Herpes Genitalis Ebook
Both innate and acquired host antimicrobial defense systems are operative on skin. Humoral and cell-mediated immune responses derive from Langerhans cells, keratinocytes, and endothelial cells that produce cytokines and lymphocytes. The skin-associated lymphoid tissue forms a protective barrier that can capture virtually any antigen that enters the skin. IgA and IgG antibodies are secreted by the eccrine sweat glands and are spread over the skin surface where they can exhibit antimicrobial effects and interfere with microbial adherence. The immunological factors important in the lower genital tract have been reviewed by Bulmer and Fox (18). Cervical mucus contains antibodies, in particular, secretory IgA, which are bactericidal in the presence of lysozyme and complement and can agglutinate bacteria and opsonize them for phagocytosis. Circulating antibodies to specific microorganisms can be demonstrated to result from many genital infections, but there is scant evidence of any...
Chlamydia The most common sexually transmitted disease (STD) in the United States, infecting more than 4.5 million people each year. It is a serious but easily cured disease that is three times more common than gonorrhea, six times more common than genital herpes, and 30 times more common than syphilis. Between 1988 and 1992,
Genital herpes may be chronic and recurring, and no known cure exists. It has been associated with an increased risk of acquiring HIV. Case reports suggest that persons with immunodeficiency have a more severe clinical course of anogenital herpes than do immunocompetent patients. Genital herpes can present as painful coalescing ulcerations requiring prophylactic maintenance therapy.
After introduction of new foreign proteins (antigen) to the body, naive cD4 cells sensitive to portions of that protein eventually are activated and multiply to construct new immune defenses. The therapeutic vaccine concept is to improve on the immune defense against a particular already-existing infection by inoculating pieces of the infectious agent's protein presented in a way to trigger new naive cell activation. An immune-enhancing adjutant is frequently used to help this process along. In 1996 investigators presented evidence that therapeutic vaccines can reduce the extent and duration of genital herpes outbreaks in people with frequent eruptions and in infected guinea pigs.
Topical microbicide An antibacterial or antifun-gal compound that can be applied directly to the lining of the vagina before intercourse to thwart sexually transmitted microbes that cause diseases such as gonorrhea, syphilis, genital herpes, chlamydia, hepatitis B, and HIV infections. Today, the development of safe, effective, female-controlled topical microbicides that will block the transmission of HIV and other STD agents is a global priority and a central focus of the STD research program of the National Institute of Allergy and Infectious Diseases (NIAID). The goal is to develop safe antimicrobial products that effectively fight a combination of infectious agents, whether they are viral, bacterial, or protozoan.
Color change from what is normal for an individual occurs, a doctor should perform an examination to determine the cause. Any abnormal aromas of the vaginal area also need to be investigated by a doctor. Abnormal discharge can be due to infection and is frequently associated with pain, burning, itching, and painful urination. pelvic inflammatory disease (PID), herpes genitalis, other STDs, infection of the inside of the uterus, and inflammation of the vagina due to lack of estrogen are other possible causes of vaginal discharge.
Topical imiquimod therapy is used for the treatment of external genital and perianal warts caused by Papilloma virus infection 17 . The FDA has recently approved imiquimod for the treatment of actinic keratoses, and there is mounting evidence that imiquimod is an effective treatment of certain types of skin cancer 47, 48 . Resiquimod is a more potent analogue of imiquimod, and trials are under way to assess its use in treatment of genital herpes and hepatitis C virus 49 . The administration of CpG ODNs could have therapeutic potential for the treatment of HSV-2, as it was demonstrated that HSV-2 DNA directly stimulates TLR9 63 . Recent studies in animal models of genital herpes have established that local-vaginal delivery of immunostimulatory CpG ODNs is effective against both primary and recurrent genital herpes infection and disease 64 (see 65 for further review in CpG ODNs applications).
The diagnosis of any stage or phase of syphilis can be complicated, especially in the setting of HIV. In primary syphilis, the hallmark symptom is a painless lesion usually on the external genital. The differential diagnosis would include other STDs such as genital herpes, chancroid, or lymphogranuloma venereum (LGV). Most of these diseases create a painful lesion or local lymphandenopathy. The lesions associated with secondary syphilis can be confused with other skin manifestations, such as pityriasis rosea, psoriasis, erythema multiforme, tinea versicolor, viral exanthema, scabies, or even a drug reaction. The simplest test used to diagnosis syphilis at these stages is a dark-field examination and or direct fluorescent antibody (DFA) stain on lesion exudates or tissue.2 The spirochetes will be visible on examination.
Herpes Any of a variety of inflammatory skin conditions characterized by spreading or creeping small clustered blisters caused by the herpes simplex virus. Forms of the virus cause cold sores and the sexually transmitted disease genital herpes (see herpes, genital) characterized by blisters on the sex organs. The virus also causes many other conditions affecting the skin. Herpes simplex virus most commonly causes cold sores in infants and children, and genital herpes in adolescents. Herpes simplex virus is also responsible for eye infections in children and for lesions on the parts of fingers and at other sites.
