Seattle, WA, USA. Genital herpes, caused by a reactivation of herpes simplex virus type 2 (HSV-2), is generally treated as a lesion in one specific area of the genital region.However, an important new finding is that the virus can frequently reactivate throughout the genital tract. This could help guide both HSV-2 treatment and prevention.

In an accompanying editorial, Edward W. Hook III, MD, of the University of Alabama at Birmingham, called the study's findings "of great potential importance, as they further challenge widely held beliefs regarding genital herpes and, by extension, its management."

Many clinicians treat patients with newly diagnosed herpes episodically, managing the signs and symptoms of periodic symptomatic recurrences, Dr. Hook wrote. The findings appear in The Journal of Infectious Diseases.

Sexually Transmitted Disease

Chlamydia trachomatis is the most common Sexually Transmitted Disease (STD) with a bacterial cause in the developed world.

 

The US Centers for Disease Control And Prevention (CDC) identifies Chlamydia as the most reported bacterial STD in the US. According to the UK Health Protection Agency, UK diagnoses rose steadily since the mid-1990s. It is the leading cause of preventable blindness worldwide.

 

Chlamydia is often refered to as the “Silent Killer” since it often has no visible symptoms, but can cause serious problems in women. If left untreated, the disease can result in pelvic inflammatory disease (painful and chronic), ectopic pregnancy and infertility.

 

However, since there aren't any immediate physical signs or symptoms in up to 70% of infected women, the disease often goes undiagnosed and many women do not seek treatment.

 

A rapid Chlamydia test is now available in the UK, antibiotics exist for treatment, and work is underway to develop a vaccine.

 

Herpes simplex is a very common viral infection. It occurs in oral (cold sores / fever blisters) or genital forms.

 

 

Even when dormant, the virus can be highly contagious. There are two viruses:

 

• Herpes Simplex Type 1 (HSV-1): most commonly occurs above the waist. 

 

• Herpes Simplex Type 2 (HSV-2): most commonly occurs below the waist; also referred to as herpes progenitalis.

 

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Medical authorities strongly advise females to practice safe sex practices and obtain regular gynecological exams.

Using a detailed sampling method and a sensitive assay, the authors showed that both symptomatic and asymptomatic HSV-2 reactivations often occurred at widely spaced regions throughout the genital tract. These reactivations were often on both sides of the body, even though clinical lesions typically emanate from one anatomic spot.

The study's findings illustrate an important new concept in HSV-2 pathogenesis, the authors wrote, and may help in developing comprehensive treatment that both suppresses and limits the transmission of HSV-2 infection.

The authors also noted limitations of their study, including a small sample size and the unique features of the study's subjects. For example, all participants had a history of symptomatic genital herpes, and three of the four had acquired HSV-2 infection within the past year, increasing the chances of high viral reactivation and lesion rates. Additionally, although there were a high proportion of days with lesions during the study period, two of the participants who had recently acquired genital herpes contributed the majority of lesion days.

Edward Hook says that "From a personal and public health perspective, the biology of the infection suggests that a national campaign for serological testing of those at risk would provide the foundation for more effective efforts to control HSV transmission to others, and that for most sexually active persons with HSV-2 whose sex partners are not known to also be infected, suppressive therapy should be the preferred approach."

CitationOverlapping Reactivations of Herpes Simplex Virus Type 2 in the Genital and Perianal Mucosa. Sunitha Tata, Christine Johnston, Meei-Li Huang, Stacy Selke, Amalia Magaret, Lawrence Corey, and Anna Wald. The Journal of Infectious Diseases 2010; 201:499–504. doi:10.1086/650302. 0022-1899/2010/20104-0005

Abstract

Background. Genital shedding of herpes simplex virus (HSV) type 2 occurs frequently. Anatomic patterns of genital HSV-2 reactivation have not been intensively studied.

Methods. Four HSV-2–seropositive women with symptomatic genital herpes attended a clinic daily during a 30-day period. Daily samples were collected from 7 separate genital sites. Swab samples were assayed for HSV DNA by quantitative polymerase chain reaction. Anatomic sites of clinical HSV-2 recurrences were recorded.

Results. HSV was detected on 44 (37%) of 120 days and from 136 (16%) of 840 swab samples. Lesions were documented on 35 (29%) of 120 days. HSV was detected at >1 anatomic site on 25 (57%) of 44 days with HSV shedding (median, 2 sites; range, 1–7), with HSV detected bilaterally on 20 (80%) of the 25 days. The presence of a lesion was significantly associated with detectable HSV from any genital site (incident rate ratio [IRR], 5.41; 95% confidence interval [CI], 1.24–23.50; ) and with the number of positive sites (IRR, 1.19; 95% CI, 1. 01–1.40; ). The maximum HSV copy number detected was associated with the number of positive sites (IRR, 1.62; 95% CI, 1.44–1.82; ).

Conclusions. HSV-2 reactivation occurs frequently at widely spaced regions throughout the genital tract. To prevent HSV-2 reactivation, suppressive HSV-2 therapy must control simultaneous viral reactivations from multiple sacral ganglia.

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TS-Si is dedicated to the acceptance, medical treatment, and legal protection of individuals correcting the misalignment of their brains and their anatomical sex, while supporting their transition into society as hormonally reconstituted and surgically corrected citizens.

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