herpes%20simplex%20virus%20infection
HERPES SIMPLEX VIRUS INFECTION
Primary herpes simplex virus (HSV) infection is first infection with either herpes simplex virus-1 (HSV-1) or herpes simplex virus-2 (HSV-2) in individuals who do not have antibodies to either HSV-1 or HSV-2.
First episode-non primary infection is infection with either HSV-1 or HSV-2 in individuals who have previously existing antibodies against HSV-1 or HSV-2 respectively.
Recurrent HSV infection results from reactivation of latent virus. It is usually brought about by triggering factors eg UV light, immunosuppression.
Orolabial HSV disease is mostly caused by HSV-1 that occurs most commonly in children <5 years of age. It is transmitted through close contact with individuals who have active viral shedding.
Genital HSV disease is caused by HSV-2 that is the usual cause of herpes genitalis. It typically occurs in adults and transmitted through sexual contact.

Prevention

  • Educate patient on how to prevent transmission by:
    • Abstaining from sexual contact during lesion recurrences or prodromes
    • Limiting the number of sexual partners
    • Informing sexual partner or former sexual partner(s) of diagnosis to prevent further transmission; advising partners to seek evaluation & treatment
    • Understanding that asymptomatic viral shedding may cause transmission
    • Using a condom to protect against transmission (not foolproof)

Counselling

Patient & Parent

  • Reduce patient’s anxiety & help patients to cope w/ the infection by educating them on the natural history of the disease, recurrent episodes, antiviral treatments, sexual relationships & perinatal transmission
  • Discuss treatment options:
    • Episodic treatment vs suppressive treatment
    • If patient has ≥6 episodes/year, consider suppressive treatment
    • Suppressive treatment may incur higher costs & inconvenience
      • Increase fluid intake to dilute urine

Follow Up

  • Interrupt treatment after 6 months-1 year to assess frequency of recurrence
  • Restart treatment if high rate of recurrences
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Infectious Diseases - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Jairia Dela Cruz, 30 Apr 2018
Early gastric cancer patients receiving Helicobacter pylori treatment are at lower risk of subsequently developing metachronous or new primary gastric cancer tumours, according to the results of a trial. Moreover, this treatment yields substantial improvements in the grade of gastric corpus atrophy.
Pearl Toh, 03 Nov 2017
Increasing daily water intake by 1.5 L can half the risk of recurrent acute uncomplicated cystitis (rAUC) in women, suggests a study presented at the recent Infectious Disease Week (IDWeek) in San Diego, California, US.
24 Dec 2015
Imipenem-cilastatin exhibited better efficacy than piperacillin-tazobactam as empiric antibiotic for febrile neutropaenia in haematopoietic stem cell transplantation (HSCT) recipients, based on a study.