Herpes : the journal of the IHMF最新文献

{"title":"Clinical Gallery. Manifestations of neonatal herpes and herpetic cervicitis.","authors":"André J Nahmias","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":83725,"journal":{"name":"Herpes : the journal of the IHMF","volume":"11 2","pages":"54-5"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25141807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Educational interventions and the prevention of herpes simplex virus transmission.","authors":"Raj Patel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Herpes simplex virus (HSV) is a common sexually transmitted infection (STI) worldwide, and the prevalence of this infection has increased significantly over the last two decades in many developed countries. The objective of educational interventions is to limit HSV transmission. There are few data on the effectiveness of such interventions but much of the published data, from the UK and the USA, suggest that they may be beneficial. In the USA, Project RESPECT demonstrated that counselling those at risk may reduce HSV acquisition, a conclusion supported by data from candidate HSV vaccine trials and educational initiatives for other STIs. Patients should be counselled on the natural history of genital HSV infection, variability in recurrence and strategies to limit transmission risk, using measures such as promoting condom use and limiting the number of sexual partners. Healthcare providers should give consistent, relevant information and know where patients can access further information. Serological testing may allow an opportunity to counsel patients about genital herpes. A significant barrier to effective implementation of educational interventions is the low level of accurate knowledge among the general public regarding genital herpes, especially about asymptomatic shedding, transmission, risk reduction strategies and therapeutic options. Often there is no link between knowledge and behaviour, with success potentially depending on the character of the patients. Due to the lack of knowledge, mass education campaigns may be required, although targeted campaigns may provide a more cost-effective solution. These campaigns should target young adults who have the highest rate of HSV acquisition. Education should also be available to pregnant women, who are likely to be highly motivated to avoid acquisition from infected partners due to the possibility of neonatal herpes.</p>","PeriodicalId":83725,"journal":{"name":"Herpes : the journal of the IHMF","volume":"11 Suppl 3 ","pages":"155A-160A"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24642346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interrupting herpes simplex virus type 2 transmission: the role of condoms and microbicides.","authors":"Andria Langenberg","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Condoms act as mechanical barriers to genital infection. In vitro models demonstrate that condoms are almost impermeable to viruses. A small amount of virus may cross the condom, but the condom can still reduce the level of virus exposure by several orders of magnitude. However, in vivo factors, such as condom failure during intercourse, can potentially limit their effectiveness. The weight of available evidence suggests that consistent and correct use of the male condom protects against herpes simplex virus (HSV) infection, as well as other sexually transmitted infections. Female condoms should theoretically protect against HSV infection as they cover a large surface area of potentially infected or susceptible tissues, but research is needed to confirm this. The lack of acceptance, or lack of consistent use, of condoms is the biggest barrier to their effectiveness. There is a need for effective counselling of individuals whose sexual behaviour increases their risk of HSV acquisition, such as young adults. Pregnant women are likely to be receptive to counselling due to the risk of neonatal herpes. No commercially available microbicides specifically inhibit HSV, although many inactivate the virus. More potent and specific microbicides are in development, but may be more expensive than those currently available. Although the effectiveness of condom and microbicide use is not completely proven, there is sufficient evidence to support the promotion of their use by healthcare professionals as an important part of safe sex counselling.</p>","PeriodicalId":83725,"journal":{"name":"Herpes : the journal of the IHMF","volume":"11 Suppl 3 ","pages":"147A-154A"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24642345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention of herpes simplex virus type 2 transmission with antiviral therapy.","authors":"Lawrence Corey,&nbsp;Rhoda Ashley","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Worldwide, herpes simplex virus type 2 (HSV-2) infection is the biggest cause of genital ulcer disease, and is responsible for the majority of cases of genital herpes. The risk of transmitting genital herpes to a partner is one of the leading causes of psychological distress for those with the disease. Antiviral compounds available for the treatment of genital herpes are known to reduce clinical recurrence rates and HSV shedding. This understanding provided impetus for a randomized, placebo-controlled study to assess the ability to interrupt transmission of HSV using oral valaciclovir therapy (500 mg, once daily). The study enrolled 1484 immunocompetent, heterosexual, monogamous couples in stable relationships where both partners were aware of the source partner's infection and the source partner had symptomatic genital herpes. Valaciclovir reduced the risk of transmitting HSV-2 infection by 48%. Furthermore, valaciclovir reduced the risk of clinical disease in the susceptible partner by 75%. As a result, the International Herpes Management Forum (IHMF) now recommends that physicians offer suppressive valaciclovir therapy to immunocompetent individuals concerned about transmitting genital herpes to a heterosexual partner, and advises safer sex behaviour, including the use of condoms, to prevent genital herpes transmission.