 and finally for HSV-2 vertical transmission during pregnancy.

Adult↗
PubMed2004

Neonatal genital herpes simplex virus type 1 infection after Jewish ritual circumcision: modern medicine and religious tradition.

OBJECTIVE: Genital neonatal herpes simplex virus type 1 (HSV-1) infection was observed in a series of neonates after traditional Jewish ritual circumcision. The objective of this study was to describe neonate genital HSV-1 infection after ritual circumcision and investigate the association between genital HSV-1 after circumcision and the practice of the traditional circumcision. METHODS: Eight neonates with genital HSV-1 infection after ritual circumcision were identified. RESULTS: The average interval from circumcision to clinical manifestations was 7.25 +/- 2.5 days. In all cases, the traditional circumciser (the mohel) had performed the ancient custom of orally suctioning the blood after cutting the foreskin (oral metzitzah), which is currently practiced by only a minority of mohels. Six infants received intravenous acyclovir therapy. Four infants had recurrent episodes of genital HSV infection, and 1 developed HSV encephalitis with neurologic sequelae. All four mohels tested for HSV antibodies were seropositive. CONCLUSION: Ritual Jewish circumcision that includes metzitzah with direct oral-genital contact carries a serious risk for transmission of HSV from mohels to neonates, which can be complicated by protracted or severe infection. Oral metzitzah after ritual circumcision may be hazardous to the neonate.

Circumcision, Male↗
PubMed2006

Valacyclovir for the treatment of genital herpes.

Genital herpes is the most prevalent sexually transmitted infection in the USA. While sometimes mild in severity, it can be a distressing and painful chronic condition. Likewise, herpes labialis and herpes zoster can be both physically and psychologically painful. While there is no cure for these conditions, treatment to alleviate symptoms, suppress recurrences and reduce transmission has been drastically improved over the past 20 years with the use of guanine nucleoside antivirals, such as valacyclovir hydrochloride (Valtrex), GlaxoSmithKline) the highly bioavailable prodrug of acyclovir (Zovirax((R)), GlaxoSmithKline), and famciclovir (Famvir, Novartis), a highly bioavailable prodrug of penciclovir (Denavir, Novartis). Clinical trials involving approximately 10,000 patients (including patients from nongenital herpes studies, such as herpes zoster) have assessed the safety and efficacy of valacyclovir in the treatment of initial genital herpes outbreaks, episodic treatment of recurrent episodes and daily suppressive therapy. It was shown that valacyclovir has similar efficacy to acyclovir in the episodic and suppressive treatment of genital herpes. Valacyclovir is the only antiviral drug approved for a once-daily dose of suppressive therapy for genital herpes, as well as the only antiviral drug US FDA approved for a 3-day regimen of episodic treatment of recurrent genital herpes. In addition, valacyclovir is also indicated in the reduction of the sexual transmission of herpes simplex virus infection and for the treatment of herpes labialis. In herpes zoster, valacyclovir is more effective than acyclovir or placebo (and as equally effective as famciclovir) in shortening the length and severity of herpes zoster-associated pain and postherpetic neuralgia. Valacyclovir has an acceptable safety profile in patients with herpes simplex and herpes zoster. The less frequent dosing regimen makes it an attractive option in the treatment of genital herpes and other viral infections, and may contribute to increased patient adherence to therapy.

Acyclovir↗
PubMed2000

Valaciclovir: a review of its long term utility in the management of genital herpes simplex virus and cytomegalovirus infections.

