Using the evidence base on genital herpes: optimising the use of diagnostic tests and information provision

Scoular, A

doi:10.1136/sti.78.3.160

Cited by 56 publications

(31 citation statements)

References 38 publications

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“…However, numerous recent reports have highlighted the limitations of this method. 9 On practical consideration, virus culture is time consuming and requires highly stringent conditions for specimen transport and storage to preserve virus viability. 7 Improved diagnostic methods are needed to improve recognition of genital herpes.…”

Section: Discussionmentioning

confidence: 99%

“…Specificity is virtually 100%, but levels of virus shedding, quality of specimen, and transport conditions influence sensitivity. [7][8][9] The rate of virus recovery declines significantly with time since the onset of lesions, from 52-93% for vesicles to 41-72% for ulcers and 19-27% for crusted lesions. 8 9 Furthermore, lack of specimen refrigeration after collection and during transport markedly reduces virus viability.…”

mentioning

confidence: 99%

“…9 10 Although earlier PCR techniques were laborious, expensive and prone to contamination, newly developed real time PCR assays are fully automated and allow virus specific detection within a closed system, with fast turn around times and low risk of contamination. [9][10][11][12] Whereas published protocols for herpes simplex virus (HSV) PCR do not always differentiate between HSV types, 10 new technologies allow simultaneous detection and typing of HSV in a single reaction tube, based on software that analyses the different Tm values of HSV-1 and HSV-2 specific probes. 11 12 This is a valuable feature for the use of PCR in routine clinical practice, as differentiating between HSV types provides important prognostic information in genital herpes.…”

mentioning

confidence: 99%

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Diagnosis of genital herpes by real time PCR in routine clinical practice

Ramaswamy

2004

Sexually Transmitted Infections

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Background: Virus isolation in cell culture is the recognised diagnostic gold standard for genital herpes. Although increasing evidence indicates that polymerase chain reaction (PCR) provides a more rapid and sensitive diagnostic method, its implementation in routine diagnostic settings has been limited by concerns over contamination and cost. Objective: To evaluate the feasibility of replacing virus culture with PCR for the diagnosis of genital herpes in settings serving large populations of genitourinary medicine (GUM) attendees. Methods: Genital swabs collected from 233 consecutive GUM attendees with suspected genital herpes were tested in parallel by virus culture and automated real time PCR. Three specimen preparation methods were evaluated and the assay reliability was assessed by repeat testing, comparison with a commercially available assay, and herpes simplex virus (HSV) sequence analysis. Probe melting temperatures (Tm) were used to differentiate between HSV types without additional post-PCR steps. Results: HSV was detected in 79/233 (34%) samples by virus culture and 132/233 (57%) samples by PCR. PCR significantly increased HSV detection in both early (,5 days) and late (>5 days) presentations and in both first and recurrent episodes. HSV detection and typing by PCR was achieved within less than 4 hours leading to a significant reduction in labour compared to virus culture. Most specimens (120/132, 91%) were typed as HSV-2. Results were highly reproducible. Conclusions: Real time PCR is a highly reproducible, rapid, and labour efficient method for HSV detection in genital swabs. Its implementation is feasible in routine diagnostic settings.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Diagnosis of genital herpes by real time PCR in routine clinical practice

Ramaswamy

2004

Sexually Transmitted Infections

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“…The use of PCR can increase the overall detection rate of HSV by 24% and yet it is currently under-utilised as a diagnostic test. 3 The West of Scotland Regional Virus Laboratory based at Garnaval General Hospital in Glasgow currently uses the LightCycler™ (biogene) (Roche Diagnostics, Lewes, UK) technique. Its real-time PCR protocols employ the incorporation of dyes and the binding of probes during each cycle of the PCR so that the accumulation of product can be measured.…”

Section: Madammentioning

confidence: 99%

'Taking the strain' from chlamydia screening

Hopwood¹,

Mallinson²,

Gleave³

2004

j fam plann reprod health care

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“…In the existing literature, it has been reported that in examinations of children with herpetic lesions in England, HSV-1 was found to be more common than HSV-2 (14), which also indicates that non-sexual infection is more common (13). When encountering genital herpes, it is important to carry out HSV serotyping.…”

Section: Genital Herpes Is a Viral Infection Caused By Hsvmentioning

confidence: 99%

Assessment for sexual abuse in a case presenting with genital herpes

Özyurt¹,

Güller²,

Baykara³

et al. 2015

Dusunen Adam

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Assessment for sexual abuse in a case presenting with genital herpes Child sexual abuse is defined as the use of a child by an adult or a significantly older person for the purpose of sexual stimulation. Sexual relations within the family (incest) "particularly involving children" is prohibited in all faiths and societies; hence, incestuous child sexual abuse is the form of abuse most difficult to determine. Prepubertal genital herpes is a presentation that definitely needs to be assessed as a potential indication for sexual abuse. Even though in adults transmission is often by sexual route, it has been pointed out that especially in cases below the age of 5 years, anogenital herpes can be transmitted by non-sexual mechanisms. As paths for a possible non-sexual transmission of genital herpes, autoinoculation, finger contact by an adult changing nappies leading to infection, hand contact between children, or transmission via infected objects (plate, fork, garments, etc.) have been reported. Guidelines helping in the assessment of sexual abuse are insufficient regarding the question how the issue should be confronted in pediatric cases of genital herpes. More evidence is required to solve this problem. In our presentation, we discuss the process of assessment for sexual abuse in the case of a girl aged 2 years 3 months presenting to the emergency department with anogenital herpes. Keywords: Genital herpes, incest, sexual abuse ÖZET Genital herpetik veziküllerle başvuran bir olgunun cinsel istismar yönünden değerlendirmesiÇocuk cinsel istismarı; çocuğun bir yetişkin veya yaşça büyük bir kişi tarafından cinsel uyarı amacıyla kullanılması olarak tanımlanmaktadır. Aile içi cinsel ilişkinin (ensest) "özellikle de çocuğa yönelik olanın" tüm inanç sistemlerinde ve toplumlarda yasaklanmış olması nedeniyle çocuğun cinsel istismarı, istismarlar içerisinde en zor saptanabilendir. Genital herpes, prepubertal dönemde cinsel istismar bulgusu olabileceğinden mutlaka değerlendirilmesi gereken bir durumdur. Yetişkinlerde cinsel yolla bulaş fazla olmasına rağmen özellikle 5 yaşın altındaki olgularda anogenital herpesin cinsel olmayan yolla da bulaşabildiği bildirilmektedir. Genital herpesin olası cinsel olmayan bulaş yolları; otoinokulasyon, alt bezleme sırasında bakım veren erişkinden parmak teması ile bulaş, çocukların birbirine elle teması, enfekte nesnelerle bulaş (tabak, çatal, elbise vb.) olarak bildirilmektedir. Cinsel istismarı değerlendirmede yardımcı olan kılavuzlar, pediyatrik genital herpes olgularının cinsel istismar yönünden nasıl ele alınması gerektiği konusunda yetersiz kalmaktadır. Bu konuda daha fazla kanıta gereksinim vardır. Bu sunumda anogenital herpes nedeniyle acil servise başvuran 2 yaş 3 aylık bir kız olguda cinsel istismar açısından değerlendirilme süreci sunulmuştur.

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Using the evidence base on genital herpes: optimising the use of diagnostic tests and information provision

Cited by 56 publications

References 38 publications

Diagnosis of genital herpes by real time PCR in routine clinical practice

Diagnosis of genital herpes by real time PCR in routine clinical practice

'Taking the strain' from chlamydia screening

Assessment for sexual abuse in a case presenting with genital herpes

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