</p>","PeriodicalId":83725,"journal":{"name":"Herpes : the journal of the IHMF","volume":"11 Suppl 3 ","pages":"170A-174A"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24642875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventing herpes simplex virus transmission to the neonate.","authors":"Zane Brown","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Neonatal herpes simplex virus (HSV) infection can have severe consequences. Skin, eye and mouth infection is rarely fatal, but disseminated or central nervous system (CNS) disease has a mortality rate of 80% in the absence of therapy, and most surviving infants have neurological sequelae. Aciclovir therapy can improve the outcome of neonatal herpes, but is often delayed due to the early non-specific symptoms of the disease. Even with early therapy, some infants develop disseminated infection or CNS complications. The virus is usually vertically transmitted to the neonate from an infected mother during delivery. As such, the optimal strategy for reducing the morbidity of neonatal herpes is to prevent the neonate from acquiring HSV infection at delivery. The highest risk of neonatal infection occurs when the mother sheds HSV at labour, which happens more frequently in women who acquire genital herpes in the third trimester. Therefore, one approach for reducing maternal-fetal transmissions is to prevent HSV acquisition in late pregnancy. Definitive classification of genital HSV infection during pregnancy as either primary, non-primary first episode or recurrent can be accomplished only when clinical evaluation is accompanied by laboratory testing, including the use of gG-specific serological tests. The serological status of the mother's sexual partner should be considered when determining her risk of infection. The use of weekly viral cultures in pregnant women with confirmed genital herpes is not warranted, as they do not predict an infant's risk of acquisition of HSV at delivery and are not cost-effective. High-risk susceptible women should be counselled about abstinence and reducing oral-genital contact near term. Observational studies suggest that caesarean section can reduce transmission of neonatal herpes, and is warranted for women who shed HSV at delivery, although different countries vary in their approach to caesarean sections and so universal recommendations are not available. If maternal antiviral therapy is considered, the potential benefits of treatment should be balanced against potential adverse outcomes for mother and fetus, although it may be warranted when the mother has severe or life-threatening disease. Studies on the use of antiviral prophylaxis in women with known recurrences at labour are ongoing. Invasive fetal monitoring can increase the risk of neonatal herpes, and should only be used in HSV-2 seropositive women for defined obstetrical indications.</p>","PeriodicalId":83725,"journal":{"name":"Herpes : the journal of the IHMF","volume":"11 Suppl 3 ","pages":"175A-186A"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24642876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert commentary: genital herpes transmission.","authors":"Peter Leone","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":83725,"journal":{"name":"Herpes : the journal of the IHMF","volume":"11 2","pages":"48-9"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25135930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of genital herpes during pregnancy: the French experience.","authors":"Suzanne Braig,&nbsp;Bruno Chanzy","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The prevalence and incidence of genital herpes are increasing worldwide. Conversely, the incidence of neonatal herpes shows global discrepancies: very higher numbers of cases are reported in parts of the USA, whereas rates remain low across much of Europe. As illustrated by the French experiences reported here, regionally appropriate management strategies for genital herpes during pregnancy do not alone account for differences in neonatal herpes rates.