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Primary Genital Herpes

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1. Guidelines for the Management of Genital Herpes in New Zealand

is rich with candidates in various phases of development. Vaccines are currently being developed both to prevent HSV-2 infection (preventive) and to treat HSV-2 infection (therapeutic). 16 EPIDEMIOLOGY AND TRANSMISSION Epidemiology KEY POINTS • As many as one in five adults have genital herpes due to HSV-2, most will have asymptomatic or unrecognised disease. • Genital herpes due to HSV-1 (through oral to genital transmission) has also become common; HSV-1 is a frequent cause of primary genital herpes (...) -25 year olds, 30% in the 25–35 year olds, and 26% from over-35 year olds. Likewise, an Auckland Sexual Health Clinic study in 2004 found most true primary (see Glossary of Terms page 3) episodes of genital herpes were HSV-1, whilst non-primary first episodes (see Glossary of Terms page 3) and recurrences were mostly HSV-2. 6 Like HSV-2, HSV-1 seroprevalence increases with increasing age and tends to be more common in women. 7 Note: Routine typing of isolates enhances a clinician’s ability to give

2017 New Zealand Sexual Health Society

2. Health-related quality of life of young people and adults with primary or recurrent episodes of genital herpes: a mixed methods systematic review protocol

Health-related quality of life of young people and adults with primary or recurrent episodes of genital herpes: a mixed methods systematic review protocol Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith (...) based on title and abstract, followed by full-text screening of the eligible articles for final inclusion. In each phase, 2 observers will independently assess each article. Discrepancies will be resolved through discussion, or by consulting a third investigator. ">Procedure for study selection Example : Title-abstract screening: 1. Not an original full research paper (e.g. review, editorial) 2. Not an in vivo animal study 3. No metastases/ only primary tumor 4. No control group 5. Combination

2018 PROSPERO

3. Interventions for men and women with their first episode of genital herpes. Full Text available with Trip Pro

), and the Alternative Medicines Specialised Register (from inception to April 2016). We handsearched a number of relevant journals, searched reference lists of all included studies, databases of ongoing trials, and other Internet databases.We included randomised controlled trials (RCTs) on participants with first-episode genital herpes. We excluded vaccination trials, and trials in which the primary objective assessed a complication of HSV infection.All studies written in English were independently assessed (...) Interventions for men and women with their first episode of genital herpes. Genital herpes is incurable, and is caused by the herpes simplex virus (HSV). First-episode genital herpes is the first clinical presentation of herpes that a person experiences. Current treatment is based around viral suppression in order to decrease the length and severity of the episode.To determine the effectiveness and safety of the different existing treatments for first-episode genital herpes on the duration

2016 Cochrane

4. How well do antivirals shorten genital herpes pain duration?

shorten genital herpes pain duration? Evidence-based answer: Oral and intravenous (IV) acyclovir each shorten the duration of pain for a first primary outbreak of herpes by about 50%; topical acyclovir shortens it by about 25% (strength of recommendation [SOR]: B, small randomized controlled trials [RCTs] with some methodological flaws). Oral valacyclovir and famcyclovir are equivalent to oral acyclovir. Adding topical acyclovir to oral acyclovir doesn’t produce additional benefit (SOR: B, RCTs (...) How well do antivirals shorten genital herpes pain duration? How well do antivirals shorten genital herpes pain duration? Toggle navigation Shared more. Cited more. Safe forever. Toggle navigation View Item JavaScript is disabled for your browser. Some features of this site may not work without it. Search MOspace This Collection Browse Statistics How well do antivirals shorten genital herpes pain duration? View/ Open Date 2015-03 Contributor Format Metadata Abstract Q: How well do antivirals

2015 Clinical Inquiries

5. Genital Herpes Infection: Serologic Screening

summaries are one-page documents that provide guidance to primary care clinicians for using recommendations in practice. This summary is intended for use by primary care clinicians. ( ) Current as of: December 2016 Internet Citation: Final Update Summary: Genital Herpes Infection: Serologic Screening . U.S. Preventive Services Task Force. December 2016. https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/genital-herpes-screening1 • • • • USPSTF Program Office • 5600 Fishers (...) Genital Herpes Infection: Serologic Screening Final Update Summary: Genital Herpes Infection: Serologic Screening - US Preventive Services Task Force Search USPSTF Website Text size: Assembly version: 1.0.0.308 Last Build: 11/16/2018 6:27:19 PM You are here: Final Summary Genital Herpes Infection: Serologic Screening Release Date: November 2016 Recommendation Summary Population Recommendation Grade Asymptomatic adolescents and adults, including those who are pregnant The USPSTF recommends

