Herpes Simplex Virus

By: Demetra Mensah- Bonsu

OVERVIEW & BACKGROUND
Herpes Simplex Virus (HSV) is a recurrent, lifelong infection with no cure. HSV belongs to a family of DNA viruses
known as Herpesviridae. Herpes Simplex Viruses are enclosed in enveloped particles and are surrounded by a group
of glycoproteins known as tegument. HSV occurs in two biologically, serologically, and epidemiologically
distinguishable types. Type 1 (HSV-1) primarily involves infections of the face and eyes while type 2 (HSV-2) primarily
causes genital infections.

CLINICAL MANIFESTATIONS
Orolabial Herpes

Genital Herpes

Primary Infection

Cause: Mainly HSV-1

Incubation period: 2 to 12
days
Symptoms: fever,pain,
burning, tingling at site of
eruption
Children:ulcers, inflamed
gums
Adults: inflammation of
pharynx and tonsils

Cause: either type of HSV

Incubation period: 2 to 12
days
Symptoms: fever, headache,
pain, itching
Duration: severe and
prolonged

Recurrent Infection

Symptoms: cold sores,

blisters, occurs infrequently,
triggered by external factors
Duration: milder and shorter

Symptoms: tenderness, pain,

burning at site of eruption
Duration: milder and shorter

EPIDEMIOLOGY
1.

Factors affecting the spread of disease

a.

2.

increased age, female gender, black race, marital status, socioeconomic status

Prevalence and Incidence

a.

global prevalence among 0-49 year olds 67%

b.

highest in Africa 87%

c.

lowest in the Americas 40-50%

d.

20 million incident cases each year in the United States

e.

increase in genital HSV-1 prevalence among college ages students

INTERVENTION STRATEGIES
Primary Prevention

Reducing sexual risk behaviors

use of condoms during anal, vaginal and oral sex

avoid sexual activity with seropositive individual during viral shedding

Vaccine Development

there is no effective vaccine for HSV infection

development is focused on

prophylactic vaccines- induces sterilizing immunity that prevents primary infection from
occurring

therapeutic vaccines- reduces symptomatic and asymptomatic shedding

live-virus vaccines-enables host to mount successful immune response

Secondary Prevention

Screening is not recommended for general population due to lack of complications with HSV infection

Screening is recommended for high risk individuals

at risk for STD/HIV infection

infected with HIV

pregnant women

Diagnosis involves physician evaluation and laboratory testing for confirmation

HerpSelect ELISA is most widely used test because it is a type specific serology

Sensitivity 91% (HSV-1), Specificity 92% (HSV-1)

Sensitivity 96% (HSV-2), Specificity 97% (HSV-2)

Tertiary Prevention

Antiviral medication for genital herpes and orolabial herpes

acyclovir, famciclovir

Over the counter medication for cold sores