Herpes simplex virus type 2 wiki

Herpes genitalis remains one of the most common sexually transmitted infections STI. Sixteen percent of patients aging 14 to 49 were reported to be seropositive for HSV-2 from to More women than men have been reported to be infected, and as expected, the prevalence increases with an increasing number of sexual partners.

In the United States, HSV remains one of the most common causes of genital ulcers, and internationally, more than 23 million new cases are reported annually. HSV-2 is transmitted through direct contact of sections in a seropositive individual who is actively shedding the virus. The virus preferentially affects the skin and mucous membranes with the virus invading epithelial cells on initial exposure and ultimately replicating intracellularly at that site.

After the initial exposure and symptoms resolve, in 10 to 14 days, on average, the virus then lays dormant in the periaxonal sheath of the sensory nerves of either the trigeminal, cervical, lumbosacral, or autonomic ganglia.

In these locations, the viral replication is often controlled by the patient's immune system and remains in a dormant state only to later reactive later in life. Histological presentations of HSV-2 include the presence of dense lymphoid infiltrates with atypical lymphocytes. When looking at the surface of cells, it is common to see epidermal ballooning and acantholysis, which leads to the classic vesiculation seen on the clinical exam.

Genital symptoms are commonly seen in the outpatient primary care setting, despite many going without a clear diagnosis. HSV-2, in particular, may present as a primary infection with painful genital ulcers, sores, crusts, tender lymphadenopathy, and dysuria. Genital lesions can be especially painful, leading to swelling of the vulva in women, burning pain, and dysuria. It is important to note that HSV-2 does not typically present with painless ulcers.

Recommended Laboratory Assessments [14] [15]. Given symptoms can mimic acute urinary tract infection, consider urinalysis and culture. Management of genital herpes centers around preventing its transmission and suppressing viral shedding through antiviral therapy and counseling regarding the risk of sexual transmission.

Primary infections with multiple ulcerating lesions will resolve after approximately 19 days, regardless of treatment interventions. Primary infection is when the individual is experiencing their first outbreak previously seronegative for HSV. Secondary or non-primary refers to an infection in a patient with preexisting immunity. Treatment is similar for both patient populations. Antiherpesviral agents include those that act as nucleoside analog-polymerase inhibitors and pyrophosphate analog—polymerase inhibitors.

The mainstay of therapy remains acyclovir, which has antiviral activity against all herpesviruses and has been FDA approved for the treatment and suppression of both HSV and VZV. These medications are preferentially taken up by those cells already infected with the virus and stop viral replication. Standard therapy for herpes simplex virus type 2 infections include acyclovir and valacyclovir. As patients seek alternative treatments that have a smaller side effect profile, essential oils have been a focus of interest.

As a result, it may be of particular benefit from a chronic suppressive treatment rather than post-infectious symptoms. Other oils that have been found to have antiviral effects against HSV include Australian tea tree oil and eucalyptus oil. HSV vaccines are being studied to reduce the severity of symptoms and to help expedite visible lesion healing. Furthermore, by reducing shedding, the severity may be reduced, as has been seen with the Varicella-zoster vaccination. There is no cure for HSV-2, early identification of symptoms, and prompt institution of pharmacotherapy can lead to early suppression of viral replication.

Abstinence during known viral shedding can decrease the risk of transmission to a seronegative partner. The Herpes viruses as a family are responsible for significant neurological morbidity, and unfortunately, HSV-2 persists in the seropositive individual for a lifetime.

The primary care physician or provider will often be the first one to diagnose and treat HSV-2 infections. However, an interprofessional team approach is the optimal means to address this condition. Genital herpes is a sexually transmitted more This was an outbreak of herpes genitalis, which had manifested as blistering on the underside of the penile shaft, just proximal to the corona of the glans, which was due to the herpes simplex 2 HSV-2 virus, otherwise referred to as genital herpes.

This book is distributed under the terms of the Creative Commons Attribution 4. Turn recording back on. National Center for Biotechnology Information , U. StatPearls [Internet].

Search term. Affiliations 1 Parkview Medical Center. Continuing Education Activity This activity reviews the evaluation and management of herpes simplex type 2 and highlights the role of the primary care provider in managing patients with this condition. Introduction Herpes genitalis can be caused by the herpes simplex virus type 1 or type 2 and manifests as either a primary or recurrent infection. Etiology Risk factors for acquiring HSV-2 infection revolve around direct exposure to fluids i.

Epidemiology Herpes genitalis remains one of the most common sexually transmitted infections STI. Pathophysiology HSV-2 is transmitted through direct contact of sections in a seropositive individual who is actively shedding the virus. Histopathology Histological presentations of HSV-2 include the presence of dense lymphoid infiltrates with atypical lymphocytes.

History and Physical Genital symptoms are commonly seen in the outpatient primary care setting, despite many going without a clear diagnosis. Evaluation Recommended Laboratory Assessments [14] [15] A direct swab of vesicular lesions within 72 hours of onset is ideal but avoid lesions that have evidence of crusting or healing.

Thomas, G. Gough, D. Latchman, and R. Coffin, J. Most commonly, viral replication occurs in epithelial tissue and establishes dormancy in sensory neurons, reactivating periodically as localized recurrent lesions. It remains one of the most common sexually transmitted infections STI but continues to be underestimated, given the vague presentation of its symptoms. In addition to providing the reader with basic knowledge of the pathogen and clinical presentation of herpes genitalis, this review article discusses important aspects of the laboratory diagnostics, antiviral therapy, and prophylaxis.