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Source: KnodelLC. Sexually Transmitted Diseases. In: DiPiro, JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM. Pharmacotherapy: A Pathophysiologic Approach, 8th edition. Accessed July 16, 2012.

  • 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.

  • Genital disease associated with HSV-2
    • Humans sole reservoir for HSV.

  • Transmitted via inoculation from infected secretions onto mucosal surfaces (e.g., urethra, oropharynx, cervix, and conjunctivae) or through abraded skin.
  • Cycle of HSV infection occurs in 5 stages:
    • Primary muco-cutaneous infection
    • Infection of ganglia
    • Establishment of lifelong latency
    • Reactivation
    • Recurrent infection

  • 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

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

  • Contact with infected secretions
    • May be transmitted when partner is asymptomatic.

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

Table 1. Presentation of Genital Herpes Infections

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