2016 U.S. Preventive Services Task Force

6. WHO guidelines for the treatment of Genital Herpes Simplex Virus

WHO guidelines for the treatment of Genital Herpes Simplex Virus WHO GUIDELINES FOR THE Treatment of Genital Herpes Simplex VirusWHO GUIDELINES FOR THE Treatment of Genital Herpes Simplex Virus WHO Library Cataloguing-in-Publication Data WHO guidelines for the treatment of genital herpes simplex virus I.World Health Organization. ISBN 978 92 4 154987 5 Subject headings are available from WHO institutional repository © World Health Organization 2016 All rights reserved. Publications of the World (...) epidemiology and burden 5 Why new guidelines for the prevention, treatment and management of STIs? 5 Approach to the revision of STI guidelines 6 References 8 WHO guidelines for the treatment of genital herpes simplex virus 9 1. Introduction 9 1.1 Epidemiology, burden and clinical considerations 9 Clinical presentation 9 Laboratory diagnosis 10 1.2 Rationale for new recommendations 10 1.3 Objectives 10 1.4 Target audience 10 1.5 Structure of the guidelines 11 2. Methods 12 2.1 Guideline Development Group

2016 World Health Organisation Guidelines

7. Management of Genital Herpes in Pregnancy

of Southampton, Consultant in Genitourinary and HIV Medicine, Solent NHS Trust3 Contents 1. Objective and scope 4 2. Search strategy 5 3. Background 6 4. Management of pregnant women with first episode genital herpes 8 5. Management of pregnant women with recurrent genital herpes 10 6. Management of women with primary or recurrent genital lesions at the onset of labour 11 7. Genital herpes in preterm prelabour rupture of membranes 13 (before 37 +0 weeks of gestation) 8. Management of HIV-positive women (...) of genital herpes infection in uninfected mothers during pregnancy, please see the transmission prevention advice in the 2014 BASHH guideline on the management of genital herpes (currently undergoing consultation). The population covered by this guideline includes pregnant women with a suspected or confirmed diagnosis of genital herpes simplex infection in primary or secondary care. This guideline is aimed at healthcare professionals working in maternity units and departments offering level 3 care

2014 Royal College of Obstetricians and Gynaecologists

8. Comparison of Acyclovir and Multistrain Lactobacillus brevis in Women with Recurrent Genital Herpes Infections: a Double-Blind, Randomized, Controlled Study. (Abstract)

Comparison of Acyclovir and Multistrain Lactobacillus brevis in Women with Recurrent Genital Herpes Infections: a Double-Blind, Randomized, Controlled Study. We performed a randomized double-blind controlled trial to compare the efficacy and safety of multistrain probiotic and acyclovir in women patients with recurrent genital herpes simplex virus type 2 (HSV-2) infections. Eighty-one patients enrolled in the study were being treated with multistrain Lactobacillus brevis one vaginal capsule (...) , and no side effect of L. brevis are valuable properties of probiotic therapy compared with acyclovir. Therefore, we concluded that multistrain L. brevis could play an important role in suppression of recurrent genital herpes simplex virus infection.

2019 Probiotics and antimicrobial proteins Controlled trial quality: predicted high

9. Primary Genital Herpes

Primary Genital Herpes Primary Genital Herpes Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Primary Genital Herpes Primary Genital (...) Herpes Aka: Primary Genital Herpes , Acute Genital Herpes , Initial Genital Herpes From Related Chapters II. Symptoms: Prodrome (precedes genital lesions by hours to days) Genital symptoms Focal, genital pain, s, burning, itching Lesions occur at the perineum, buttock, upper thigh or perianal area Systemic symptoms Malaise Myalgias III. Signs: Skin Lesions Lesion development Starts as shallow Umbilicates with central depression Ulcerate early in course s and then re-epitheliazes without scarring

2018 FP Notebook

10. Herpes simplex - genital

are usually bilateral and develop 4–7 days after exposure to HSV infection. People may complain of dysuria, vaginal or urethral discharge, and systemic symptoms such as fever and malaise. A primary episode can last up to 20 days, and is often more severe than a recurrent episode. Following primary infection, the virus becomes latent in local sensory ganglia. Recurrent genital herpes refers to a recurrence of clinical symptoms due to reactivation of pre-existent HSV infection after a latent period. People (...) -clinically (asymptomatically) — at least 80% of people with proven HSV are unaware that they have been infected. Ideally, all people with suspected genital herpes should be referred to a specialist in genito-urinary medicine for diagnosis, treatment, screening for STIs, counselling, and follow-up. If this is not possible or acceptable, the person should be managed in primary care if the appropriate expertise is available. For initial episodes, treatment with oral aciclovir (200 mg five times a day

2017 NICE Clinical Knowledge Summaries

11. Novel Role for Interleukin-17 in Enhancing Type 1 Helper T Cell Immunity in the Female Genital Tract following Mucosal Herpes Simplex Virus 2 Vaccination Full Text available with Trip Pro

