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At least 919 records · Page 51Linked to original sources
PubMed2007

HIV-1 drug resistance in variants from the female genital tract and plasma.

BACKGROUND: Human immunodeficiency virus type 1 (HIV-1) drug-resistance mutations may arise in a fraction of viral variants, and these variants may differ between compartments, including the genital tract and blood. METHODS: We studied 14 women with detectable HIV-1 in both the genital tract and plasma despite antiretroviral treatment. We obtained HIV-1 RNA sequences from 280 unique viral variants and then determined the resistance genotype and the predicted phenotype (Virtual Phenotype; Virco BVBA) of each variant. RESULTS: Eight patients (57%) displayed mutations conferring high-level HIV-1 drug resistance. Although we observed differences in specific mutations among viral variants, 13 of the 14 women showed highly concordant HIV-1 genotypic and predicted phenotypic resistance patterns in the 2 compartments. In 1 patient, resistance mutations appeared only in plasma; all variants in her genital tract, which displayed a low viral load, were susceptible. CONCLUSIONS: These data suggest that, for the majority of women, determination of HIV-1 drug resistance in the plasma will approximate the drug-resistance pattern in the genital tract. Analysis of individual variants enabled us to identify minority species bearing distinctive linked mutations, which may serve as a source of novel resistance genotypes. These data are relevant to clinical management and the evolution of drug resistance.

Adult↗
PubMed1999

New therapies and prevention strategies for genital herpes.

Genital herpes is among the most prevalent sexually transmitted diseases. Optimal management of genital herpes includes accurate diagnosis, antiviral therapy, and counseling of patients about complications and transmission of herpes simplex virus (HSV). Antiviral therapy offers significant palliation, and the option of episodic or suppressive treatment should be offered to all patients with genital herpes. Valacyclovir and famciclovir are two newer antiviral agents that are effective and safe for the treatment of genital herpes. Prevention strategies for sexual and perinatal transmission of HSV have not been well defined. Availability of type-specific serological tests for HSV antibodies may assist in identifying persons at risk for acquiring or transmitting HSV infection. Further research is needed to define strategies to prevent the spread of this epidemic infection.

AIDS-Related Opportunistic Infections↗
PubMed1998

Long-term immunity and protection against herpes simplex virus type 2 in the murine female genital tract after mucosal but not systemic immunization.

The degree and duration of immunity against herpes simplex virus type 2 (HSV-2) infection of the female genital tract were assessed after intranasal (i.nl.) or intraperitoneal (i.p.) immunization with a recombinant adenovirus vector expressing HSV glycoprotein B (AdgB8). After intravaginal HSV-2 challenge, control mice rapidly developed disease and displayed high virus titers in vaginal washes. In contrast, virus titers decreased significantly and at similar rates in i.nl. and i.p. immunized mice and by day 7 were undetectable in vaginal wash samples. Assessment of genital pathology and survival showed that only i.nl. immunization provided long-term protection. Examination of antibody-secreting cells (ASCs) during the decline in vaginal virus titers revealed that gB-specific IgA ASCs were only observed in the genital tissues of i.nl. immunized mice. These results indicate that mucosal immunization provides a high and long-lasting level of immunity from sexually transmitted viral infections of the female genital tract.

Adenoviruses, Human↗
PubMedDate not supplied

Management of genital infection caused by human papillomavirus.

Recent studies of genital wart therapy have evaluated laser surgery, interferon, and 5-fluorouracil. On the basis of considerations of efficacy, cost, adverse effects, and recurrence rates, cryotherapy with liquid nitrogen remains the recommended therapy for most sexually transmitted warts. None of the treatment methods eradicates the papillomavirus, and genital wart recurrences are seen with each method. The influence of treatment of genital warts on the natural course and sequelae of genital papillomavirus infection is unknown.

Condylomata Acuminata↗
PubMed1995

Herpes simplex virus type 2 meningitis in the absence of genital lesions: improved recognition with use of the polymerase chain reaction.

Herpes simplex virus type 2 (HSV-2) is known to cause aseptic meningitis, which can be recurrent. The diagnosis of HSV-2 infection is suggested when meningitis occurs simultaneously with genital lesions but may be obscure if genital lesions are not present or are not appreciated. Viral culture of the CSF is sometimes positive, but it may also be negative, especially in cases of recurrent disease. We report three cases of HSV meningitis in young women who did not have a history of genital herpetic lesions and for whom genital lesions were not noted on presentation. With use of the polymerase chain reaction (PCR), HSV DNA was detected in CSF from all three patients. The diagnosis of HSV meningitis was further confirmed by a positive culture of CSF in one patient's case and by demonstration of intrathecal synthesis of HSV antibodies in a second patient's case. The use of PCR can improve the recognition of HSV meningitis in adults presenting with aseptic meningitis, even in the absence of herpetic lesions.

