Genital Herpes Simplex Infections

Abstract

Herpes simplex virus infection is a sexually transmitted disease that is becoming increasingly more common. Symptomatic primary infections tend to be severe and prolonged, whereas recurrences are milder and shorter in duration. The most sensitive and specific laboratory test currently available for detecting and typing HSV is tissue culture. The most appropriate management strategy for pregnant women at risk for transmitting the virus at delivery is currently being studied and debated, but evidence indicates that routine surveillance cultures in pregnant women with a history of HSV infection are of no clinical usefulness and that, if there are no visible lesions, culture is not necessary and vaginal delivery is acceptable. Although acyclovir can effectively control symptomatology and speed the healing of lesions, it does not, with current dosage regimens, decrease the frequency of subsequent recurrences. Asymptomatic viral shedding is now considered to cause a large proportion of HSV transmissions; the role of acyclovir in suppression of viral shedding is an area requiring further study.