Genital herpes simplex infection in women

Sexually transmitted diseases: epidemiological and clinical aspects in adults

Sexually transmitted diseases (STDs) are the first 10 causes of unpleased diseases in young adult women in the world. The concept of STDs includes a series of syndromes caused by pathogens that can be acquired by sexual intercourse or sexual activity.Adolescents and young adults are responsible for only 25% of the sexually active population and they represent almost 50% of all newly acquired STDs.In this way, we evaluated the epidemiological and clinical aspects of most relevant pathogens as Neisseria gonorrhoeae, Chlamydia trachomatis, Treponema pallidum, Haemophilus Ducreyi, Trichomonas vaginalis, herpes simplex virus, human papilloma virus (HPV) with the exception of hepatitis, and HIV infections for which we suggest specific guidelines.To attain this objective, we analyzed the results of epidemiological and clinical aspects of STDs through a review of the literature using MEDLINE and PubMed database for original articles published using the terms "sexual transmitted disease, epidemiology, diagnosis and therapy" from 2005 to 2014.

Global epidemiology of sexually transmitted diseases

Sexually transmitted diseases (STDs) are among the first ten causes of unpleasant diseases in young adult males in developing countries and the second major cause of unpleasant diseases in young adult women. Adolescents and young adults (15-24 years old) make up only 25% of the sexually active population, but represent almost 50% of all new acquired STDs. In general, STDs are epidemics and present an enormous health and economic consequences. An adequate screening for STDs should be done on a routine basis in every part of the world. Many STDs are asymptomatic and therefore can difficult to control. The purpose of reporting of STDs is to ensure that persons who are infected will be quickly diagnosed and appropriately treated to control the spread of infection and also so that partners are notified, tested and appropriately treated. It is estimated that reported cases of STDs represent only 50%-80% of reportable STD infections in the United States, reflecting limited screening and low disease reporting. High-risk sexual behavior is a highly contributive factor of this process as it often leads to teenage pregnancies and HIV/AIDS. One possible explanation for this behavior is that people do not have enough information about the transmission of STDs or ignore the precautions required for safe sex. Approximately 60% of new HIV infections worldwide occur in young people. The frequency of high-risk behaviors among youths may also be influenced by opportunity to engage in them, particularly the amount of time that they are unsupervised by adults. However, in diagnosing and treating these patients, we can effectively prevent the spread of HIV/AIDS. Individuals infected with STDs are 5-10 times more likely than uninfected individuals to acquire or transmit HIV through sexual contact. The breaking of the genital tract lining or skin creates a portal of entry for HIV and, hence, HIV-infected individuals with other STDs are more likely to shed HIV in their genital secretions. To date, the condom is the most effective method available for males for protection against STDs. It is important to control STDs, and prevention can be the key of this process. Prevention can be achieved through education of the population, identification of symptomatic and asymptomatic people, and effective diagnosis and treatment of these patients and their partners.

Divergence of reiterated sequences in a series of genital isolates of herpes simplex virus type 1 from individual patients

Both serotypes of herpes simplex virus (HSV), HSV-1 and HSV-2, are aetiological agents of genital herpes, although genital herpes caused by HSV-1 recurs less frequently. The HSV-1 genome contains a number of short, tandemly repeated sequences, and some reiterated sequences can serve as sensitive markers for the differentiation of HSV-1 strains. In the present study, variation in reiterations (assumed to be due to different copy numbers of tandemly repeated sequences) was examined in HSV-1 isolates from genital lesions from the same individual. Six sets (three primary-recurrence sets and three multiple-recurrence sets) of HSV-1 isolates were analysed: the primary-recurrence set consisted of two isolates (one isolated at a primary episode and the other at a recurrent episode) from the same individual; the multiple-recurrence set consisted of plural isolates from different episodes of recurrence in the same individual. Variations in length of the major DNA fragment, containing reiteration I (within the a sequence) and/or reiteration IV (within introns of genes US1 and US12), were detected between isolates of each multiple-recurrence set, but not of the primary-recurrence set. Thus, HSV-1 isolates of multiple-recurrence sets are assumed to have diverged more widely within each set than those of primary-recurrence sets, probably because of more rounds of virus DNA replication. This divergence of reiterations seems to indicate a forward step in the division of HSV-1 from a common ancestor into different lineages.

Herpes simplex virus infection of the uterine cervix--relationship with a cervical factor?

OBJECTIVE

To determine the prevalence of genital herpes simplex virus (HSV) in women of reproductive age and to evaluate a potential relation of asymptomatic HSV shedding with a cervical factor.

DESIGN

Prospective study.

SETTING

Outpatient infertility clinic of a university hospital.

PATIENT(S)

Randomly chosen asymptomatic women (n = 1,262) with a median age of 30 years.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

Prevalence of cervical HSV, cervical index parameters, and other variables of CM quality, including CM penetrability in vivo and in vitro.

RESULT(S)

The prevalence of HSV infection of the uterine cervix was 5.2% (identified with cell culture). There was a tendency toward increased viscosity of the CM in HSV-positive women, but no significant relation with the other variables of CM quality (amount, spinnbarkeit, ferning, cervical appearance, and cellularity of the CM), or with the summarized Insler score or the cervical index according to World Health Organization guidelines. Postcoital testing and the in vitro penetration test, using either partners' or donors' semen, showed that the penetrability of the CM did not differ significantly between women with and without cervical HSV shedding. Asymptomatic cervical HSV infection was not significantly associated with bacterial colonization of the lower genital tract, with leukocyte counts in cervical secretions, with the pH of the CM or the vaginal fluid, or with antisperm antibodies in the CM.

CONCLUSION(S)

The results suggest that in asymptomatic women under controlled endocrine conditions, cervical HSV infection is not a significant cause of impaired quality and penetrability of the CM.