Genital Herpes
GENERAL PRINCIPLES
Genital herpes is caused by herpes simplex virus (HSV), types 1 and 2, usually type 2. The proportion of herpes caused by HSV-1 continues to increase among women and men who have sex with men (MSM).
HSV-2 is more likely to recur and may require suppressive therapy.DIAGNOSIS
• Infection is characterized by painful grouped vesicles in the genital and perianal regions that rapidly ulcerate and form shallow tender lesions.
• The initial episode may be associated with inguinal adenopathy, fever, headache, myalgias, and aseptic meningitis; recurrences are usually less severe. Highest rates of transmission are with active lesions; however, asymptomatic shedding of virus is frequent and can lead to transmission.
• Confirmation of HSV infection requires culture or polymerase chain reaction (PCR). Clinical presentation is often adequate for diagnosis.