UNLABELLED: Valaciclovir is an aciclovir prodrug used to treat infections caused by herpes simplex virus (HSV) and varicella zoster virus, and for prophylaxis against cytomegalovirus (CMV). Oral valaciclovir provides significantly better oral bioavailability than oral aciclovir itself, contributing to the need for less frequent administration. Several studies have demonstrated the efficacy of long term (> 90 days) therapy with valaciclovir for the suppression of genital HSV disease in otherwise healthy individuals with HSV infection. In 1 randomised, double-blind trial, once daily valaciclovir (1000 mg, 500 mg and 250 mg) produced statistically significant suppression of disease recurrence, as did twice daily valaciclovir 250 mg and aciclovir 400 mg. Valaciclovir dosages of > or = 500 mg daily are recommended for suppression of genital herpes recurrences in immunocompetent individuals. This disease occurs frequently in patients with human immunodeficiency virus (HIV) infection and, in a single randomised double-blind trial, prophylactic valaciclovir (1000 mg once daily or 500 mg twice daily) and aciclovir (400 mg twice daily) were found to be of similar efficacy in the suppression of genital herpes. However, a higher than expected dropout rate indicated that more studies of valaciclovir in patients with HIV are required. In a randomised trial of patients undergoing renal transplant, valaciclovir 2 g 4 times daily for 90 days significantly reduced the incidence and delayed the onset of CMV disease: the incidence in valaciclovir-treated patients who were CMV-seronegative at baseline, and recieived a kidney from a CMV-seropositive donor, was 3% versus 45% for placebo after 90 days of treatment. Acute graft rejection was also reduced in the valaciclovir-treated group. A small study in heart transplant patients compared valaciclovir (2 g 4 times daily) with aciclovir (200 mg 4 times daily) and found a significant reduction in CMV antigenaemia favouring valacilovir at the end of the treatment period. Additional reductions in other indices of CMV in those given valaciclovir compared with aciclovir were also noted. In a preliminary study of prophylaxis for CMV disease in bone marrow transplant recipients valaciclovir (2 g 4 times daily) was superior to aciclovir (800 mg 4 times daily) in terms of time to CMV viraemia or viruria. Although valaciclovir (8 g/day for approximately 30 weeks) reduced the incidence and time to CMV disease compared with aciclovir (3.2 g/day) in patients with advanced HIV disease, valaciclovir was associated with more gastrointestinal complaints and an increased risk of death, leading to premature termination of the study. As yet, no trials comparing the efficacy of valaciclovir with famciclovir (the oral prodrug for penciclovir) in the suppression of recurrent episodes of genital herpes have been published, nor have direct comparisons been made, between valaciclovir with ganciclovir in patients with CMV disease. Valaciclovir is well tolerated at dosages used to suppress recurrent episodes of genital herpes (500 to 1000 mg/day) in immunocompetent and HIV seropositive individuals, with headache being reported most often. However, a potentially fatal thrombotic microangiopathy (TMA)-like syndrome has been reported in some immunocompromised patients receiving high-dose prophylactic valaciclovir therapy (8 g/day) for CMV disease for prolonged periods, and the risk of this syndrome appears to be higher in patients with advanced HIV disease. While the clinical benefits of valaciclovir in some immunocompromised patients may outweigh the risk of TMA, close monitoring for symptoms of TMA is indicated in all immunocompromised patients receiving high-dose valaciclovir. CONCLUSION: Oral valaciclovir is an effective drug for the suppression of recurrent episodes of genital herpes in immunocompetent and immunocompromised individuals. (ABSTRACT TRUNCATED)

Acyclovir↗
PubMedDate not supplied

[Endogenous reinfection as a cause of recurrent genital candidiasis on women].

The cause of primary, recurrent genital candidosis (RGC), that 5% of the female population was afflicted with, is still unknown. It is not clear whether RGC is a result of reinfection or infection recidive caused by Candida sp. The goal of the study is to examine Candida presence in women's genital and intestinal tract; by resistotypization of the same isolated species of Candida fungi to prove their identity as well as the validity of the stated thesis that endogenous reinfection may be one of the possible causes of RGC. The study included 70 women (T-group) afflicted with primary RGC who, at the moment of the examination, were in the phase of manifest infection. In the control group there were 70 women (C-group) not afflicted with RGC. The microbiological test consisted of the microscopic and culture examination of women's genital and intestinal material. The Candida species were differentiated according to the gemination test and the biochemical activity measured by commercial Candi-Fast-test (Mycoplasma International, France) and Vitec-AMS-system (bioMerieux, France). Candi-Fast test examined the sensitivity of Candida species to antimicotics and determined the resistotypes of isolated species. The study did not show statistically significant difference between examined groups in terms of the Candida presence in intestinal tract. The Candida colonization of intestinal mucosa was proved in 24 women (34.28%) with RGC. Eighteen women (25.71%) of the control group, had Candida sp. in intestinal tract. The most frequent RGC agent, as well as most frequent coloniser of intestinal mucosa is Candida albicans (C. albicans--RGC--84.28%; T-group--intestinal tract--C. albicans--87.50%; C-group--intestinal tract--C. albicans--94.44%). In 20 women with RGC there was a presence of identical resistotypes of isolated Candida sp. Identical resistotypes of C. albicans was found in 19 women of the test group, in their genital and intestinal tract. Only in one patient it was recorded the same resistance types of C. trapicalis. In four patients Candida species isolated from genital and intestinal material were not identical. In two women with RGC C. albicans on vaginal mucosa was accompanied by C. glabrata in intestinal tract, while in two more women the presence of various resistotypes C. albicans was identified in genital and intestinal tract.