Adult↗
PubMedDate not supplied

Genital herpes: pathogenesis and chemotherapy in the guinea pig model.

Genital herpes is different from other common venereal diseases in that there is no cure. As yet the natural history of genital herpes is not well understood. There are many unanswered questions regarding the biology of the disease; the virulence of the virus strains, individual host responses, and means for prevention and control all require further investigation. The study of genital herpes has been greatly aided in recent years by the development of animal models. The clinical and pathologic features of acute and recurrent genital disease of guinea pigs inoculated with low doses of herpes simplex virus are similar to those seen in human infection. Therefore, questions not readily studied in human infection--such as latent infection in the nervous system, the natural history, prevention, and treatment of neonatal herpes, the effects of immunosuppression on herpes infection, and the efficacy and toxicity of antiviral drugs and vaccines--are amenable to study in the guinea pig model. The applications of this animal model and its relevance to human disease are herein reviewed.

Animals↗
PubMed1997

Genital asymmetry in men.

This study examined genital asymmetry in a large sample of men. The probands were 6544 non-delinquent men who were interviewed by the Kinsey Institute for Research in Sex, Gender and Reproduction from 1938 to 1963. The measures were four indicators of penile and scrotal asymmetry, along with self-reported handedness, from Kinsey's interview protocol. Most men reported some degree of lateral asymmetry in their flaccid penis and in their testicles; less asymmetry was reported for their erect penis. The asymmetry typically occurred in the left direction, and this pattern occurred in both right- and nonright-handers. However, this 'leftward' pattern was significantly less pronounced in nonright-handers. The results are discussed in relation to previous findings of genital asymmetry in men, the possible relationship of genital asymmetry to functional cerebral asymmetry, and recent data suggesting genital asymmetry may predict patterns of cognitive performance and genital/sexual organ cancers.

Adult↗
PubMed2004

Complex malformations of the female genital tract. New types and revision of classification.

BACKGROUND: Complex malformations of the female genital tract are often incorrectly identified, treated and reported, probably due to not considering the malformation as a cause of the clinical symptoms and neither the embryological origin of the different elements of the genitourinary tract. METHODS: Complex malformations are studied and classified, and new types are presented. The new types of complex malformations presented are: (i) Cases of unilateral vaginal or cervico-vaginal atresia with renal agenesis and uterine duplication, with or without communication between hemiuteri; (ii) the unilateral Rokitansky syndrome; and (iii) the combination in the same patient of unilateral Rokitansky syndrome (Müllerian defect) on one side and blind vagina and ipsilateral renal agenesis syndrome (Wolffian defect) on the other side. RESULTS: A revised version of the clinical and embryological classification of genital malformations is presented and an associated diagram points out the origin of these malformations. CONCLUSIONS: These genital malformative anomalies reaffirm our hypothesis about the embryology of the human vagina as deriving from the Wolffian ducts and the Müllerian tubercle; and they show that gynecologists should be aware of the related symptoms and the embryology of the female genital tract in order to achieve a better comprehension of the malformations for their right correction or therapeutic approach.

Abnormalities, Multiple↗
PubMed1984

Secretory IgA antibody in cervicovaginal secretions from women with genital infection due to herpes simplex virus.

Sequential samples of cervicovaginal secretions from women with untreated first and recurrent episodes of genital infection due to herpes simplex virus type 2 (HSV-2) were assayed for IgA antibodies to HSV-2 by using fluorescent antibodies to human secretory piece (sIgA) and human IgA. Among women with first-episode genital herpes, sIgA antibody to HSV-2 was detected in 20 of 31 women from whom HSV was isolated from the cervix, compared with four of 13 women from whom it was not (P less than .05). Among women with first-episode genital herpes, the mean titer of sIgA antibody to HSV-2 peaked between days 9 and 16 of disease, whereas among women with recurrent genital HSV, the peak occurred at days 3-8 of disease. HSV-2 was not isolated from the cervix from any of 130 samples taken when titers of sIgA antibody to HSV-2 were greater than or equal to 1:2, compared with 98 of 259 samples taken when titers were less than or equal to 1:2 (P less than or equal to .01).

Adult↗
PubMed1989

Genital infections due to herpes simplex virus type 2 in male guinea pigs.

