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Genital Herpes Update
- 3. Testing Scenario 25 year old woman presents for STI screening because she’s met a new partner. She’s had no sex in 6 months, she has no symptoms at all. What HSV tests, if any, do you include in her screening visit?
- 4. Exploring Prevalence of STIs Hepatitis B 0.42 Million HIV 0.56 Million Chlamydia 2 Million HPV (warts) 20 Million HSV 2 ~50 Million CDC estimate: 1.6 million new HSV 2 infections per year
- 8. Subtle Presentation—Excoriation Photo courtesy of Jeffrey Gilbert, MD.
- 9. Buttocks Recurrent HSV Photo courtesy of Jeffrey Gilbert, MD.
- 10. Anal Herpes
- 11. Thigh herpes
- 12. Urethral Herpes Gilbert J.
- 16. What codes get HSV serology covered by insurance? Genital itching 689.1 Pain with intercourse 625.0 Pain with urination 788.1 Female genital pain 625.0 Neuralgia 724.3 Burning, tingling, numbness, prickling 782.0
- 24. Wald A J Clin Inv 1997.
Editor's Notes
- Reference: Gilbert J. You may think you don’t see much herpes, but…you may only see the tip of the iceberg: a guide to genital herpes and herpes zoster. Data on file, GlaxoSmithKline. 2001. VAL933R0.
- Atypical Recurrent HSV Atypical is defined as not fitting the “classic” textbook description Atypical presentations and/or locations are found frequently and are common Reference: Gilbert J. You may think you don’t see much herpes, but…you may only see the tip of the iceberg: a guide to genital herpes and herpes zoster. Data on file, GlaxoSmithKline. 2001. VAL933R0.
- Reference: Gilbert J. You may think you don’t see much herpes, but…you may only see the tip of the iceberg: a guide to genital herpes and herpes zoster. Data on file, GlaxoSmithKline. 2001. VAL933R0.
- Reference: Ashley R et al. Genital Herpes: Review of the Epidemic and Potential Use of Type-Specific Serology. Clin Microbiol Rev . 1999;12:1-8.
- Though the rationale that I describe today to place HSV 2 positive patients on suppression to reduce HIV acquisition have not yet been proven, they make a whole lot of sense. When the genital epithelium is disupted, with or without recognized symptoms, HIV can enter the body more easily, if it is around. CD4 cells, the targets of HIV, are recruited by the immune system to the site of HSV reactivation. There the cells sit, on broken skin, just waiting to be infected by any HIV that is nearby. Connie Celum and her associates have ongoing studies to see if suppressing HSV 2 with acyclovir can decrease new HIV infections. Perhaps next year, we will have more than theoretical information to warrant suppression for HSV 2 infected patients.