Novel Role for Interleukin-17 in Enhancing Type 1 Helper T Cell Immunity in the Female Genital Tract following Mucosal Herpes Simplex Virus 2 Vaccination It is well established that interferon gamma (IFN-γ) production by CD4+ T cells is critical for antiviral immunity against herpes simplex virus 2 (HSV-2) genital infection. However, the role of interleukin-17A (IL-17A) production by CD4+ T cells in HSV-2 antiviral immunity is yet to be elucidated. Here we demonstrate that IL-17A plays (...) an important role in enhancing antiviral T helper type 1 (Th1) responses in the female genital tract (FGT) and is essential for effective protection conferred by HSV-2 vaccination. While IL-17A did not play a critical role during primary genital HSV-2 infection, seen by lack of differences in susceptibility between IL-17A-deficient (IL-17A-/-) and wild-type (WT) C57BL/6 mice, it was critical for mediating antiviral responses after challenge/reexposure. Compared to WT mice, IL-17A-/- mice (i) infected

2017 Journal of virology

12. Maintenance Dose Study of GEN-003 in Subjects With Genital Herpes Infection

: Parallel Assignment Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) Primary Purpose: Treatment Official Title: A Randomized, Placebo-controlled, Double-blind Study to Assess the Efficacy and Safety of a Maintenance Dose of GEN-003 in Subjects With Genital Herpes Infection Actual Study Start Date : May 24, 2017 Actual Primary Completion Date : December 22, 2017 Actual Study Completion Date : June 11, 2018 Resource links provided by the National Library of Medicine (...) , phosphatidylcholine, and cholesterol. Other Name: Adjuvant Placebo Comparator: Placebo 0.9% normal saline administered as a 0.5mL intramuscular (IM) injection Other: 0.9% normal saline Placebo Outcome Measures Go to Primary Outcome Measures : Percentage of Days With Genital Herpes Lesions [ Time Frame: The 6-month period after vaccination ] Subject-reported via electronic diary Secondary Outcome Measures : Number of Genital Herpes Recurrences [ Time Frame: The 6-month period after vaccination ] Subject-reported

2017 Clinical Trials

13. Nasal Immunization Confers High Avidity Neutralizing Antibody Response and Immunity to Primary and Recurrent Genital Herpes in Guinea Pigs Full Text available with Trip Pro

Nasal Immunization Confers High Avidity Neutralizing Antibody Response and Immunity to Primary and Recurrent Genital Herpes in Guinea Pigs Genital herpes is one of the most prevalent sexually transmitted infections in both the developing and developed world. Following infection, individuals experience life-long latency associated with sporadic ulcerative outbreaks. Despite many efforts, no vaccine has yet been licensed for human use. Herein, we demonstrated that nasal immunization (...) with an adjuvanted HSV-2 gD envelope protein mounts significant protection to primary infection as well as the establishment of latency and recurrent genital herpes in guinea pigs. Nasal immunization was shown to elicit specific T cell proliferative and IFN-γ responses as well as systemic and vaginal gD-specific IgG antibody (Ab) responses. Furthermore, systemic IgG Abs displayed potent HSV-2 neutralizing properties and high avidity. By employing a competitive surface plasmon resonance (SPR) analysis combined

2016 Frontiers in immunology

14. Primary Genital Herpes Simplex Virus Type I in Preterm Prelabour Rupture of Membranes at 30 Weeks' Gestation Full Text available with Trip Pro

Primary Genital Herpes Simplex Virus Type I in Preterm Prelabour Rupture of Membranes at 30 Weeks' Gestation Background. Disseminated herpes simplex virus (HSV) in the neonate is associated with significant morbidity and mortality. Current guidelines recommend caesarean in third-trimester maternal primary genital HSV outbreaks to prevent transmission from mother to fetus. In the premature fetus, however, expectant management is often necessary to reduce morbidity of prematurity. The benefit (...) of performing caesarean after 6 hrs of rupture of membranes (ROM) to reduce maternal-fetal transmission is unclear. Case. A female patient with primary genital HSV type 1 outbreak coinciding with preterm, prelabour rupture of membranes (PPROM) at 30 + 3 weeks' gestation. An immediate caesarean section was not performed after multidisciplinary team discussion due to the benefits of glucocorticoids on immune complications of prematurity. The patient had expectant management for 5 days with intravenous (IV

2015 Case reports in obstetrics and gynecology

15. Herpes simplex infection

Herpes simplex infection Herpes simplex infection - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Herpes simplex infection Last reviewed: February 2019 Last updated: April 2018 Summary Symptoms of genital herpes range from asymptomatic to tingling and burning without lesions, to recurrent genital ulcerations. Symptoms of herpes labialis include tingling and burning followed by development of vesicular then ulcerative (...) lesions involving the oropharynx and perioral mucosa. Aciclovir, famciclovir, and valaciclovir are effective at shortening the duration and severity of an outbreak. Daily suppressive therapy reduces recurrences by 80% and reduces transmission risk by approximately 50%. HSV type-specific antibody tests are used to diagnose infection with or without lesions and distinguish between type 1 and 2. Definition Infection with HSV-1 or HSV-2 can cause oral, genital, and ocular ulcers. The primary episode

