HERPES GENITALIS

The term herpes genitalis refers to herpes simplex infection of the genitalia. The majority of cases are caused by HSV-2 but some are caused by HSV-1.

Painful grouped vesicles.
Primary infection may be severe. Recurrent disease less so.
In the immunosuppressed, chronic ulcers may occur.
Diagnosis may be via PCR or culture.
Can get type-specific serology to determine type.
HSV-1 does not protect from HSV-2.

Clinical

The classic appearance of grouped vesicles on an erythematous base is usually NOT seen. Instead, localized pain, erosions, or erythema all are common. Primary infection can be very painful lasting several days to a week. Recurrent episodes are often of shorter duration. Over time, recurrences tend to occur less often. Stressful events of at least 7 days duration significantly predict recurrences.

Asymptomatic Shedding

In a study of the drug pritelivir untreated patients shed virus 16.6% of days. (On pritelivir, they shed only 2.1% of days.)

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