Herpes Simplex Type 2

Herpes genitalis can be caused by the herpes simplex virus type 1 or 2, manifesting as a primary or recurrent infection.  Most commonly, viral replication occurs in epithelial tissue and establishes dormancy in sensory neurons, reactivating periodically as localized recurrent lesions.  It remains one of the most common sexually transmitted infections (STI) but continues to be underestimated, given the vague presentation of its symptoms. In addition to providing the reader with basic knowledge of the pathogen and clinical presentation of herpes genitalis, this review article discusses important aspects of laboratory diagnostics, antiviral therapy, and prophylaxis. This article is aimed at all healthcare providers managing patients with herpes genitalis and attempts to improve the often suboptimal counseling and targeted use of laboratory diagnostics, treatment, and preventive measures provided to patients. Herpes simplex virus type 2 (HSV-2) continues to be a common infection, affecting approximately 22% of adults ages 12 and older, representing 45 million adults in the United States alone. While HSV-1 often affects the perioral region and can be known to cause genital lesions, HSV-2 is more commonly the consideration when patients present with genital lesions. Despite this, most infection outbreaks will present with nonspecific symptoms such as genital itching, irritation, and excoriations, which may cause diagnosis and treatment to be delayed. As a result, further exposure to uninfected individuals may occur.