Adult↗
PubMed1989

Sexually dimorphic neurons in the terminalia of Drosophila melanogaster: I. Development of sensory neurons in the genital disc during metamorphosis.

The adult terminalia of Drosophila melanogaster males and females are sexually dimorphic. The sensory neurons that innervate the sex-specific bristles of the analia and genitalia arise within the genital disc during metamorphosis. Using antibodies that recognize peripheral neurons, I have followed the development of neurons in the female genital, the male genital and the shared anal primordium. Neurons form only in the expressed genital and anal primordium at the onset of the white prepupal stage. Two basic types of neurons differentiate in the genital disc; exteroreceptors that innervate the external bristles and enteroreceptors that innervate the internal reproductive organs. Within the genital disc, each structure has a sex-specific time during pupation when its neurons differentiate even when neurons are derived from homologous primordia. The data suggest that the sexually dimorphic arrangement of sensory neurons is a product of sex-specific neurogenesis.

Animals↗
PubMed2003

A unique population of extrathymically derived alpha beta TCR+CD4-CD8- T cells with regulatory functions dominates the mouse female genital tract.

A better understanding of the regulatory role of genital tract T cells is much needed. In this study, we have analyzed the phenotype, distribution, and function of T lymphocytes in the female genital tract of naive, pregnant, or Chlamydia trachomatis-infected C57BL/6 mice. Unexpectedly, we found that the dominant lymphocyte population (70-90%) in the genital tract was that of CD3(+)alphabetaTCR(int)CD4(-)CD8(-) T cells. Moreover, these cells were CD90(low) but negative for the classical T cell markers CD2 and CD5. The CD3(+)B220(low) cells were NK1.1 negative and found in nude mice as well as in mice deficient for MHC class II, beta(2)-microglobulin, and CD1, indicating extrathymic origin. They dominated the KJ126(+)Vbeta8.2(+) population in the genital tract of DO11.10 OVA TCR-transgenic mice, further supporting the idea that the CD3(+)B220(low) cells are truly T cells. The function of these T cells appeared not to be associated with immune protection, because only CD4(+) and CD8(+) T cells increased in the genital tract following chlamydial infection. Notwithstanding this, the infected, as well as the uninfected and the pregnant, uterus was dominated by a high level of the CD3(+)CD4(-)CD8(-)B220(low) cells. Following in vitro Ag or polyclonal stimulation of the CD3(+)CD4(-)CD8(-)B220(low) cells, poor proliferative responses were observed. However, these cells strongly impaired splenic T cell proliferation in a cell density-dependent manner. A large fraction of the cells expressed CD25 and produced IFN-gamma upon anti-CD3 plus anti-CD28 stimulation, arguing for a strong regulatory role of this novel T cell population in the mouse female genital tract.

Animals↗
PubMed2006

Antigen-specific CD8+ T cells respond to Chlamydia trachomatis in the genital mucosa.

Following sexual transmission, Chlamydia trachomatis specifically targets genital tract epithelial cells. Because epithelial cells are readily recognized by CD8+ T cells, the response of CD8+ T cells to Chlamydia infection has been explored in a number of studies. It has been shown that CD8+ T cells are present in the genital tracts of mice following C. trachomatis infection, but the specificity of these T cells has remained undefined. To determine whether Chlamydia-specific CD8+ T cells migrate to the genital tract in response to Chlamydia infection, we generated retrogenic mice that express a TCR specific for a Chlamydia-specific T cell Ag CrpA. T cells from the retrogenic mice were transferred into naive recipient animals to increase the frequency of Chlamydia-specific T cells to a level at which they could be tracked during primary infection. We observed that the Chlamydia-specific retrogenic T cells proliferated in lymph nodes draining the genital tract in response to genital infection with C. trachomatis. Furthermore, we found that these cells acquired the ability to produce IFN-gamma and migrated into the genital mucosa of the infected mice.

Adoptive Transfer↗
PubMed1999

Evaluation of vaginal introital sampling as an alternative approach for the detection of genital Chlamydia trachomatis infection in women.

