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Herpes Simplex

Abbreviations: CNS: central nervous system • CSF: cerebrospinal fluid • DFA: direct fluorescent antibody • HAEM: HSV-associated erythema multiforme • HHV: human herpesvirus • HSV: herpes simplex virus • IV: intravenous • PCR: polymerase chain reaction • SEM: skin, eye, and mouth • STI: sexually transmitted infection • VZV: varicella-zoster virus

The first 300 words of the full text of this article appear below.

	Objectives

 
After completing this article, readers should be able to:

1. Characterize the epidemiology of herpes simplex virus (HSV) infection, including mode of transmission, incubation period, and period of communicability.
   
2. Recognize the difference in clinical manifestations of HSV1 and HSV2 infection.
   
3. Diagnose various manifestations of HSV infection.
   
4. Describe the difference in the clinical manifestations and outcome of HSV infection in newborns and older infants and children.
   
5. Discuss the management of HSV infection.
   
6. List the indications and limitations of oral acyclovir treatment for HSV infection.
   

	Introduction

 
HSV causes a contagious infection that affects approximately 60% to 95% of adults worldwide. HSV1 and HSV2 primarily infect human populations. HSV1 is associated chiefly with infections of the mouth, pharynx, face, eye, and central nervous system (CNS), and HSV2 is associated primarily with infections of the anogenital region, although both serotypes may infect any area. (1)

	Epidemiology

 
Most adults are infected with HSV and carry latent viruses, but the serotype, severity of symptoms, and mode of transmission vary with age. Children are infected primarily with orolabial HSV1 by 5 years of age, with infection rates of 33% in populations that are of lower socioeconomic status and 20% in those who have improved socioeconomic status. By adulthood, HSV1 affects 70% to 80% in the lower socioeconomic population and 40% to 60% in the higher socioeconomic population. (1) Globally, the prevalence of HSV1 increases consistently with age, reaching 40% by age 15 years and increasing to 60% to 90% in older adults. (2) In the United States, the prevalence of HSV1 increases consistently with age, from 26.3% in 6- to 7-year-old children and 36.1% in 12- to 13-year-old children to 90% among those older than 70 years. (2)(3) Of note, the overall prevalence of HSV1 in the United States has . . . [Full Text of this Article]

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