Herpes Flashcards
What is the definition of ‘initial episode’ of herpes simplex virus?
First episode with either herpes simplex virus type 1 (HSV-1) or type 2 (HSV-2).
This is then further subdivided dependent on whether the individual has had prior exposure to the other type
What is the definition of ‘Primary infection’ with herpes simplex virus?
first infection with either HSV-1 or HSV-2 in an individual with NO pre-existing antibo- dies to EITHER type
What is the definition of ‘Non-primary infection’ with herpes simplex virus?
first infection with either HSV- 1 or HSV-2 in an individual WITH pre-existing anti- bodies to the OTHER type
What is the definition of ‘Recurrent episode’ of herpes simplex virus?
RECURRENCE OF CLINICAL SYMPTOMS due to reactivation of pre-existent HSV-1 or HSV-2 infection after a period of latency
Which herpes simplex virus is the most common cause of genital herpes in the UK?
HSV-1
Which herpes simplex virus is the most common cause of RECURRENT ano-genital herpes in the UK?
HSV-2
What proportion of people develop symptoms at the time of primary infection with HSV-2?
1/3 (one third)
What is the incubation period for herpes simplex virus?
2 days to 2 weeks
What effect does prior infection with HSV-1 have on the first infection by HSV-2?
modifies the clinical manifestations, usually making symptoms less severe
What factor makes HSV-1 the more likely cause of primary genital herpes than HSV-2?
Younger age (women <50 years, men <35years)
How much more likely is recurrent episodes for HSV-2 than HSV-1?
FOUR TIMES more frequent
Which anatomical sites can herpes simplex virus be shed from ASYMPTOMATICALLY?
external genitalia
anorectum
cervix
urethra
What 2 factors increase the frequency of HSV-2 shedding in HIV positive people?
low CD4 counts
seropositive for HSV-1
When are systemic symptoms most common in any-genital herpes?
PRIMARY infection rather than in non-primary or recurrent disease
What is the distribution/pattern of lesions and lymphadenitis in initial episode of ano-genital herpes?
usually bilateral
When would superinfection of herpetic lesions typically occur?
SECOND week
What increases the risk of auto-inoculation of HSV?
damaged and inflamed skin
this can occur in both acquisition and recurrent disease
What are the potential complications of herpes simplex virus?
Superinfection
Autonomic neuropathy resulting in urinary retention
auto inoculation
aseptic meningitis
How may atypical genital herpes present?
small, non-specific erythema, erosions, or fissures
What percentage of proctitis is due to HSV?
16%
What percentage of MSM with HSV-associated proctitis had visible external anal ulceration?
32%
What method is used to identify HSV from lesions?
HSV DNA detection by polymerase chain reaction (PCR)
What percentage of cultures will miss a diagnosis of herpes?
30%
When can HSV serology be considered?
recurrent genital disease of UNKNOWN CAUSE
to help identify recent or established infection in order to aid counselling - eg pregnancy
investigating asymptomatic partners of patients - eg planning pregnancy, possible discordant relationships