BACKGROUND: Genital Chlamydia trachomatis infections in women are traditionally detected by testing cervical and urethral samples. This sampling approach is not acceptable in some, e.g. screening situations. We evaluate an alternative approach, i.e. use of vaginal self-collected specimen for testing by polymerase chain reaction. METHODS: The sensitivity of self-collected vaginal (introital) samples to diagnose genital infections by Chlamydia trachomatis using Roche AMPLICOR CT/NG PCR was compared with the cervical- and first-voided urine samples from women consulting with- (Group 1; n=123) and without (Group 0; n=160) genital symptoms. Women were interviewed regarding genital hygiene. Genital symptoms and signs were noted. RESULTS: C. trachomatis DNA was detected in 13.0% of women from Group 1 and in 5.0% of women from Group 0, i.e. in urine of 6.5% vs. 1.9%, in the cervical swab in 9.8% vs. 5.0% and in vaginal swab in 11.4% vs. 3.8% of women, respectively. The vaginal sample was the most sensitive specimen for detecting C. trachomatis in the Group 1 women. It had sensitivity of 87.5% vs. 75% for cervical- and 50% for urine specimens. In Group 0, the cervical sample was 100% sensitive, while the vaginal introital sample and urine had a sensitivity of 75% and 37.5%, respectively. C. trachomatis was less often detected in urine of women who routinely practised genital washing. CONCLUSIONS: Vaginal sampling performed by the woman herself is a sensitive approach and might serve as an important stimulus for screening for C. trachomatis infections in young women at risk.

Adolescent↗
PubMedDate not supplied

Prevalence of human papilloma virus genital infections in sexually transmitted diseases clinic attendees in Ibadan.

All patients, who presented at the Sexually Transmitted Disease clinic of the University College Hospital, Ibadan, between the period of August 1996 and January 1998 were included in this study. They were examined for genital infections in order to determine the prevalence rate of Human papilloma virus genital infection (genital warts) among them. Out of the 1,373 patients seen in the clinic during the period, 861 (62.71%) had STD while the remaining 512 (37.29%) had other conditions. Out of these 861 cases, 69 (8.01%) had HPV genital infection, while the remaining 792 (91.9%) had other STDS. Of these 69 cases of genital warts, 35 (50.7%) were males while 34 (49.3%) were females. Their ages ranged between 17 and 74 years, with the peak incidence in the 20-29 years age group. 32 (46.4%) had concurrent genital infections with non-gonococcal urethritis and cervicitis 9(13%) constituting the most common type. The highest incidence (36.2%) of this condition was found among petty traders while the lowest was found among the business executives and applicants. In 67 (97%) of these patients, the nature of sexual intercourse was vaginal, while in 1 (1.5%) it was oral and another 1 (1.5%) both vaginal and oral. 26 (37.7%) of the patients had just one sexual partner, while 7 (8.1%) had 2 or more. Only 2 (2.9%) admitted to have had any sexual contact with commercial sex workers. The sites of warts in males include the shaft of the penis, the glans penis, perineum and intrameatum. In females, warts were found in the vulva, vagina, cervix, perineum and perianal regions. 42 (60.9%) of these patients were placed on 20% podophyllin on tincture of benzoin, 17 (24.6%) on cryotherapy and 1 (1.5%) on both. They all did well on the different treatment regimens except for 1 (1.5%) that had to change from podophyllin to cryotherapy when there was no reduction in size. 11 (15.9%) were however lost to follow up.

Adolescent↗
PubMed2002

Case study: type-specific HSV serology and the correct diagnosis of first-episode genital herpes during pregnancy.

It is now known that the physical presentation of genital herpes simplex (HSV) infection can be misleading in making the diagnosis of genital herpes. An incorrect diagnosis can be particularly damaging in pregnancy where it may result in extended exposure of the fetus to antiviral agents, an inappropriate route and timing of delivery and a significant increase in fetal exposure to HSV during labour and delivery. Case 1 describes a 32-year-old woman at 30 weeks in her first pregnancy who had the appearance and clinical course typically ascribed to primary genital HSV infection. In contrast, Case 2, a 24-year-old woman at 34 weeks' gestation, had the physical appearance of a recurrent episode. Type-specific serological testing revealed that what Case 1 was actually experiencing was the first symptomatic reactivation of genital herpes, whereas Case 2 had a true primary genital HSV-2 infection that was accompanied by minimal symptoms. Had serology testing not been available, Case 1 would probably have delivered unnecessarily by Caesarean section, and Case 2 would have been managed as a recurrent infection and allowed to deliver vaginally with potentially disastrous results. These cases illustrate the usefulness of a type-specific serology in diagnosing genital herpes in pregnant women.