Valaciclovir A medication used in the treatment of herpes zoster (shingles) and herpes simplex (genital herpes). It inhibits the replication of viral DNA that is necessary for viruses to reproduce themselves. Valaciclovir is actually a prodrug, meaning that it is not active itself against the virus. Rather, in the body it is converted to acyclovir, which is active against the viruses. It has been shown to be more effective at lower doses than acyclovir. Valaciclovir, therefore, is active against the same viruses as acyclovir but has a longer duration of action. (Trade name is Valtrex.)
The virus is highly contagious when the blisters are present it is often transmitted by kissing. The virus can also be spread by children who touch their blisters and then touch other children. About 10 percent of oral herpes cases in adults are acquired by oral-genital sex with a person with active genital herpes.
The epidemiological association with HPV has been controversial. Studies investigating this hypothesis (most of which examined a limited number of viral subtypes) have produced mixed but mostly negative results (37,38). Laser or cryogenic treatment for prior HPV also has been suggested as a possible precipitating factor for VVS. Recent case-control studies utilizing physician-reported diagnoses found no increased risk associated with prior HPV infection, genital warts, chlamydia, genital herpes, or gonorrhea (34). Emerging data on host factors, such as reduced immune cell function (30-32) and genetic susceptibility to chronic inflammation (27-29), support the hypothesis that either bacterial or viral infections, or other potential inflammatory triggers (exposure to noxious chemicals, laser treatment, semen allergy), may play a role in VVS pathogenesis.
Herpes genitalis Infection of the genital and anorectal skin and mucosa with herpes simplex virus type 2. It is usually spread by sexual contact and is classed as a sexually transmitted disease. Itching and soreness are usually present before a small patch of erythema develops. Then a vesicle that erodes appears. These are usually painful and heal in about 10 days. They may occur in any part of the genitalia. Although genital herpes lesions usually occur in limited areas (such as the cervix), as HIV infection progresses, the herpes may involve more widespread anatomical areas and be resistant to topical therapy. acyclovir has been of considerable benefit in treating the initial infection. Genital herpes is one of the gynecological problems that Social Security Disability Determination Service (DDS) specialists consider when assessing the degree to which the disease affects a woman's ability to function.
A much greater concern is herpes simplex virus infection in newborn infants. The virus is most frequently transmitted to an infant from the mother during vaginal delivery or, sometimes, via ascending infection. Transmission is much more likely to occur during a vaginal birth in a mother who is having a first episode of genital herpes. In such cases, the rate of transmission may be 33 to 50 percent. Unfortunately, in most cases, infected neonates are born to women in whom neither the history nor the physical examination suggests active infection.
Infections, including vulvovaginal candidiasis, bacterial vaginosis, genital herpes simplex, human papillomavirus, syphilis, cytomegalovirus, toxoplas-mosis, hepatitis B, and hepatitis C. These infections may be associated with pregnancy complications or perinatal infection.
Valaciclovir versus acyclovir in the treatment of first-episode genital herpes infection results of an international, multicenter, double-blind randomized clinical trial. Sex Transm Dis 1997 24 481. 77. Loveless M, Harris W, Sacks S. Treatment of first episode genital herpes with famciclovir, Programs and Abstracts of the 35th Interscience Conference on Anitmicrobial Agents and Chemotherapy, San Francisco, Sept 17-20, 1995, Abstract A12. 78. Mertz G et al. Double-blind placebo-controlled trial of oral acyclovir in the first episode genital herpes simplex virus infection. J Am Med Assoc 1984 252 1147. 79. Jungmann E. Genital herpes. Clin Evid 2004 11 2073. 80. Stone K, Whittington W. Treatment of genital herpes. Rev Infect Dis 1990 12 610. 81. Wald A et al. Two-day regimen of acyclovir for treatment of recurrent genital herpes simplex virus type 2 infection. Clin Infect Dis 2002 34 944. 82. Wald A. New therapies and prevention strategies for genital herpes. Clin...
Herpes simplex virus type II causes 85 percent of genital herpes cases. Type I, which causes most herpes infections above the waist, is responsible for the other 15 percent. The infection is spread by contact with the genital secretions of a person with an active lesion. It is possible, however, for a person with no active lesion to shed virus and infect a sex partner. The virus can infect any skin or mucous membrane surface on the body. For example, a person with a cold sore who engages in oral sex can transmit genital herpes to a partner. Doctors may diagnose genital herpes by symptoms alone, but there are also several lab tests that can confirm the infection. A specimen from the base of a lesion can identify the type of cell. Herpes also grows rapidly in tissue culture specimens from a new lesion can be identified within 48 hours in the lab. Blood tests can look for antibodies to herpes the newest blood tests can tell the difference between type I and II. The antiviral drug...