2018 BMJ Best Practice

16. Genital Herpes

infected with , virus remains latent in spinal nerve roots until outbreaks Outbreaks may be triggered with various stressors IV. Precautions Genital Herpes is asymptomatic in 65-90% of patients Asymptomatic viral shedding occurs on 10-20% of all days (regardless of outbreak) Most common in the first year of infection, but frequent shedding may persist for years V. Symptoms Primary infection ( ) May be associated with fever, malaise and adenopathy HSV DNA migrates up the infected axon to the affected (...) spinal cord sensory HSV persists in the sensory life long, dormant until next outbreak On periodic reactivation, HSV DNA migrates down axon and erupts again See ( ) Prodromal symptoms (duration hours to days) Focal, genital pain, s, burning, itching Lesions occur at the perineum, buttock, upper thigh or perianal area Vesicular (duration 2 weeks for primary herpes, and 6-12 days for secondary herpes) s erupt at the areas of pain and ultimately ulcerate and then heal Course First outbreak (primary

2018 FP Notebook

17. Genital Herpes in Pregnancy

Genital Herpes in Pregnancy Aka: Genital Herpes in Pregnancy II. Findings See See See III. Management: Pregnancy (> 36 weeks gestation) Treat primary infections on protocol Culture and lesion every 3-5 days until negative if indicated See below for prevention of transmission indications Culture positive All women with active lesions IV. Complications: Vertical transmission V. Prevention: Neonatal Herpes Simplex Virus transmission Prevent transmission from HSV positive partner Abstinence or use during (...) outbreak References VI. References Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Genital Herpes in Pregnancy." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics in Obstetrics About FPnotebook.com is a rapid access, point-of-care medical reference for primary care and emergency clinicians. Started in 1995, this collection now contains 6656

2018 FP Notebook

18. Recurrent Genital Herpes

predictive of more frequent recurrences Severe primary outbreak Male gender More frequent initially, decrease over time Exposure to provocative factors Stressful situations Heat or cold extreme exposure Immunocompromised IX. References Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Recurrent Genital Herpes." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database (...) Recurrent Genital Herpes Recurrent Genital Herpes Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Recurrent Genital Herpes Recurrent

2018 FP Notebook

19. Guidelines for the Management of Genital, Anal and Throat HPV Infection in New Zealand

, Anal and Throat HPV Infection in New Zealand – 9th Edition 2017 Only available online at www.hpv.org.nz 2. Sexually Transmitted Infections – Summary of Guidelines 2017 Patient information pamphlets 1. Some Questions and Answers about HPV and Genital Warts 2. Cervical Smears and Human Papillomavirus Infection (HPV) 3. Preventing HPV Cancers by Vaccination: What Everyone Should Know 4. HPV and Men 5. HPV and Throat Cancer: Common Questions and Answers HERPES Tollfree 0508 11 12 13 www.herpes.org.nz (...) Health professionals’ resources 1. Guidelines for the Management of Genital Herpes in New Zealand – 12th Edition 2017 Only available online at www.herpes.org.nz 2. Sexually Transmitted Infections – Summary of Guidelines 2017 Patient information pamphlets 1. The Facts: A guide for people with Herpes Simplex Includes – Genital Herpes – The Facts Herpes and Relationships Herpes and Pregnancy Facial Herpes 2. Herpes: Myth vs Facts Helpline Website Resources New Zealand Sexual Health Society (NZSHS

2017 New Zealand Sexual Health Society

20. Genital Ulcer Disease

Genital Ulcer Disease Genital Ulcer Disease (GUD) MANAGEMENT SUMMARY Are the lesions on examination • Multiple vesicles; or tender, shallow ulcerations; +/- inguinal adenopathy? Patient complains of genital sore(s) / ulcer(s) In New Zealand, GUD due to STI is largely confined to herpes simplex virus (either HSV-2 or HSV-1), or syphilis. Tropical causes of GUD such as chancroid or lymphogranuloma venereum are RARE. Consider if there has been an overseas sexual contact in an endemic region (...) or with someone from a high-prevalence population group. Some ulcerative lesions are due to non-sexually acquired dermatological conditions. However, it is important to remember that most breaks in the genital skin are due to micro-trauma to the epidermis. YES Tests • Viral swab for herpes simplex virus (HSV) testing from the base of the lesion (HSV PCR testing is the preferred test) • Syphilis serology should be routinely requested NO • Larger typically solitary painless ulcers +/- unilateral non- tender

2017 New Zealand Sexual Health Society

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