Adult↗
PubMed2001

Lower genital tract infections among pregnant women: a review.

OBJECTIVES: To determine the prevalence of lower genital tract infections, discuss briefly common maternal foetal complications associated with them and assess the usefulness of diagnostic algorithms in their management among pregnant women in the developing countries. DATA SOURCE: Articles published in English language since 1987 were looked through MEDLINE and OVID using key words supplemented by manual search in libraries except when full text of a subject was accessible via internet. STUDY SELECTION: Original and review articles addressing genital tract infections, associated complications and diagnostic evaluation in pregnant women were included. Emphasis was given to articles reported from developing countries. DATA EXTRACTION: A total of thirty five articles were retrieved and reviewed for information on the performance of diagnostic algorithms, prevalence rates and adverse maternal-foetal effects of lower genital tract infections in pregnancy. DATA SYNTHESIS: Lower genital tract infections are very common among apparently healthy looking pregnant women with an overall prevalence of 40-54%. Specific pathogens that were isolated from the vagina and/or cervix of asymptomatic pregnant women include: C. albicans (14-42%), T. vaginalis (11-20%), C. trachomatis (7-31%), N. gonorrhoea (0.5-14%) and group B streptococcus (4-25%). Untreated, genital tract infections in pregnant women may result in: foetal loss, preterm labour, preterm birth, premature rupture of the membranes, low birthweight, eye and lung damage in the newborn. Although the feasibility is good, the performance of clinical algorithms in the evaluation and management of lower genital tract infections is worse in pregnant women and better results are achieved for vaginal infections than cervical infections. CONCLUSION: Routine screening for clinically important pathogens should be considered during antenatal service. There is a need to develop simple, cheap and reliable laboratory tests and better clinical algorithms for the diagnosis of reproductive tract infections among pregnant women.

Abortion, Spontaneous↗
PubMed2002

Antivirals in the prevention of genital herpes.

Genital herpes remains one of the most common sexually transmitted infections. Despite best efforts to prevent sexually transmitted diseases in the era of AIDS, the incidence of genital herpes continues to rise, and evidence that herpes simplex virus type 2 is a significant cofactor in the transmission of HIV infection is mounting. Because of the common psychosocial consequences of genital herpes transmission, prevention modalities against transmission of genital herpes are urgently required from both personal and public health perspectives. Most discordant couples are either unaware of genital herpes in one partner or unaware of clinical activity of the virus during sexual exposure that results in transmission. Yet, the body of evidence available suggests that the antiviral drugs currently used in the treatment of genital herpes are effective in suppressing asymptomatic virus shedding and, thus, could play a future role in reducing transmission. The first study to examine that possibility has recently been made public.

Antiviral Agents↗
PubMed2002

[Genital leiomyomas of the male nipple: two cases].

BACKGROUND: Genital leiomyoma is a rare benign solitary skin tumor, not painful, developed from smooth muscle. Genital leiomyoma arising from the nipple is extremely rare, especially in males. CASES REPORT: A 47 year-old male had a 2 cm cutaneous plaque with nodules located on the right nipple. This plaque was circumscribed, erythematous, pruriginous and was not painful. The lesion had been noticed by the patient two years ago. A 37 year-old male showed a 1.5 cm cutaneous plaque located on the left nipple. The plaque was slightly erythematous, pruriginous, not painful and had been noticed by the patient 5 years earlier. Histology provided the diagnosis of genital leiomyoma in both cases. No surgical therapy was performed. DISCUSSION: Cutaneous leiomyomas are classified in 3 types regarding their origin: multiple or solitary piloleiomyoma, arising from arectores pilorum muscles, solitary genital leiomyoma, arising from the dartoic, vulvar, or mammillary muscles, and solitary angioleiomyoma, arising from the vein muscles. Clinically, genital leiomyoma is a 1 cm diameter solitary erythematous, firm nodule. According to many authors, genital leiomyoma is asymptomatic, but in the 2 patients, the lesions were pruriginous. Surgical excision is usually performed.

Adult↗