Obstetric Management of Women with a History of Recurrent Genital Herpes

The patient is a 52-year-old African American man with a past medical history of HIV infection (on antiretroviral therapy, CD4 count 399 cells/µL, and undetectable HIV viral load) and recurrent genital herpes. While on valacyclovir, the patient presented with four tumorous lesions on the perineum and scrotum. A biopsy specimen stained positively with HSV-1 and HSV-2 immunostains and displayed a lymphoplasmacytic infiltrate. The patient received foscarnet and imiquimod for two weeks with minimal improvement. Based on the previous activity of leflunomide, which has both antiviral and immunomodulatory properties, in cytomegalovirus and herpes simplex infections, leflunomide 20 mg orally twice daily was started. The patient received 23 days of foscarnet, 14 days of topical imiquimod, and 11 days of leflunomide with approximately 80% reduction in the size of the perineal lesion. After nine months on leflunomide there was complete regression of the large perineal lesion and only two small ulcerations remained on the scrotum. Pseudotumoral herpes lesions in HIV patients represent an immune reconstitution event and are poorly responsive to the usual anti-herpes agents. This report demonstrates the successful use of leflunomide in the treatment of an HIV patient with pseudotumoral herpes. Thalidomide has also been used with some success.

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Audit of Adherence to Referral Pathway for Pregnant Women with History of Genital Herpes booked at a Tertiary Referral Maternity Hospital, Aug 2015 - Aug 2016.

10.26226/morressier.58ef94ddd462b80290b5071d ◽

2017 ◽

Author(s):

Orla Cunningham

Keyword(s):

Pregnant Women ◽

Genital Herpes ◽

Maternity Hospital ◽

Tertiary Referral ◽

History Of

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Pathogenetic Therapy of Patients with Recurrent Genital Herpes

Antibiotics and Chemotherapy ◽

10.37489/0235-2990-2020-65-5-6-30-34 ◽

2020 ◽

Vol 65 (5-6) ◽

pp. 30-34

Author(s):

L. L. Logvina ◽

D. N. Bayram ◽

Z. A. Kambachokova ◽

F. V. Shavaeva ◽

Z. S. Krymshokalova ◽

...

Keyword(s):

Lipid Peroxidation ◽

Blood Plasma ◽

Genital Herpes ◽

Antioxidant Defense ◽

Clinical Manifestations ◽

Complex Treatment ◽

Herpesvirus Infection ◽

Recurrent Genital Herpes ◽

Complex Therapy ◽

Pathogenetic Therapy

Evaluation of the effectiveness of aminophthalhydroside in the complex treatment of patients with recurrent genital herpes was carried out. The efficacy of the drug was assessed by clinical, biochemical, and immunological criteria. The inclusion of aminophthalhydrazide in the complex therapy of patients with recurrent herpesvirus infection led to an earlier relief of clinical manifestations of the disease, an increase in the relapse period, a decrease in lipid peroxidation products in the blood plasma, an increase in the content of antioxidant defense components, and correction of immunological disorders.

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Tc1/Tc2 imbalance in the peripheral blood of patients with recurrent genital herpes

Journal of Huazhong University of Science and Technology [Medical Sciences] ◽

10.1007/bf02828063 ◽

2006 ◽

Vol 26 (1) ◽

pp. 145-147

Author(s):

Deng Yunhua ◽

Yang Dongliang ◽

Chen Xingping ◽

Chen Yinling

Keyword(s):

Genital Herpes ◽

Peripheral Blood ◽

Recurrent Genital Herpes

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Asymptomatic shedding of herpes simplex virus from the genital tract: uncertainty and its consequences for patient management

International Journal of STD & AIDS ◽

10.1258/0956462961917799 ◽

1996 ◽

Vol 7 (4) ◽

pp. 229-232 ◽

Cited By ~ 12

Author(s):

S E Barton ◽

P E Munday ◽

R J Patel

Keyword(s):

Herpes Simplex Virus ◽

Herpes Simplex ◽

Genital Herpes ◽

Genital Tract ◽

Patient Management ◽

Sexual Transmission ◽

Supportive Counselling ◽

History Of ◽

Simplex Virus ◽

The Relationship

A frequent component of the management of patients with genital herpes concerns the possibility of asymptomatic shedding and potential sexual transmission of the virus. Approaches intended to provide supportive counselling and reassurance of patients about these issues need now to be modified in the light of increasing data of the frequency of asymptomatic detection of virus and the effects of antiviral therapy on this phenomenon. Further studies to delineate the relationship between asymptomatic detection of HSV in the genital tract and the mechanism of sexual transmission of this virus need to be conducted before clinicians instigate antiviral suppressive treatment primarily to prevent sexual transmission of HSV. However, it is important that the new data and our greater understanding of the natural history of genital herpes is translated into accurate and comprehensible information for our patients.

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2017 European guidelines for the management of genital herpes

International Journal of STD & AIDS ◽

10.1177/0956462417727194 ◽

2017 ◽

Vol 28 (14) ◽

pp. 1366-1379 ◽

Cited By ~ 30

Author(s):

Rajul Patel ◽

Oliver J Kennedy ◽

Emily Clarke ◽

Anna Geretti ◽

Arvid Nilsen ◽

...

Keyword(s):

Genital Herpes ◽

Early Recognition ◽

Recurrent Genital Herpes ◽

Sexually Transmitted ◽

European Guidelines ◽

Duration Of Illness ◽

Clinical Scenarios ◽

Immunodeficiency Virus ◽

Initiation Of Therapy

Genital herpes is one of the commonest sexually transmitted infections worldwide. Using the best available evidence, this guideline recommends strategies for diagnosis, management, and follow-up of the condition as well as for minimising transmission. Early recognition and initiation of therapy is key and may reduce the duration of illness or avoid hospitalisation with complications, including urinary retention, meningism, or severe systemic illness. The guideline covers a range of common clinical scenarios, such as recurrent genital herpes, infection during pregnancy, and co-infection with human immunodeficiency virus.

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