Aynaud O, Bijaoui G, Ionesco M, Gorgette O, Poveda J D, Zummer K
Service de Prévention et de Dépistage des Tumeurs de la ville de Paris.
Ann Dermatol Venereol. 1994;121(5):376-81.
Our aim was to assess the frequency of herpetic genital infection (HSV) among men attending a human papillomavirus (HPV) screening centre. Clinical screening of a herpetic lesion was completed with biological detection of HSV by cell culture and by polymerase chain reaction (PCR). We also evaluated the role of the male viral factor on the female partners.
We performed a genital examination by colposcopy of 135 men whose female partners presented an HPV genital infection. The HPV lesions detected underwent biopsy by Southern blot viral analysis. The lesions which clinically appeared to be caused by HSV were removed for HSV detection and typing by cell culture and by PCR. Sperm was collected for viral detection by cell culture and PCR was collected for viral detection by cell culture and PCR from patients presenting a herpetic type urethral symptomatology.
Peniscopy detected HPV lesions in 46 p. 100 of the men, in 88 p. 100 of cases in the balano-preputial zone and in 82 p. 100 of cases their morphology was exophytic. The other areas were in 14.5 p. 100 of cases urethral and 9 p. 100 anal. We detected a dysplasic lesion in 6 p. 100 of cases. In 74 p. 100 of cases molecular hybridization by Southern detected 6/11/42 type HPV and in 6.4 p. 100 of cases HPV 16. Clinical examination revealed the presence of genital herpetic infection in 15.5 p. 100 of cases, of these 76 p. 100 were preputial and 24 p. 100 meato-urethral. PCR detected HSV-2 in 88 p. 100 of the preputial lesions and in 86 p. 100 of the spermatic ejaculates from the meato-urethral lesions. The chi 2 test showed that no link exists between a herpetic genital infection and the presence of an HPV lesion, but that the risk is greater (OR = 2.15; IC 95 p. 100 = 0.84-5.49). We also observed that 50 p. 100 of the female partners of men with both HPV+HSV infections had high grade cervical lesions.
This study shows that clinical examination in an HPV screening centre enabled detection of clinical HSV in 15.5 p. 100 of cases as opposed to 17 p. 100 biologically. Thus the good clinical-virological correlation shows that clinical criteria remain the principal elements for detecting viral genital infections, it therefore appears advantageous to only use the new HSV identification techniques for targeted detection. Also, herpetic genital infection is independent of human papillomavirus infection. When screening for HPV, herpetic genital infection should be taken into account as we have observed that the female partners of men with both HPV + HSV are at greater risk of presenting high grade cervical lesions.
我们的目的是评估在一家人类乳头瘤病毒（HPV）筛查中心就诊的男性中疱疹性生殖器感染（HSV）的发生率。通过细胞培养和聚合酶链反应（PCR）对HSV进行生物学检测，从而完成对疱疹性病变的临床筛查。我们还评估了男性病毒因素对其女性伴侣的影响。
我们对135名女性伴侣患有HPV生殖器感染的男性进行了阴道镜下的生殖器检查。对检测到的HPV病变进行Southern印迹病毒分析活检。将临床上疑似由HSV引起的病变切除，通过细胞培养和PCR进行HSV检测及分型。收集精液通过细胞培养进行病毒检测，并对出现疱疹样尿道症状的患者收集前列腺液通过细胞培养和PCR进行病毒检测。
阴茎镜检查发现46%的男性存在HPV病变，88%的病例病变位于龟头包皮区域，82%的病例病变形态为外生性。其他区域分别为14.5%的病例位于尿道，9%的病例位于肛门。6%的病例检测到发育异常病变。74%的病例通过Southern印迹分子杂交检测到6/11/42型HPV，6.4%的病例检测到HPV 16型。临床检查发现15.5%的病例存在生殖器疱疹感染，其中76%位于包皮，24%位于尿道口。PCR检测发现88%的包皮病变及86%的尿道口病变的精液中存在HSV - 2。卡方检验表明，生殖器疱疹感染与HPV病变之间不存在关联，但风险更高（比值比=2.15；95%置信区间=0.84 - 5.49）。我们还观察到，HPV和HSV双重感染男性的女性伴侣中，50%患有高级别宫颈病变。
本研究表明，在HPV筛查中心进行临床检查能够检测出15.5%的临床HSV病例，而生物学检测为17%。因此，良好的临床与病毒学相关性表明，临床标准仍是检测生殖器病毒感染的主要依据，所以仅将新的HSV鉴定技术用于靶向检测似乎更为有利。此外，生殖器疱疹感染与人类乳头瘤病毒感染无关。在筛查HPV时，应考虑到生殖器疱疹感染，因为我们观察到HPV和HSV双重感染男性的女性伴侣出现高级别宫颈病变的风险更高。
