07-19-2006, 07:10 AM
The correct answer is E. This patient has herpes simplex virus-2, which is a very common sexually transmitted disease in the United States. It is estimated that 22% of the adult population has antibodies to the virus, even though only a small percentage of this group ever reports symptoms. Unfortunately, approximately 90% of those who report symptoms will have a recurrence. Transmission is possible during asymptomatic periods and subclinical shedding of the virus is well documented. Herpes simplex virus-2 can be transmitted by skin-to-skin contact when lesions are present, even when a condom is used. Acyclovir, an antiviral agent that inhibits viral DNA polymerase, shortens the duration of symptoms and the viral excretion time. Individuals who have recently acquired a sexually transmitted disease that have not been vaccinated against the Hepatitis B virus should be offered the Hepatitis B vaccine.
Many patients with frequent reactivation of herpes simplex virus-2 require chronic daily suppressive therapy with acyclovir to reduce the frequency of reactivation. It is incorrect to say that chronic daily suppressive therapy with acyclovir does not reduce the frequency of reactivation (choice A).
Transmission of HSV-2 is possible even during asymptomatic periods and subclinical shedding of the virus is well documented. Therefore he needs to use barrier protection all of the time, even when lesions are not present, to decrease the likelihood of transmission. He needs to use condoms with his wife only when lesions are present (choice B) is incorrect
Herpes simplex virus-2 usually becomes a life-long latent infection in the sensory ganglion cells, not epithelial cells (choice C). Once stressors such as trauma, fever, UV light, sexual intercourse, or immunodeficiency reactivate the virus in the neural tissue, HSV is transported back to the epithelium and another episode occurs
Many patients with frequent reactivation of herpes simplex virus-2 require chronic daily suppressive therapy with acyclovir to reduce the frequency of reactivation. It is incorrect to say that chronic daily suppressive therapy with acyclovir does not reduce the frequency of reactivation (choice A).
Transmission of HSV-2 is possible even during asymptomatic periods and subclinical shedding of the virus is well documented. Therefore he needs to use barrier protection all of the time, even when lesions are not present, to decrease the likelihood of transmission. He needs to use condoms with his wife only when lesions are present (choice B) is incorrect
Herpes simplex virus-2 usually becomes a life-long latent infection in the sensory ganglion cells, not epithelial cells (choice C). Once stressors such as trauma, fever, UV light, sexual intercourse, or immunodeficiency reactivate the virus in the neural tissue, HSV is transported back to the epithelium and another episode occurs