> Genital Herpes: screening tests not recommended for HSV

The Services Task Force prevention of the United States (USPSTF) has published in December 2016, the final recommendations and a statement on the use of blood tests for screening.

After having carefully examined the evidence, the USPSTF concluded that the damage of screening outweigh the benefits. These recommendations align with those of other healthcare organizations, including the American Academy of Family Physicians, the American College of Obstetrics and Gynecology, and other centers for the control and prevention of diseases.

“Despite genital herpes is common, the test is not &is generally helpful for people without symptoms, in part becauseé the early identification improve the health of a person as there is no cure for herpes,” explained a member of the task force, Ann E. Kurth, in a press release.

“Besides,” he then added – sinceé the current screening methods are often imprecise, the damage of the screening include high rates of false positives, and then a needless potential anxiety and disruption of personal relationships in connection with the diagnosis”.

The HSV is a sexual transmitted infection, which strikes one american in six of età between 14 and 49 years. Despite the antiviral drugs can treat the symptoms of infection by HSV and prevent outbreaks, and cannot cure the infection below. There are two types of HSV: HSV1 (especially infections of the oral) and HSV2 (infection mainly genital).

The recommendations also point out that the current test for HSV-1, which is becoming more and moreù a genital infection, you can notò identify if the site of infection is oral or genital.

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The task force also recommends consulting a behavioral intensive care for the prevention of sexually transmitted diseases in high-risk individuals, and recommend the close observation of pregnant women with a recent infection. Even if the infection neonatal HSV is rare, può be dangerous to life, and to women with active infection at the time of the birth of the child should be offered the possibilityà of a caesarean section.

In an editorial linked to the study, Edward W. Hook, University of Alabama at Birmingham, endorses the recommendations, but with warnings.

The recommendation against serological screening for HSV genital is correct, writes the specialist – but must relate to doctors and patients and serve as a call to action for the National Institutes of Health, other federal agencies and industry partners, to address this epidemic in the course, giving priorities to the development of improved testing and test strategies for the diagnosis of HSV”.

He stressed that the genital herpes as a public health problem is “largely underestimated”. Moreover, the infection by HSV affects disproportionately the black non-hispanic, and provides an example of “disparityà of the startling health” in the United States. The strong link between genital herpes and HIV infection provides another reason to address the problem.

However, the lack of a national control programme, the lack of vaccine for prevention, and the widespread unawareness of the disease among the infected individuals, people who are in a difficultyà in action. Tests for HSV are not increased in quality over the last ten years and need to be improved. Reduce the stigma and misconceptions about the infection by HSV is also important to increase the control adds Hook.

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“Even if it is disappointing that you have così little progress in terms of performance, the current recommendation, USPSTF should serve to renew the efforts to develop the best evidence for HSV, to improve the management strategy, and to tackle the stigma that is pervasive and harmful associated with genital herpes,” concludes the expert.

The final recommendations are consistent with a draft made available for public comment in the month of August and update the recommendations of the 2005.

Source: JAMA. 2016; 316 (23): 2493-2494, 2525-2543; The conclusions are also available on the web site, USPSTF.

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