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Herpes genitalis hos menn

Sist revidert:
Sist revidert av:


Definisjon:
En residiverende, livslang venerisk sykdom med sårdannelser i genitalområdet som skyldes herpes simplex virus 2 (HSV 2) eller sjeldnere herpes simplex virus 1 (HSV 1)
Forekomst:
20-40% i aldersgruppen 20-40 år har hatt primærinfeksjon med HSV-2
Symptomer:
Allmennsymptomer hos 80% og vesikkelutbrudd på forhuden eller rundt urinrørsåpningen, det svir og er ubehagelig
Funn:
Kliniske funn er vesikler, bristede vesikler, sår, ev. impetigo
Diagnostikk:
Tilleggsundersøkelser kan være virusdyrkning eller PCR
Behandling:
Ved primærutbrudd anbefales behandling med perorale antivirale midler
  1. Donovan B. Sexually transmissible infections other than HIV. Lancet 2004; 363: 545-56. PubMed  
  2. Gnann JW Jr, Whitley RJ. Clinical Practice. Genital Herpes. N Engl J Med. 2016;375(7):666-674. doi:10.1056/NEJMcp1603178 DOI  
  3. Albrecht MA. Epidemiology, clinical manifestations, and diagnosis of genital herpes simplex virus infection. UpToDate, last updated Jan 10, 2017. www.uptodate.com  
  4. Bradley H, Markowitz LE, Gibson T, McQuillan GM. Seroprevalence of herpes simplex virus types 1 and 2--United States, 1999-2010. J Infect Dis 2014; 209:325. PubMed  
  5. Bernstein DI, Bellamy AR, Hook EW 3rd, et al. Epidemiology, clinical presentation, and antibody response to primary infection with herpes simplex virus type 1 and type 2 in young women. Clin Infect Dis 2013; 56:344. PubMed  
  6. Langenberg AG, Corey L, Ashley RL, Leong WP, Straus SE. A prospective study of new infections with herpes simplex virus type 1 and type 2. Chiron HSV Vaccine Study Group. N Engl J Med 1999; 341: 1432 - 8. New England Journal of Medicine  
  7. Workowski KA, Bolan GA, Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep 2015; 64:1. PubMed  
  8. Tobian AAR, Serwadda D, Quinn TC, et al. Male Circumcision for the Prevention of HSV-2 and HPV Infections and Syphilis. N Engl J Med 2009; 360: 1298-309. New England Journal of Medicine  
  9. Wald A, Zeh J, Selke S, Warren T, Ryncarz AJ, Ashley R, et al. Reactivation of genital herpes simplex virus type 2 infection in asymptomatic seropositive persons. N Engl J Med 2000; 342: 844-50. New England Journal of Medicine  
  10. Salvaggio MR. Herpes simplex clinical presentation. Medscape, last updated Sep 18, 2015.
  11. Johnston C, Magaret A, Son H, et al. Viral Shedding 1 Year Following First-Episode Genital HSV-1 Infection. JAMA 2022. pmid:36272098 PubMed  
  12. Corey L, Handsfield HH. Genital herpes and public health: addressing a global problem. JAMA 2000; 283: 791-4. Journal of the American Medical Association  
  13. Lautenschlager S, Eichmann A. The heterogeneous clinical spectrum of genital herpes. Dermatology 2001; 202: 211-9. PubMed  
  14. Ramaswamy M, McDonald C, Smith M, et al. Diagnosis of genital herpes by real time PCR in routine clinical practice. Sex Transm Infect 2004;80:406-410. PubMed  
  15. Drake S, Taylor S, Brown D, Pillay D. Improving the care of patients with genital herpes. BMJ 2000; 321:619-23. British Medical Journal  
  16. Ashley RL, Wald A. Genital herpes: review of the epidemic and potential use of type-specific serology. Clin Microbiol Rev 1999; 12: 1-8. PubMed  
  17. Albrecht MA. Treatment of genital herpes simplex virus infection. UpToDate, last updated Jun 04, 2019. www.uptodate.com  
  18. Skiveren J, Bermark S, et al.: Klinisk retningslinje for rensning af akutte og kroniske sår: Sæbe, skyllevæsker og skylletryk. Sist revidert 31.07.2017. Center for kliniske retningslinjer, Aalborg Universitet. www.cfkr.dk  
  19. Nilsen A. Systemisk antiviral behandling ved herpes genitalis. Tidsskr Nor Lægeforen 2002; 122: 2805-6. PubMed  
  20. Corey L, Wald A, Patel R, Sacks SL, Tyring SK, Warren T, et al, for the valacyclovir HSV transmission study group. Once-daily valacyclovir to reduce the risk of transmission of genital herpes. N Engl J Med 2004; 350: 11-20. New England Journal of Medicine  
  21. Brown TJ, McCrary M, Tyring SK. Antiviral agents: non-antiretroviral correction of nonantiviral drugs published correction appears in J Am Acad Dermatol 2002; 47: 972. J Am Acad Dermatol 2002; 47: 581-99. PubMed  
  22. Diaz-Mitoma F, Sibbald RG, Shafran SD, Boon R, Saltzman RL. Oral famciclovir for the suppression of recurrent genital herpes: a randomized controlled trial. Collaborative Famciclovir Genital Herpes Research Group. JAMA 1998; 280: 887-92. Journal of the American Medical Association  
  23. Benedetti J, Corey L, Ashley R. Recurrence rates in genital herpes after symptomatic first-episode infection. Ann Intern Med 1994; 121: 847-54. Annals of Internal Medicine  
  24. Wald A. New therapies and prevention strategies for genital herpes. Clin Infect Dis 1999; 28: S4-13. PubMed  
  • Terje Johannessen, professor i allmennmedisin, Trondheim

Tidligere fagmedarbeidere

  • Svein Z. Bratland, spesialist i allmennmedisin, Sandviken Legesenter, Bergen, og seniorrådgiver i Statens helsetilsyn, Oslo
  • Per Inge Lundmo, overlege Kirurgisk klinikk, Urinveissykdommer, RiT og førsteamanuensis Norges teknisk-naturvitenskapelige universitet, Trondheim