Genital herpes: Natural history and treatment of acute episodes

Abstract

Genital herpes is a common, distressing infection whose incidence has been underestimated. Recent serological surveys, employing type-specific antibody assays, show a rising prevalence of previous herpes simplex virus (HSV) type 2 infections in post-adolescent populations in developed countries; many of these infections have been asymptomatic. In some geographical locations, HSV-1 infections are a common cause of first episodes. They may occur in stable, monogamous relationships and are less likely to recur than genital infections caused by HSV-2. The clinical features of first episode genital herpes show marked individual variation in severity; they tend to be more severe in women than in men. Local and distant complications are common in immunocompetent individuals and may be life-threatening in those who are immunocompromised. The psychological and social consequences which result from the life-long infection and its risks of transmission to new sexual partners often prove more disabling to affected individuals than do the milder physical symptoms associated with recurrent episodes. Counselling, support, and patient education are essential components of management. Acyclovir is clearly established as the first choice therapy in both first and recurrent episodes of genital herpes. This drug has potent antiviral effect and provides significant clinical benefit in first episodes. Systemic therapy for initial episodes does not prevent either the establishment of latency or the development of future recurrences even when used in high or prolonged dosage. Episodic treatment of recurrences, with either oral or topical acyclovir, requires early patient initiation of therapy to provide significant clinical benefit.

Identification of Herpes Simplex Virus Genital Infection: Comparison of a Multiplex PCR Assay and Traditional Viral Isolation Techniques

“…Increased transit time between specimen collection and inoculation into cell culture seems to considerably reduce the infectivity that can occur during prolonged transport (12,13). Additionally, recurrent HSV infections, as well as lesions that are in healing stages, are much less likely to yield positive viral cultures for HSV (1,6). On the other hand, like herpes-specific culture, PCR analysis detects only the target virus but does not yield an isolate for further testing.…”

“…Genital herpes simplex virus (HSV) infection is of major public health importance, having markedly increased in prevalence throughout the past two decades (1)(2)(3)(4)(5)(6)(7). Genital HSV is the most common infective cause of genital ulcerative disease in developed countries and is second in prevalence of viral sexually transmitted diseases only to human papilloma virus, which induces anogenital warts, as the most common viral sexually transmitted disease (1).…”

“…Genital HSV is the most common infective cause of genital ulcerative disease in developed countries and is second in prevalence of viral sexually transmitted diseases only to human papilloma virus, which induces anogenital warts, as the most common viral sexually transmitted disease (1).…”

“…HSV type 2 and, less commonly, type 1, are the major causes of genital herpes (1,3). HSV genital infection typically manifests itself as crops of painful, disfiguring lesions that chronically recur.…”

Cytotoxicity and Anti - Herpes Activity of Selected Medicinal Plants Cited for Management of HIV Conditions in Kakamega County – Kenya

“…Most immunocompetent individuals experience subclinical infections with either HSV-1 or HSV-2, mainly following reactivation of latent virus and subsequent mucocutaneous replication [14]. Infections may sometimes occur without symptoms and this usually lead to asymptomatic virus shedding, which is significant for oral HSV-I transmission among children, sexually transmitted HSV in adults and mother to child transmission during birth [16]. Acyclovir resistant strains are much less virulent in immune-competent individuals but cause serious and persistent symptoms in the immunocompromised [14].…”