HERPES SIMPLEX VIRUS (HSV)



GENITAL HERPES SIMPLEX VIRUS (HSV)DEFINITIONGenital Herpes Simplex is a chronic, life-long viral infection which can be caused by two types of viruses, herpes simplex virus type 1 (HSV-1 oral herpes) and herpes simplex virus type 2 (HSV-2-genital herpes). Both viral types cause similar symptoms and can occur in different locations. HSV is transmitted by direct contact such as kissing or sexual intercourse with a person who is actively shedding the virus. Most cases of recurrent genital herpes are caused by HSV-2; however, an increasing proportion of anogenital herpetic infections have been attributed to HSV-1 infection, which is especially prominent amount young women and men having sex with men (MSM).Most persons infected with HSV-2 have not had the condition diagnosed. Many such persons have mild or unrecognized infections but shed virus intermittently in the anogenital area. As a result, most genital herpes infections are transmitted by persons unaware that they have the infection or who are asymptomatic when transmission occurs.SUBJECTIVE DATAHistory may include:Previous HSV infection Recent change in sexual partnerPartner with symptoms of HSV-1 or HSV-2Lack of STD protection (condom use)Report of multiple sexual partners and/or partner with multiple partnersOBJECTIVE DATAPhysical exam findings:Primary episode:burning or tingling at site of exposureblisters, which rupture, causing shallow, painful ulcers on labia, penis, perineum, buttocks, thighs, in perianal area, in the mouth or on the lipsswellingdysuria, or inability to voiddyspareuniafever, malaiseregional lymphadenopathyRecurrent:lesions are smaller and more localized inflammation is less severeLABORATORYLaboratory tests may include: (based on Agency protocol)Herpes cultureHerpes PCR testingHerpes antibody testing (serologic type-specific glycoprotein G (gG)-based assays recommended)Chlamydia test, gonorrhea test, VDRL, wet prep, HIV testing as indicatedASSESSMENTAnogenital herpes viral infectionTREATMENT PLANPer agency protocol following current CDC STD Treatment GuidelinesRefer to STD Clinic or PMD for treatmentSPECIAL CONSIDERATIONSPregnancy HIV infection CLIENT EDUCATION/COUNSELINGProvide Medication Information SheetProvide STD education and informationOffer other STD testingProvide current educational information on HSVProvide contraceptive information, if indicated Encourage consistent and correct condom use to reduce STD exposureClients should inform current sex partner(s)Educate partners, if possible, about symptoms and encourage partners to seek clinical evaluationFOLLOW-UPAs recommended by providerREFERRALPregnancy - refer to prenatal providerHIV/Immunosurpressed Client with multiple reinfectionsREPORTING Mandated state reporting is not required. REFERENCESCDC: Sexually Transmitted Disease Treatment Guidelines, 2015Reportable Diseases in Michigan: A Guide for Physicians, Health Care Providers and Laboratories, 2018 2019Reviewed/Revised: 2020 ................
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