Genital Herpes

Question 1

What kind of infectious agent is genital herpes?

Answer 1

Chronic, lifelong viral infection

Question 2

How/when is genital herpes transmitted?

Answer 2

Transmitted sexually during viral shedding

Question 3

Describe the two types of genital herpes (herpes simplex virus/HSV).

Answer 3

HSV-1:
- associated with increased anogenital infections, especially among:
- young women
- men who have sex with men

HSV-2:
- 2-3 fold increased risk of HIV infection

Question 4

Who should be tested for genital herpes?

Answer 4

Test those who:
- have another STI
- have 10+ sexual partners
- are HIV + (due to high co-infection rates)

Question 5

What tests should be ordered for genital herpes under which conditions?

Answer 5

If symptomatic or if blisters/fluid present:
- NAAT/PCR test of fluids (most accurate)

If asymptomatic or ulcers are already open/healed:
- IgG serology to differentiate between HSV-1 and HSV-2:
- if positive: needs a confirmatory test
- if negative: restest in about 12 weeks (since it takes about 3 months to seroconvert)

Question 6

List PO pharmaceutical treatments for a first episode of genital herpes, including drug, dose, frequency, and duration.

Answer 6

Acyclovir 400 mg TID x 7 - 10 days

Acyclovir 200 mg 5 times/day x 7 - 10 days

Valacyclovir 1 g BID x 7 - 10 days

Famciclovir 250 mg TID x 7 - 10 days