Genital Herpes Simplex Virus Infection Diagnosis And Treatment

Genital herpes (GH), one of the most common sexually transmitted diseases (STDs), is lifelong and its recurrences may be frequent, causing severe morbidity and psycnological dysfunction. A series of studies were conducted which focused on some problems in the diagnosis and treatment of the disease.1. To evaluate the usefulness of viral culture in the diagnosis of GH, herpes simplex virus (HSV) in 132 samples taken from typical GH patients were detected by standard viral culture and typed by fluorescein-conjugated type-specific monoclonal antibodies. The time for the appearance of the cytopathic effect in the culture after inoculation was observed, and the effects of the methods used in the collection, transportation, and storage of clinical samples were compared. It was found that: (1) The sensitivities of viral culture for early macule-papules, vesicle-pustules, ulcers, crusts, male urethra! specimens and cervical specimens were 40%(4/10), 96.8%(30/31), 85.7%(36/42), 26.3%(5/19), 50%(8/16) and 71.4%(10/14), respectively. (2) 95.7%(89/93) of positive specimens displayed cytopathic effects within 5 days after inoculation. (3) When clinical samples were maintained within 24 hours at room temperature, within 3 days at 4°C, and within 1 month at -20°C, the virulence was comparable to that of the samples maintained at -70°C. It is demonstrated that the sensitivity of viral culture is influenced by the stage and type of the lesions and the methods used in the collection, transportation and storage of clinical samples.2. In order to evaluate the usefulness of HSV type-specific PCR in the diagnosis of urogenital HSV infections, and to investigate the prevalence of the disease in the patients with different syndromes, 132 specimens taken from typical GH patients, 53 samples from atypical genital lesions (including fissure, folliculitis, balanitis, etc.) and 36 samples from primary syphilis were detected by HSV type-specific PCR and viral culture, and 109 specimens from non-gonococcal urethritis (NGU) or mucopurulent cervicitis (MPC) and 176 cervical specimens from prostitutes were detected by HSV-PCR. It was found that: (1) The sensitivities of HSV-PCR for early macule-papules, vesicle-pustules, ulcers, crusts, male urethral specimens and cervical specimens were 60%(6/10), 96.8%(30/31), 92.9%(39/42), 84.2%(16/19), 68.8%(11/16) and 85.7%(12/14), respectively. There were significant differences between the sensitivities of PCR and viral culture for all typical samples and crusts (P <0.01). (2) The positive rates of HSV-PCR and viral culture for the samples from atypical lesions were 30.2%(16/53) and 26.4%(12/53) (x~2=2.25, P >0.05), respectively. (3) The positive rates of HSV-PCR and viral culture for the...