Objectives: To examine the seroprevalence and correlates of antibodies to herpes simplex viruses type 1 (HSV-1) and type 2 (HSV-2), and to assess patients' knowledge and attitude towards genital herpes infection and its serotesting, before and after counselling. Methods: A cross sectional study among genitourinary medicine (GUM) clinic attenders in Coventry, a UK metropolitan city. Participants were asked to complete a self administered questionnaire before and after counselling. Patients were counselled before testing and after receiving the result. A commercially available enzyme immunoassay (EIA) was used to identify HSV-1 and HSV-2 antibodies (Gull/ Meridian EIA). Results: 223 patients participated in the study (97% of eligible patients). Overall, prevalence of HSV-2 antibody was 43/216 (20%) (19/103, 18% for males and 24/113 (21%) for females, p=0.61) while prevalence of HSV-1 antibody was 129/215 (60%) (60% for both sexes, p=0.91). In the multivariate analysis HSV-2 seropositivity was higher among black people and those with a history of genital herpes. HSV-1 seropositivity was independently associated with less education, increased years of sexual activity (between 14-25 years), and history of cold sores. The majority of patients wanted this serotesting to be available in the clinic (204/222 (92%) before and 216/218 (99%) after counselling, p=0.0003) and 97% accepted the test when offered. Only three patients regretted having the test and four patients contacted the department within 6 months of receiving the results for more counselling. Conclusion:The vast majority of the study population not only wanted to be tested, but accepted the test when offered. HSV-2 infection is common and largely unrecognised among our study population. The psychological impact of introducing type specific HSV serological testing in a clinical setting seems to be minimal. Counselling could improve patients' awareness of the infection and the acceptability of the test and its results. G enital herpes infection is the most common cause of genital ulceration, in both the developed world and in developing countries.1 2 The annual number of reported cases of genital herpes presenting to genitourinary medicine (GUM) clinics in England and Wales increased fourfold between 1976 and 1996. 3 In the United States, HSV-2 seroprevalence rose from 16% in 1978 to 22% in 1990. 4 5 Seroprevalence studies revealed that we diagnose only about 20% of patients with genital herpes and that the majority of these cases are unrecognised by both patients and clinicians.6 Clearly, undiagnosed genital herpes infections are the major factor in fuelling the genital herpes epidemic, as source partners in most transmission events are unaware that they have genital herpes. Patients shed the virus and transmit it even in the absence of clinical signs.7 Although the efficacy of transmission is higher at the time of lesions, most transmission has been shown to occur during periods of asymptomatic viral shedding. Accurate type specific serological tests c...
A case of granuloma annulare (GA) localised to the shaft of the penis is reported with a brief review of the current literature. We concluded that penile GA, although rare, should be considered in the diVerential diagnosis of granulomatous lesions of the penis and that histopathological examination of the lesion is essential for the diagnosis. (Sex Transm Inf 1999;75:186-187)
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. G enital herpes infection is the most common cause of genital ulceration, not only in the developed world, but also in many developing countries. 1 2 Its impact on the psychosocial and psychosexual life of many patients and its importance in HIV transmission are well recognised. 3 4 Neonatal herpes, although rare in the United Kingdom, is a devastating illness. 5 Diagnosis of genital herpes is increasing. In developed countries, it is estimated that as many as 20% of the general population may be herpes simplex virus type 2 (HSV-2) seropositive. Seroprevalence rates as high as 60-90% have been reported in several developing countries. 6 7 Serprevalence rates among genitourinary clinic attenders in London were found to be 25% in females and 17% in males, while in the control group of blood donors, the corresponding rates were 12% in females and 3% in males. 8 Several recent developments have changed many of the traditional concepts about this infection. 9-13 Accurate type specific serological tests have been available for the last few years. While the presence of HSV-2 antibodies essentially confirms the previous genital herpes infection, the presence of HSV-1 antibodies indicates previous infection with HSV-1 without identifying the site of infection, which may be oral or genital.Patients' attitudes have been assessed in previous studies. 14 However, no information is available about the knowledge or opinions of clinicians. General practitioners (GPs) are often the first clinicians to see these patients. This study assessed GPs' knowledge of genital herpes, especially recent information about shedding, transmission, and clinical presentation. We also assessed their opinions regarding serotesting of genital herpes. METHODSGPs working in...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.