Talk:Herpes/GA Review

Good Article Review

At this version: [1]

Reviews always dwell on faults with article so I will start on a positive note. This a very well-written and comprehensive article. During my first read through, these problems came to light:

• The Lead is way too long.

I've copy edited and trimmed this to try and improve - hoping some "professional" copyeds come soon!~ Ciar ~ _{(Talk to me!)} 05:26, 13 March 2008 (UTC)

• Citations are needed for, HSV-1 being more infectious during primary episodes, the number of asymptomatic infections and HSV-1 amelioration of subsequent HSV-2 infections.

Not sure of the correct places in the text for these. I moved a ref for asymptomatic shedding/frequency to lead, but the others I can't find. I've either deleted text during the copyediting or am just missing it! ~ Ciar ~ _{(Talk to me!)} 06:44, 14 March 2008 (UTC)

• The dates in the Table of prevalence data do not line up very well, making the table very difficult to read. Fixed.

I don't see the problems on the computers I use, so may be a browser problem. I'll try putting phyical rows in the table when I get a chance.~ Ciar ~ _{(Talk to me!)} 05:26, 13 March 2008 (UTC)

It looks OK with Firefox but it's a bit messy using Explorer.--GrahamColm^Talk 11:41, 13 March 2008 (UTC)

I altered the table and checked it with Firefox and Explorer - how does it look at your end?~ Ciar ~ _{(Talk to me!)} 06:30, 14 March 2008 (UTC)

• In the Lead the prevalence in Sub-Saharan Africa is given as 80&, where as in the body it is given as 30-80 for females and 10-50 for males.

reworded/numbered this according to table~ Ciar ~ _{(Talk to me!)} 05:26, 13 March 2008 (UTC)

• There is a big problem with how the seroprevalence data is presented. This is the prevalence of antibody and not disease. Most readers will not know the difference.
• There is a greater emphasis on herbal remedies than antivirals and the latter could be {{main|}} linked to the main article.

IMO, the herbal remedies don't warrant a page of their own, and I think it will be problematic, with some editors, to completely remove the section, so I have compromised and trimmed out the excessive details.~ Ciar ~ _{(Talk to me!)} 05:26, 13 March 2008 (UTC)

• WRT Diagnosis and testing:

"Genital herpes is more difficult to diagnose than oral herpes since most HSV-2-infected persons have no classical signs and symptoms." citation please!

The diagnosis section was covered by a rewiew article that was already cited in several sentences. I didn't wish to over cite, since this is GAR that doesn't require excessive refs, but have included the ref tag after this sentence anyway.~ Ciar ~ _{(Talk to me!)} 06:24, 13 March 2008 (UTC)

How do you test someone who is asymptomatic? What do you swab? What specimens do you send to the lab? Serology is no use because it does not differentiate between past and current infection, (is there a test for IgM?).

H'mmmm, how to answer this? Do you wish me to spell this out in the article or just respond on the talk page? My knowledge on the matter is this. People that become infected with HSV are infected for life. The virus does not get eliminated from the body by the immune system, it just goes into hiding in the ganglia. Before it hides, the immune system (in most cases) develops antibodies against the virus, and the infected person becomes seropositive against HSV (this usually takes a couple of weeks to happen). Since the virus is not eradicated, serology is used as a predictor of persons infected with the virus - modern serology tests CAN distinguish between HSV-1 and HSV-2 since there a slight differences in the proteins that these two viral species produce (Wald's group do this - I'll see if I can find a ref to support - and also if it gives details on IgM + IgG testing). Asymptomatic people are the people infected with HSV (as determined by serology testing and/or previous symptoms) that do not have recurrences. Serology testing (as mentioned above) indicates the presence of earlier infection - yes - but since the virus is not removed from the body, it is used as a predictor for current infection (HSV produces chronic infections) - and is also used to determine HSV infection in asymptomatic individuals. Although they do not have noticable symptoms, they can still release/shed the virus, and this is detected for research purposes by rubbing swabs (like Q-tips) across the infected area (e.g. if the person is seropos for HSV-2, they usually swab the anogenital area, and the swab is tested for viral DNA by PCR) - I can search for relevant articles that show this too. Is this the info you are looking for, and do you think this level of detail should be added to the article to pass GAR? ~ Ciar ~ _{(Talk to me!)} 06:51, 13 March 2008 (UTC)

I'll take another look at this, but I think the answer is asymptomatic people are not tested.--GrahamColm^Talk 11:41, 13 March 2008 (UTC)

H'mmm, I'd say that opinion was too general. I agree that most people that do not know they are infected do not seek testing. However, some people do get tested if they find out they have had exposure to a herpes infected individual regardless of whether they develop symptoms themselves, and other people routinely get tested for STDs - if this did not happen, the existence of asymptomatic people wouldn't be known, right? Just a thought ;) Thanks for helping whittle out the probs BTW ~ Ciar ~ _{(Talk to me!)} 19:36, 13 March 2008 (UTC)

We know about the existence of asymptomatic infections from prospective epidemiological studies. This comes round to my worry about the seroprevalence data. We need to distinguish clearly between incidence and prevalence; two releted but distinct epidemiological concepts. The way the article reads now implies a high incidence of symptomatic disease in some countries, whereas there is a high prevalence of infection. I'm nitpicking because I forsee the article going to FAC sooner rather than later and we could sort these issues out now. Please don't worry about the GA - it's in the bag.--GrahamColm^Talk 19:56, 13 March 2008 (UTC)

No, I don't think this is needed to pass GAR. I've edited the serology section and would be happy to leave it at that. Also, this article will pass GAR but the references need a little work and a clear distinction must be made between seroposivity and active infection.--GrahamColm^Talk 12:57, 13 March 2008 (UTC)

I added an intro paragraph to the epidemiology section for the time being with a ref I could only get the abstract for - not ideal, but the best I could find just now. Haven't been able to identify prevelance data for active disease yet! ~ Ciar ~ _{(Talk to me!)} 07:22, 14 March 2008 (UTC)

:Although a citation is given I do not agree with: "Although these procedures produce highly sensitive and specific diagnoses, their high costs and time constraints limit their regular use in clinical practice." Even PCR isn't that expensive these days. Is this statement meant to refer to the developing countries?

The reference says discourage and I have edited this passage accordingly.--GrahamColm^Talk 11:41, 13 March 2008 (UTC)

I am placing the GA review on hold and will come back to it later. Please give me a reminder on my talk page when it is ready for reappraisal. (Watching!) Graham. --GrahamColm^Talk 11:05, 12 March 2008 (UTC)

• I am promoting the Article to GA. Thanks for being patient and addressing my concerns so quickly. You don't need me to tell you that there is still much work to be done if you are considering FAC. I hope you found the review valuable. Best wishes. Graham.--GrahamColm^Talk 10:45, 14 March 2008 (UTC)

Yipee....thanks Graham! I think I'll throw it in for peer review before tackling the jump to FAC! ~ Ciar ~ _{(Talk to me!)} 23:40, 14 March 2008 (UTC)