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SOURCE

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Source: Knodel LC, Duhon B, Argamany J. Sexually transmitted diseases. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill; 2017. http://accesspharmacy.mhmedical.com/content.aspx?bookid=1861&sectionid=146072585. Accessed March 7, 2017.

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DEFINITION

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  • Herpes used to describe two distinct but antigenically related serotypes of herpes simplex virus (HSV)

    • HSV type 1 (HSV-1) most commonly associated with oropharyngeal disease.

    • HSV type 2 (HSV-2) most closely associated with genital disease.

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ETIOLOGY

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  • Genital disease associated with HSV-2

    • Humans sole reservoir for HSV.

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PATHOPHYSIOLOGY

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  • Transmitted via inoculation from infected secretions onto mucosal surfaces (eg, urethra, oropharynx, cervix, and conjunctivae) or through abraded skin.

  • Cycle of HSV infection occurs in five stages:

    • Primary mucocutaneous infection.

    • Infection of ganglia.

    • Establishment of lifelong latency.

    • Reactivation.

    • Recurrent infection.

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EPIDEMIOLOGY

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  • Most common cause of genital ulceration in United States.

  • Major public health concern due to.

    • Morbidity.

    • Recurrent nature.

    • Potential for complications.

    • Ability to be transmitted asymptomatically.

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PREVENTION

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  • Suppressive therapy with recommended antivirals reduces frequency and severity of recurrences in 70–80% of patients.

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RISK FACTORS

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  • Contact with infected secretions.

    • May be transmitted when partner is asymptomatic.

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CLINICAL PRESENTATION

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  • Summary of clinical presentation of genital herpes provided in Table 1.

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Table Graphic Jump Location
TABLE 1.Presentation of Genital Herpes Infections

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