</p>","PeriodicalId":83725,"journal":{"name":"Herpes : the journal of the IHMF","volume":"11 2","pages":"45-7"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25135929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical trials of prophylactic and therapeutic herpes simplex virus vaccines.","authors":"Lawrence R Stanberry","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Herpes simplex virus type 2 (HSV-2) is a suitable target for a vaccine, despite available antiviral therapies, because the virus causes lifelong infection and significant medical and psychosocial morbidity. A vaccine has the potential to reduce HSV acquisition, disease severity and the number of cases of neonatal herpes. It could also reduce transmission of HIV, which is epidemiologically linked to HSV. Prophylactic vaccines for HSV-2 must give broad and durable immunity across all mucosal surfaces to be effective. This is a significant challenge, as the major determinants of effective immunity have not yet been identified. Even if full protection cannot be achieved, vaccines would still be useful if they could increase the threshold of infection, or prevent clinical disease. However, it is possible that a vaccine could reduce symptomatic disease, but not eliminate asymptomatic shedding, which could inadvertently increase transmission from individuals who believe they are not infectious. Investigated prophylactic vaccines for HSV-2, including subunit vaccines encoding HSV glycoproteins packaged with adjuvants, have shown some benefits. The Chiron gD2gB2-MF59 vaccine gave transient protection of less than 6 months. The GlaxoSmithKline gD2-alum MPL vaccine conferred a 73-74% reduction in acquisition of symptomatic HSV-2 disease and a 38-42% reduction in the acquisition of HSV-2 infection in HSV-seronegative women, but gave no protection in men or HSV-1 seropositive women. Therapeutic vaccines aim to prevent HSV recurrences or minimise disease severity and duration, thereby reducing transmission. Research indicates that to be effective, therapeutic vaccines need to stimulate strong cell-mediated immune responses. Vaccines have induced HSV-specific antibody responses alone but have failed to protect recipients from recurrences. Further research is needed to define determinants of immunity to HSV-2, including identifying HSV-2 antigens, in order to design more effective vaccines.</p>","PeriodicalId":83725,"journal":{"name":"Herpes : the journal of the IHMF","volume":"11 Suppl 3 ","pages":"161A-169A"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24642874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modelling the genital herpes epidemic.","authors":"Sally Blower","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Mathematical models are useful tools for summarizing and testing current knowledge about a system and predicting trends. Models have shown that medical and behavioural changes can substantially affect herpes simplex virus type 2 (HSV-2) transmission and can be used to develop rational epidemic control policies. The spread of the genital herpes epidemic and the potential impact of HSV antiviral treatment in the immunocompetent population have been addressed by four models. HSV drug resistance to antiviral drugs is predicted to be minimal. Assuming that drug-resistant mutants are attenuated both in infectivity and reactivity, one model predicted that even after 25 years, only 5 in 10,000 individuals will shed drug-resistant virus, even if rates of usage of antivirals are high. The models show that increased usage of episodic antiviral therapy will be beneficial in reducing the herpes epidemic. Results also show that the transmission rate can be reduced by preventing infection (safer sex), reduced time spent in non-monogamous relationships or the advent of effective therapeutic HSV vaccines. One model has indicated that suppressive therapy will have only a minimal impact on HSV prevalence; however, the results of this modelling study are limited as it assumed that suppressive therapy would only be given to incident infections. More recent research using a model based upon virological core groups (and treating both incident and prevalent infections) shows that suppressive therapy could cause a substantial reduction in HSV-2 incidence rates. Current modelling is also focused on modelling how HSV-2 antiviral treatment will impact the HIV epidemic.</p>","PeriodicalId":83725,"journal":{"name":"Herpes : the journal of the IHMF","volume":"11 Suppl 3 ","pages":"138A-146A"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24642344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal HSV infection Part II: Obstetric considerations -- a tale of hospitals in two cities (Seattle and Atlanta, USA).","authors":"Andre J Nahmias","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article presents various aspects of maternal genital and neonatal herpes simplex virus (HSV)-1 and HSV-2 infection for hospitals in two cities in the USA - Seattle and Atlanta - to serve as models for the different subpopulations within developed and developing countries. Reasons are given for the disparity between the increasing rates of genital HSV-1 and HSV-2 infections observed in several areas of the world and the general low rates of newborn herpes noted in sites other than some hospitals in Seattle, Atlanta, Cincinnati and Helsinki. A key reason for the disparity appears to be the continuing difficulty in diagnosing maternal genital herpes and neonatal herpes. Contributing factors include the variability in different communities in sexual behaviour patterns, and in the rates of maternal genital HSV infection, caesarean sections and postmortem procedures. Unresolved challenges in the obstetric management of genital herpes aimed at preventing neonatal herpes are also presented.</p>","PeriodicalId":83725,"journal":{"name":"Herpes : the journal of the IHMF","volume":"11 2","pages":"41-4"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25135928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}