[Viral sexually transmitted diseases and their treatments]

Abstract

In occidental countries, the sexually transmitted diseases (STDs) originate mostly from virus: human papillomavirus (HPV) and Herpes simplex virus (HSV). During the latest 15 to 20 years, their prevalence has been regularly growing. Those viruses have in common a capacity for latency. The persistence of the virus in keratinocytes (PVH) or in ganglionic cells (HSV) and the lack of an efficient preventive or final curative treatment have several consequences: 1) a possible capacity of transmitting itself during sexual intercourse in the absence of clinical lesions, 2) a potency to recur all along the life especially when the organism suffer from immunodepression (patients with graft, chimiotherapy or AIDS). The oncogenic capacity of some HPV subtypes in anogenital cancers is now recognized. Those neoplasias are observed most often in immunodepressed patients but are nevertheless classically found in the uterine cervix of immunocompetent women. Genital herpes is often clinically diagnosed but its confirmation is obtained through isolating the HSV from the liquid of the vesicles or from a swab of the lesion. Biopsy is not usually useful. For HPVs, it is different since culture of papillomavirus is not possible. Diagnosis can then be get through biopsy: specific features (koïlocytes) or HPV identification. Treatments are also totally different. Since the appearance of aciclovir, followed by valaciclovir and famciclovir, antiviral drugs are available against herpes. There is no antiviral drug against HPV. The HPV infections are treated through destroying the clinical lesions: laser, cryotherapy, podophylline...