A small-animal model of genital herpes simplex virus (HSV) infection has not been available for investigating the pathogenesis of disease in males. Male Hartley guinea pigs were inoculated on the medial thigh with 10(5)-10(6) plaque-forming units of HSV type 2. Animals developed vesicular lesions in the genital area, including the penis. Transient urinary retention, hindlimb paralysis, and acute urethral shedding of HSV also occurred. During acute infection, virus was detected in neural and genital tissue homogenates, including the peripheral nerve, lumbosacral dorsal root ganglia (DRG), spinal cord, brain, vas deferens, epididymis, testes, seminal vesicle, and prostate. Recurrent disease developed in all animals. Persistent virus was detected in DRG but rarely in the vas deferens, seminal vesicle, epididymis, and testes. This model produces disease similar to that seen in men and should prove useful for studying the pathogenesis and immunology of male genital HSV type 2 infections.

Acute Disease↗
PubMed1996

DNA immunization against experimental genital herpes simplex virus infection.

A nucleic acid vaccine, expressing the gene encoding herpes simplex virus (HSV) type 2 glycoprotein D (gD2) under control of the cytomegalovirus immediate-early gene promoter, was used to immunize guinea pigs against genital HSV-2 infection. The vaccine elicited humoral immune responses comparable to those seen after HSV-2 infection. Immunized animals exhibited protection from primary genital HSV-2 disease with little or no development of vesicular skin lesions and significantly reduced HSV-2 replication in the genital tract. After recovery from primary infection, immunized guinea pigs experienced significantly fewer recurrences and had significantly less HSV-2 genomic DNA detected in the sacral dorsal root ganglia compared with control animals. Thus, immunization reduced the burden of latent infection resulting from intravaginal HSV-2 challenge, and a nucleic acid vaccine expressing the HSV-2 gD2 antigen protected guinea pigs against genital herpes, limiting primary infection and reducing the magnitude of latent infection and the frequency of recurrent disease.

Animals↗
PubMed2001

The importance of diagnosing genital herpes.

Genital herpes is the result of infection by herpes simplex virus type 2 (HSV-2) and, to a lesser extent, HSV-1. Recent years have seen a rise in the prevalence of genital HSV infection in both industrialized and developing countries. The main factors attributed to the spread of HSV infection include asymptomatic virus shedding, and under-recognition and under-diagnosis of the disease. At the level of the individual patient, genital herpes is associated with significant psychosocial morbidity and complications such as neonatal herpes, the result of transmission of HSV from mother to baby. HSV-2 infection is also implicated in the transmission and acquisition of human immunodeficiency virus (HIV). As genital HSV infection has substantial public health implications, increased awareness of the disease and its prevalence, together with better use of diagnostic tests, may be one step towards more effective management and infection control.

Herpes Genitalis↗
PubMed2005

Clonal history of papillomavirus-induced dysplasia in the female lower genital tract.

BACKGROUND: Dysplastic lesions of the vagina or the vulva often occur in women who have a previous history of cervical dysplasia. Most lesions in the female lower genital tract are induced by infections with high-risk oncogenic human papillomaviruses (HR-HPVs), including HPV16 and HPV18. HR-HPV genomes frequently integrate into host cell chromosomes at random sites. We analyzed viral integration sites in multiple metachronous lesions of the lower genital tract from women previously treated for HR-HPV-positive cervical dysplasia or cancer to determine whether the metachronous lesions emerged from a single common preexisting dysplastic cell clone or as consequence of independent HR-HPV infection events in the female lower genital tract. METHODS: From among 1500 patients with anogenital lesions, seven patients with high-grade vaginal or vulvar lesions and with a previous history of cervical disease (five with prior high-grade cervical dysplasia and two with a history of cervical cancer) were included in this study. Integration sites of HPV16 or HPV18 in vaginal or vulvar lesions were mapped by an adaptor ligation polymerase chain reaction (PCR) method. The sequence information was used to design an integrate-specific PCR assay that was applied to DNA extracted from archival paraffin-embedded material derived from biopsy samples of cervical lesions. RESULTS: Identical HPV DNA integration loci were found in vaginal or vulvar and cervical samples of all lesions available for four of the five patients with a prior history of high-grade cervical dysplasia and for both patients with a history of cervical cancer. CONCLUSIONS: These data indicate that high-grade dysplastic lesions in the female lower genital tract may emerge primarily as monoclonal lesions from a transformed cell population derived from the uterine cervix.

Adult↗
PubMed1996

Porcine SRY gene locus and genital ridge expression.

Porcine SRY gene locus was cloned through use of a strategy of anchored polymerase chain reaction (PCR) amplification from a male pig genomic DNA size-selected library constructed in a plasmid vector as well as 3' reverse transcription (RT)-PCR amplification of porcine genital ridge SRY transcripts. In total, 1664 bp of genomic DNA and 106 bp of 3' cDNA are presented. The open reading frame of porcine SRY consists of 624 bp representing 208 amino acids (aa) with a centrally located HMG box domain of 79 aa, an amino-terminal region of 59 aa, and a carboxy terminal of 70 aa. Structurally, porcine SRY resembles human and bovine SRY more closely than it does mouse Sry, and it lacks the carboxy-terminal activation domain seen in the mouse Sry molecule. Similar to human and bovine testicular SRY transcripts, the porcine SRY genital ridge transcript has a relatively short 3' untranslated region (UTR), in contrast to the extended UTR of the mouse genital ridge Sry transcript. The porcine SRY gene is expressed within the cells of the genital ridge of the developing male pig embryo between Days 21 and 26 (e21-e26) of gestation, during which time the primitive gonads are bipotential, but not on Day e31, by which time male testis determination is histologically evident.

