妊娠期生殖器疱疹和新生儿疱疹

生殖器疱疹是病毒性性传播疾病之一.孕妇妊娠期感染该病可能引起严重不良后果并可能导致新生儿疱疹.由于新生儿疱疹死亡率很高,因此,成为公众健康关注的焦点.妊娠期生殖器疱疹通常无典型临床表现,诊断比较困难,PCR技术因具有高敏感性,有可能代替病毒培养而成为单纯疱疹病毒感染的诊断标准.抗病毒抑制疗法能有效减少妊娠晚期的皮损复发和病毒排出,从而有效减少新生儿疱疹的发生.     

Genital herpes: Heisenberg revisited

In the confirmation of recurrences of genital herpes, patient defined disease reactivation and virological data hold the scientific high ground. The influence of the psyche on recurrence rates and perception of recurrences has been largely neglected and marginalised up to the present, possibly because research work in that area has been and continues to be of poor calibre. However, neglected psychological variables may render otherwise relevant clinical trials uninterpretable. Psychological aspects of counselling before testing for serum herpes simplex type 2 antibodies are also discussed.




     

Genital herpes. A pervasive psychosocial disorder

The reports of patients with genital herpes suggest that it is not an awesome physical disability; the more distressing consequences appear to be psychosocial. The symbolic meaning of the disease and its effects on self-esteem and body image have the greatest destructive impact. Patients move through a sequence of adaptational responses remarkably similar to those described for cancer. Of greatest importance is their growing sense of social isolation and their reluctance to initiate relationships with members of the opposite sex.     

Genital herpes: an increasing problem?

Over the past 10 years there has been a pronounced increase in the number of cases of genital herpes seen in sexually transmitted disease (STD) clinics in the United Kingdom. The reporting system, however, does not differentiate between primary and recurrent infections, and consequently any increase in the number of patients reattending clinics with recurrent genital herpes would falsely inflate the statistics. A study of cases of herpes seen in the department of genitourinary medicine of this hospital in the two years 1972 and 1982 is presented. It showed that the proportion of patients attending with recurrent herpes had increased from 18% in 1972 to 31% in 1982. As a result of this, the 68% increase between 1972 and 1982 in the total number of cases of herpes seen in the clinic overestimates the real increase in the size of the problem, which is closer to 40%, based upon cases of primary herpes only. Modifications to the national recording system are necessary to overcome the problems highlighted by this study. These modifications could include classifying each case of genital herpes as primary, recurrent, or recurrent but not previously recorded, which would provide a more accurate picture of the size of the problem of genital herpes in the population.     

Genital herpes and HSV transmission in HIV patients

There is a bidirectional relationship between HSV-2 and HIV-1, both at the cellular level, as well as regarding transmission and even progression of HIV-1 infection. There is clear evidence that anti-herpetic therapy reduces the plasma and mucosal HIV-1 viral load, as well as transmission. Serologic testing for HSV-2 in patients with an increased HIV-1 risk, coupled with a better understanding of the interaction between the viruses and appropriate anti-herpetic suppression therapy could both reduce the HIV-1 transmission rate and help the individual with an HIV infection.     

Genital herpes: general practitioners' knowledge and opinions

OBJECTIVES: To evaluate GPs' knowledge about genital herpes, especially recent information and to assess their attitudes towards serotesting. METHODS: GPs working in Coventry and the surrounding area were asked to complete an anonymous questionnaire. RESULTS: 70% of GPs (183 out of 261) responded to the questionnaire. Overall, 56% of the questions were answered correctly. 73% of participants knew that source partners in most transmission events are unaware of their infection and 77% were aware that patients shed the virus and transmit it even in the absence of clinical signs. As many as 43% did not know that the majority of infected individuals are unaware of their infection and 44% only knew that most transmission occurs during periods of asymptomatic shedding. Only 53% were aware that the proportion of genital herpes caused by HSV-1 is not decreasing. The majority (78%) supported the availability of its serotesting. CONCLUSIONS: This study demonstrates the lack of knowledge, among studied GPs, in some areas about genital herpes, especially recent information and indicates the need for more education about the condition. Most GPs in the study support the availability of genital herpes serotesting, although more studies need to be done before the wide availability of this testing.