Genital Herpes
Genital herpes is a common sexually transmitted disease (STD) caused by herpes
simplex virus (HSV) type 1 or type 2, affecting more than 400 million persons worldwide
(Feltner et al., 2016). Primary HSV infection is from a previously unexposed person
having close contact with someone who is actively shedding the virus from skin or
secretions. HSV-2 accounts for most frequent genital herpes cases and is more likely to
cause symptomatic recurrences than HSV-1 (Groves, 2016).
It is estimated that each year 776,000 people in the United States get new genital
herpes infections, with 11.9% between ages 14-49 years old having HSV-2 infection
(CDC, 2017). In the state of Indiana, genital herpes is not an STD requiring to be
reported to Centers for Disease Control and Prevention (CDC) so I was unable to find
statistics specific to Indiana.
Signs and symptoms
The classic presentation of HSV, whether primary infection or secondary outbreak, is
absent most of the time (Groves, 2106). Many patients have reported either minimal or
no symptoms at all. Studies report 65% to 90% of patients with genital HSV infection
are unaware of its presence (Feltner et al., 2016). A visible outbreak consists of single
or clustered vesicles on the genitalia, perineum, buttocks, upper thighs, or perianal
areas that ulcerate before resolving. Symptoms of primary infection include malaise,
fever, or localized adenopathy with secondary outbreaks being milder (Dinesh &
Deepak, 2016).
Treatments per current clinical guidelines
There is actually no treatment that can cure herpes but antiviral medications can either
prevent or shorten outbreaks and, if taking daily, can decrease chances of transmission
to partners. According to CDC guidelines, treatment for first clinical episodes include
Acyclovir 400mg po tid x 7-10 days or 200mg po 5x/day x 7-10 days, or Famciclovir
250mg po tid x 7-10 d, or Valacyclovir 1g po bid x 7-10 days (CDC, 2015). For adults
with recurring genital herpes, 500 mg of valacyclovir two times daily for a total of three
days (CDC, 2015).
For primary infections where the symptoms can be severe, antiviral therapy is usually
started even before the symptoms are confirmed by laboratory diagnosis and the length
of the therapy is 7-10 days or till the lesions are healed (CDC, 2016). In severe cases,
to relieve pain, clinicians recommend the use of analgesics or sitz baths where the
patients’ hips and buttocks are immersed in lukewarm water (Groves, 2016).
Follow-up
Almost all persons with symptomatic first-episode genital HSV-2 infection will later
experience recurrent episodes of genital lesions (Groves, 2016). Intermittent
This study source was downloaded by 100000842670546 from CourseHero.com on 03-02-2022 12:21:34 GMT -06:00
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, asymptomatic shedding occurs in persons with genital HSV-2 infection, even in those
with long-lasting or clinically silent infection (Dinesh & Deepak, 2016). Antiviral therapy
for recurrent genital herpes can be administered either as suppressive therapy to
reduce the frequency of recurrences or occasionally to improve or shorten the duration
of lesions (Groves, 2016).
The frequency of genital herpes recurrences diminishes over time so it is important that
providers should discuss the need to continue therapy. However, neither treatment
discontinuation nor laboratory monitoring in a healthy person is necessary (CDC, 2015).
Effective episodic treatment of recurrent herpes requires initiation of therapy within 1
day of lesion onset. The patient should be provided with a supply or prescription for the
medication with instructions to initiate treatment immediately when symptoms begin
Groves, 2016).
Possible psychological issues that may present
The psychological effect of HSV infection can be significant as the common concerns
regarding genital herpes include the severity of initial clinical signs, recurrent episodes,
sexual relationships and transmission to sex partners, and ability to bear healthy
children (CDC, 2015). Patients often feel embarrassment, shame, and stigma
associated with a herpes diagnosis that can interfere with their relationships. Providers
can address these concerns by encouraging patients to recognize that while herpes is
not curable, it is a manageable condition.
Side effects of medication or the disease itself
The most common side effects of acyclovir treatment for genital herpes include nausea,
vomiting, and diarrhea (CDC, 2015).
Complications of genital herpes include acute urinary retention, aseptic meningitis,
pelvic inflammatory disease, hepatitis, encephalitis, and pneumonitis (Groves, 2016)
Find and identify your local or state statistics for your assigned STD from the
CDC website
As mentioned above, the state of Indiana does not require reporting of herpes or
trichomoniasis, so I was unable to find statistics specific to Indiana. Only positive cases
of chlamydia, gonorrhea, and syphilis are to be reported using the Indiana Confidential
Sexually Transmitted Disease (STD) Report (ISDH, 2019).
