ARTICLE TOOLS1-
The purpose of this descriptive study was to examine
gender differences in the disease experience of persons who have genital
herpes. Participants were 60 volunteers (34 females, 26 males) with
recurrent genital herpes. Their average age was 31.7 years and the
average length of time since diagnosis was 5.3 years. They completed
questionnaires that included items about disease characteristics,
disease stressors, and disease impact. The majority of reported
stressors related to the consequences of the disease. A wide diversity
of stressors were described, and results gave evidence of gender
similarities in the disease experience. Exceptions were that women
reported experiencing more worry with regard to negative effects on
future and present health, disruption of daily activity, and disease
symptoms. Men reported that recurrences last longer. Both disease
symptoms and the presence of an intimate relationship were related to
the perceived disease impact. Implications for sensitive interventions
are discussed.Keywords:
- Recurrent
genital herpes; - congenital abnormalities;
- case-control
design
Abstract
Objective.
To study the possible links between recurrent symptomatic genital
herpes during pregnancy and risk for congenital abnormalities (CAs). Method.
The occurrence of prospectively and medically-recorded recurrent
genital herpes during pregnancy in the mothers of cases with different
congenital abnormalities and in the mothers of matched controls without
CAs was compared in the population-based large data set of the Hungarian
Case-Control Surveillance System of Congenital Abnormalities. Results.
Of 22,843 cases with CAs, 59 (0.26%) were born to mothers with
recurrent symptomatic genital herpes, while of 38,151 control newborns
without CAs, 86 (0.23%) were born to mothers with recurrent genital
herpes during the study pregnancy (adjusted OR: 1.1, 95% CI: 0.8–1.6).
Pregnant women with clinically recognised recurrent genital herpes in
the first trimester of pregnancy are not linked with a higher risk for
any CAs. Conclusion. Recurrent genital herpes during pregnancy
does not associate with a higher risk of CAs.Clinical features of genital
herpes, perceived causes, stress symptoms, treatments, and psychosocial
factors in 70 young adults as compared to normative data for
non-patient controls are described. The clinical features of the disease
were congruent with those of other groups studied. Stress was viewed as
the major cause of recurrence, headaches the major stress symptom, and
acyclovir (an antiviral drug), was the major treatment. Statistically
significant differences were found between scores obtained from the
sample of young adults with genital herpes on three of four standardized
psychological instruments when compared with normative data for non
patient controls. Young adults with genital herpes had a lower self
concept, more psychopathology, a greater frequency of daily hassles, and
less intensity of uplifts. No differences were found, however, between
the two groups in scores on depression.
Keywords:
- antenatal;
- attitudes;
- herpes;
- knowledge
Abstract
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.
Human papillomavirus and
Herpes simplex virus are the most common genital viral infections
encountered in clinical practice worldwide. We reviewed the literature
focusing on new and experimental treatment modalities for both
conditions, based on to the evidence-based data available. The
modalities evaluated include topical agents such as immune response
modifiers (imiquimod, resiquimod, and interferon), antivirals
(penciclovir, cidofovir, and foscarnet), sinecatechins, microbiocidals
(SPL7013 gel, and PRO 2000 gel), along with experimental
(oligodeoxynucleotides), immunoprophylactic, and immunotherapeutic
vaccines.
Many patients with genital
herpes will have recurrences, and for some the recurrences may be
frequent and severe and accompanied by profound psychosexual morbidity.
Some patients can successfully be managed with
intermittent courses of oral or topical acyclovir to be used with each
recurrence. However this treatment is of limited efficacy, and longterm
acyclovir suppression may be useful. This form of treatment is highly
successful for patients with frequent recurrences most of whom will have
no episodes during treatment.
The optimum
dosage for commencing acyclovir suppression is 200 mg four times daily,
and the dose may subsequently be reduced. Some patients can
successfully be managed on 400 mg twice daily. Treatment should be
stopped after 1–2 years as there is some evidence of a decrease in the
frequency of recurrences. Selecting patients for suppression should be
based on the frequency, severity, and duration of recurrences as well as
any associated emotional problems. Some patients may recur on
suppression, usually due to inadequate dosage.
Many patients with first episode genital herpes
experience emotional and psychological problems. However these problems
only continue if patients have recurrences and continued psychological
support is essential. Long-term acyclovir suppression improves
psychological wellbeing but is not a substitute for information,
counselling, and expert psychosexual support.This descriptive study was
designed to examine the disease experience of persons who have genital
herpes by identifying the nature and frequency of disease-related
stressors and coping responses associated with these stressors.
Participants were 34 women and 26 men who were on average 5.3 years
postdiagnosis, and experienced a mean of 6.4 recurrences per year.
Respondents reported a wide range of disease-related
stressors (M = 7). The category of stressors identified most
often was related to disease consequences (73.9%), and included
difficulty with intimate relationships, difficulty with relationships
involving family and friends, fear of transmission through both sexual
activity and casual contact, and concern about negative effects on
health. Respondents tended to use active coping, planning, and
acceptance more often than passive strategies such as denial.
Implications for clinical assessment and intervention are discussed.In recent years, it has become
increasingly clear that genital ulcers from herpes simplex virus (HSV)
are associated with HIV acquisition. In light of this evolving synergy
in transmission and the availability of effective antiviral therapy,
proper diagnosis and management of HSV becomes increasingly important.
Unfortunately, conventional HSV management is founded on several popular
misconceptions. Herein, we hope to dispel these common misconceptions
and expand the current model of herpetic reactivation. By doing so, we
aimed to unveil potential pitfalls in current herpetic management.Genital herpes is a common,
distressing infection whose incidence has been underestimated. Recent
serological surveys, employing type-specific antibody assays, show a
rising prevalence of previous herpes simplex virus (HSV) type 2
infections in post-adolescent populations in developed countries; many
of these infections have been asymptomatic. In some geographical
locations, HSV-1 infections are a common cause of first episodes. They
may occur in stable, monogamous relationships and are less likely to
recur than genital infections caused by HSV-2.
The clinical features of first episode genital herpes
show marked individual variation in severity; they tend to be more
severe in women than in men. Local and distant complications are common
in immunocompetent individuals and may be life-threatening in those who
are immunocompromised. The psychological and social consequences which
result from the life-long infection and its risks of transmission to new
sexual partners often prove more disabling to affected individuals than
do the milder physical symptoms associated with recurrent episodes.
Counselling, support, and patient education are
essential components of management. Acyclovir is clearly established as
the first choice therapy in both first and recurrent episodes genital
herpes. This drug has potent antiviral effect and provides significant
clinical benefit first episodes. Systemic therapy for initial episodes
does not prevent either the establishment of latency or the development
of future recurrences even when used in high or prolonged dosage.
Episodic treatment of recurrences, with either oral or topical
acyclovir, requires early patient initiation of therapy to provide
significant clinical benefit.
