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Herpes Simplex Virus Infections

HSV is a member of the herpesvirus family, which includes varicella zoster virus, Epstein-Barr virus, and cytomegalovirus. Like all herpesviruses, HSV tends to establish latent infection and eventually it reactivates and becomes infectious. Most HSV-infected patients have asymptomatic infections or the symptoms are only mildly uncomfortable. However, a substantial number of patients experience frequent painful recurrences or severe or life-threatening recurrences.

Virology and Pathogenesis

Two types of HSV exist: HSV-1 and HSV-2. Both types can infect.

Manifestations of HSV Infections

HSV-1. Asymptomatic oral lesions, nonoral or non-genital skin lesions, encephalitis, neonatal disease, genital lesions.

HSV-2. Asymptomatic genital lesions, neonatal disease, nonoral, nongenital skin lesions, meningitis, oral lesions.

During epithelial cell infection, HSV infects the regional sensory or autonomic nerves, traveling via the nerve axon to the neuron, where it establishes a latent infection. Subsequently, the virus may reactivate. Factors may cause reactivation include immunodeficiency, physical and psychosocial stress, trauma, and exposure to ultraviolet light.


Seroprevalence increases for HSV with age and is more common among patients in lower socioeconomic class (50-60%) than among those of middle (35%) or higher socioeconomic class (10-20%).

HSV-2 infection risk among individuals reporting one sexual partner is less than 10%. Among individuals reporting 2 to 10 partners the risk is higher.

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