Herpes Genitalis Ebook
Diagnosis of genital herpes requires the characteristic history and physical appearance of lesions plus the selective use of immunofluorescent assay C. Acyclovir (Zovirax) is the drug of choice for the treatment and suppression of genital herpes. It is usually well tolerated, but nausea, vomiting, rash, or headache occur rarely. Topical acyclovir is not effective. Serious or life-threatening HSV infections require intravenous acyclovir.
A diverse range of psychological symptomatology is associated with STDs, in which maladaptive or pathological responses to infection (or fear of infection) may occur. Most of the studies that evaluated the psychological effects of having a STD have been carried out in patients attending genitourinary clinics, and focused on genital herpes, a common, recurrent, and painful infection. The response to diagnosis of a STD can include depression, anxiety, anger, social withdrawal, feelings of loneliness, and sexual dysfunction. (1Z, 8) Also, high rates of hypochondriasis and veneroneurosis (a strong but unfounded conviction of having a venereal disease) are found in STD clinics and are frequently associated with psychiatric morbidity. Psychological interventions can effectively reduce the distress associated with STDs, contribute to the control of the infection, increase compliance with medication regimes, and reduce somatic symptoms misattributed to a STD.
Most DNA viruses of animals contain double stranded DNA. For example, Simian Virus 40 (SV40) is a smallish, spherical virus that causes cancer in monkeys by inserting its DNA into the host chromosome. Another double stranded DNA virus, Herpes virus, is spherical with an extra outer envelope of material stolen from the nuclear membrane of the host cell (Fig. 17.14). The internal nucleic acid with its protein shell is referred to as the nucleocapsid. This family includes viruses that cause cold sores and genital herpes as well as chickenpox and infectious mononucleosis. The herpes viruses are difficult to cure completely as they are capable of remaining in a latent state where they cause no damage but merely replicate in step with the host cell. Active infections may then break out again after a long period of quiescence, due to stress or other factors.
The following drugs are used primarily in the treatment of herpesviruses. Among these are herpes simplex virus-1 (HSV-1), which typically causes herpes labialis (cold sores) or herpes esophagitis herpes simplex virus-2 (HSV-2), which is responsible for most cases of genital herpes varicella zoster virus (VZV), which produces chickenpox and shingles Epstein-Barr virus (EBV), which is the major cause of infectious mononucleosis and cytomegalovirus (CMV), which can produce pneumonia, gastroenteritis, retinitis, encephalitis, and mononucleosis in immunocompromised individuals.
Genital herpes is caused by the herpes simplex virus type 1 or 2 (HSV-1, HSV-2), or human herpes virus 1 and 2 (HHV-1, HHV-2). Subunit HSV vaccines are based upon two envelope glycopro-teins, gB and gD which have been shown to be strongly immunogenic and protective in animal studies (Stanberry 1991). Four separate formulations have been evaluated to date, all derived from CHO expression systems. Three vaccines developed by Chiron contained truncated HSV-2 gD absorbed to alum, gD with a muramyl tripeptide adjuvant, and a bivalent vaccine composed of gD and gB with MF59 adjuvant. Although all these vaccines were immunogenic, the first was only modestly protective, the second caused unacceptable side-effects while the third failed to protect (Corey et al. 1999 Langenberg et al. 1995 Straus et al. 1994 Straus et al. 1997). The fourth vaccine (from GlaxoSmithKline) is also based on truncated HSV-2 gD and alum combined with the novel adjuvant 3-de-O-acylated monophosphoryl lipid A. This...
Avoidance of sexual intercourse during active symptoms and the use of condoms with a spermicide reduce but do not eliminate the chance of transmission. Spermicidal jellies and creams can inactivate herpes simplex viruses. There is no cure for genital herpes, although medications such as acyclovir and famciclovir Table 25.13 Genital Herpes Simplex The main features of genital herpes simplex are presented in table 25.13.
In all but a few cases, a primary infection with HSV resolves within a few weeks and without any long-term consequences. However, the ability of HSV to establish itself in a latent state and to reactivate periodically during the lifetime of the host and cause recurrent lesions is a significant challenge to the development of therapeutic strategies against HSV. There has long been evidence that acute and chronic psychosocial stress can trigger recurrences of both oral and genital infections. Support for this hypothesis has been provided by studies that have demonstrated that emotional stress is associated with the development of recurrent HSV infections (Katcher et al., 1973 Young et al., 1976 Friedmann et al., 1977 Bierman, 1983 Schmidt et al., 1985 Glaser et al., 1987) and that personality may play a role in the frequency of these recurrences (Stout and Bloom, 1986). The severity of HSV infection has also been correlated with psychosocial factors (Silver et al., 1986 Longo and Clum,...
Although HSV-1 is generally considered to be associated with orofacial infections and HSV-2 with genital infections, both serotypes can affect any region of the body. Both HSV-1 and HSV-2 cause a wide variety of clinical syndromes in humans (e.g., herpes labialis, gingivostomatitis, keratocon-junctivitis, herpes genitalis) with the basic lesion being an intraepithelial vesicle from which progeny virus is shed. It is during the primary infection that virus particles first enter sensory nerve endings that innervate the lesion and are then transported to the local sensory ganglia (e.g., trigemi-nal ganglia for orofacial infections dorsal root ganglia for genital infections). Once the virus reaches these sensory ganglia, the virus may either produce an acute infection resulting in subsequent neuronal cell death or enter a dormant or latent phase (reviewed in Jones, 2003). During this latent state, there is restricted viral gene expression that is limited to the production of what are...
The causative agent of genital herpes is usually herpes simplex virus type 2 (HSV-2), a medium-sized, enveloped, double-stranded DNA virus. On electron micrographs it looks like herpes simplex virus type 1 (HSV-1), the cause of cold sores ( fever blisters, herpes simplex labialis), and the genomes of the two viruses are about 50 homologous. This disease, like cold sores, often recurs, because the virus becomes latent. Either virus can infect the mouth and the genitalia, but the type 2 virus causes more severe genital lesions whose frequency of recurrence is greater than that of the type 1 virus. During initial infection and for as long as 1 month after, the virus is found in genital secretions. During recurrence, the virus is usually present in large numbers for less than a week. HSV-1, p. 607
Viral STDs are at least as common as bacterial STDs, but so far they are incurable. Genital herpes simplex is widespread and like most other STDs can be transmitted in the absence of symptoms. Human papillomaviruses cause genital warts some play an important role in cancer of the cervix and probably cancers of the vagina, penis, and rectum. HIV disease generally ends in AIDS despite advances in treatment, millions around the world die of the disease every year because they do not have access to therapy, and as yet there is no effective vaccine. Why should a person be concerned about genital herpes simplex is it not just a cold sore on the genitals Explain.
There are very few effective antiviral drugs because it is difficult to formulate a drug that eradicates the virus from the cells without also killing the cells themselves. The currently available antiviral therapeutics are mostly effective in treating the herpes virus, of which there are 4 main types. The first is the herpes simplex virus (the cause of cold sores), genital herpes, and herpes simplex keratitis. The second is the varicella zoster virus, the virus causing chicken pox and shingles. The third variety is the Epstein-Barr virus, which causes mononucleosis. Last, is the cytomegalovirus, a common infectious agent in AIDS patients.