Amino Acid Sequence↗
PubMed2001

Tampons as a self-administered collection method for the detection and quantification of genital HIV-1.

OBJECTIVE: To assess the detection and quantitation of HIV-1 from tampon eluents in comparison with cervicovaginal lavage (CVL) and plasma specimens from the same women. METHODS: Ninety-seven tampon, 105 CVL, and 104 plasma specimens from 105 HIV-1 seropositive women were analyzed using Version 3 of the Chiron bDNA assay, with sensitivity of 50 HIV-1 RNA copies/ml. Data analyses used McNemar's test, Wilcoxon signed rank test, and Mantel--Haenszel chi-squared and odds ratios with 95% confidence intervals to assess differences in proportions. RESULTS: In women for whom both plasma and genital specimens were available, HIV-1 was detected less frequently in genital specimens: [tampons (33/97, 34%) and CVL (48/104, 46%)] than plasma specimens (86/104, 83%) (P < 0.001 for both plasma versus tampon and for plasma versus CVL). However, the proportion of genital specimens with detectable virus did not differ significantly by collection method (P = 0.14). Among women with detectable virus using both collection methods (n = 23), viral load was similar for tampon eluents (median, 355 copies/ml; range, 52--120,898) and CVL specimens (median, 265 copies/ml; range, 61--35,637;P = 0.88). CONCLUSION: Tampon eluent specimens are slightly less sensitive than CVL specimens in the detection of genital HIV-1, although quantification of viral load, when detectable by both methods, was similar.

Adult↗
PubMed1995

Hand and genital sympathetic skin potentials in flaccid and erectile penile states in normal potent men and patients with premature ejaculation.

Sympathetic skin potentials were recorded from the hand and genital region in 14 normal potent men and 18 patients with premature ejaculations. With the penis flaccid the sympathetic skin potentials obtained did not differ significantly in both groups. However, when erection was induced by 50 mg. intracavernous papaverine injection, the genital sympathetic skin potentials were significantly suppressed in all but 3 normal men, while the hand potentials did not change. In subjects with premature ejaculation genital and hand sympathetic skin potentials were suppressed during erection as a generalized bodily reaction except in 1 patient. This phenomenon may indicate that the specific and regional suppression of genital sympathetic activity during erection could not be properly adjusted in patients with premature ejaculation.

Action Potentials↗
PubMed2001

Genital herpes in pregnant and nonpregnant women.

The incidence of genital herpes is increasing. Proper diagnosis and management is crucial in pregnant women because transmission to neonates can be deadly. The diagnosis and management of potential genital herpes obstetric complications can decrease transmission rates to neonates. Standards of care have recently changed regarding the clinical presentation of genital herpes: Many cases of genital herpes are asymptomatic. This article discusses management and treatment options in pregnant and nonpregnant women.

Centers for Disease Control and Prevention, U.S.↗
PubMed1992

The relationship of hydrogen peroxide-producing lactobacilli to bacterial vaginosis and genital microflora in pregnant women.

Lactobacilli provide an important microbial defense against genital colonization by pathogens. The role of hydrogen peroxide (H2O2) in the control of genital microflora was explored in a cross-sectional study of 275 women in the second trimester of pregnancy. Vaginal cultures were obtained for detection of H2O2-positive and H2O2-negative lactobacilli and other members of the genital microflora. Compared with women with H2O2-negative lactobacilli, women colonized by H2O2-positive lactobacilli were less likely to have bacterial vaginosis, symptomatic candidiasis, and vaginal colonization by Gardnerella vaginalis, Bacteroides, Peptostreptococcus, Mycoplasma hominis, Ureaplasma urealyticum, and viridans streptococci (P less than or equal to .05 for each comparison). In addition to the above organisms, women without vaginal lactobacilli were more likely than those women with H2O2-positive lactobacilli to have Chlamydia trachomatis, and less likely to be colonized by Enterococcus or coagulase-negative staphylococci (P less than .05 for each comparison). Vaginal colonization by group B streptococci or Escherichia coli was not related to the presence of H2O2-positive lactobacilli. These data suggest that the presence of H2O2-positive lactobacilli in the vagina is inversely correlated with infection by some genital pathogens in pregnant women.

Bacteria↗