References
Centers for Disease Control and Prevention. (2017). Genital Herpes-CDC Facts Sheet.
Retrieved from https://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm
This study source was downloaded by 100000842670546 from CourseHero.com on 03-02-2022 12:21:34 GMT -06:00
https://www.coursehero.com/file/52527838/NR602-Week7-STD-GenitalHerpesdocx/
Genital herpes is a common sexually transmitted disease (STD) caused by herpes
simplex virus (HSV) type 1 or type 2, affecting more than 400 million persons worldwide
(Feltner et al., 2016). Primary HSV infection is from a previously unexposed person
having close contact with someone who is actively shedding the virus from skin or
secretions. HSV-2 accounts for most frequent genital herpes cases and is more likely to
cause symptomatic recurrences than HSV-1 (Groves, 2016).
It is estimated that each year 776,000 people in the United States get new genital
herpes infections, with 11.9% between ages 14-49 years old having HSV-2 infection
(CDC, 2017). In the state of Indiana, genital herpes is not an STD requiring to be
reported to Centers for Disease Control and Prevention (CDC) so I was unable to find
statistics specific to Indiana.
Signs and symptoms
The classic presentation of HSV, whether primary infection or secondary outbreak, is
absent most of the time (Groves, 2106). Many patients have reported either minimal or
no symptoms at all. Studies report 65% to 90% of patients with genital HSV infection
are unaware of its presence (Feltner et al., 2016). A visible outbreak consists of single
or clustered vesicles on the genitalia, perineum, buttocks, upper thighs, or perianal
areas that ulcerate before resolving. Symptoms of primary infection include malaise,
fever, or localized adenopathy with secondary outbreaks being milder (Dinesh &
Deepak, 2016).
Treatments per current clinical guidelines
There is actually no treatment that can cure herpes but antiviral medications can either
prevent or shorten outbreaks and, if taking daily, can decrease chances of transmission
to partners. According to CDC guidelines, treatment for first clinical episodes include
Acyclovir 400mg po tid x 7-10 days or 200mg po 5x/day x 7-10 days, or Famciclovir
250mg po tid x 7-10 d, or Valacyclovir 1g po bid x 7-10 days (CDC, 2015). For adults
with recurring genital herpes, 500 mg of valacyclovir two times daily for a total of three
days (CDC, 2015).
For primary infections where the symptoms can be severe, antiviral therapy is usually
started even before the symptoms are confirmed by laboratory diagnosis and the length
of the therapy is 7-10 days or till the lesions are healed (CDC, 2016). In severe cases,
to relieve pain, clinicians recommend the use of analgesics or sitz baths where the
patients’ hips and buttocks are immersed in lukewarm water (Groves, 2016).
Follow-up
Almost all persons with symptomatic first-episode genital HSV-2 infection will later
experience recurrent episodes of genital lesions (Groves, 2016). Intermittent
This study source was downloaded by 100000842670546 from CourseHero.com on 03-02-2022 12:21:34 GMT -06:00
https://www.coursehero.com/file/52527838/NR602-Week7-STD-GenitalHerpesdocx/
, asymptomatic shedding occurs in persons with genital HSV-2 infection, even in those
with long-lasting or clinically silent infection (Dinesh & Deepak, 2016). Antiviral therapy
for recurrent genital herpes can be administered either as suppressive therapy to
reduce the frequency of recurrences or occasionally to improve or shorten the duration
of lesions (Groves, 2016).
The frequency of genital herpes recurrences diminishes over time so it is important that
providers should discuss the need to continue therapy. However, neither treatment
discontinuation nor laboratory monitoring in a healthy person is necessary (CDC, 2015).
Effective episodic treatment of recurrent herpes requires initiation of therapy within 1
day of lesion onset. The patient should be provided with a supply or prescription for the
medication with instructions to initiate treatment immediately when symptoms begin
Groves, 2016).
Possible psychological issues that may present
The psychological effect of HSV infection can be significant as the common concerns
regarding genital herpes include the severity of initial clinical signs, recurrent episodes,
sexual relationships and transmission to sex partners, and ability to bear healthy
children (CDC, 2015). Patients often feel embarrassment, shame, and stigma
associated with a herpes diagnosis that can interfere with their relationships. Providers
can address these concerns by encouraging patients to recognize that while herpes is
not curable, it is a manageable condition.
Side effects of medication or the disease itself
The most common side effects of acyclovir treatment for genital herpes include nausea,
vomiting, and diarrhea (CDC, 2015).
Complications of genital herpes include acute urinary retention, aseptic meningitis,
pelvic inflammatory disease, hepatitis, encephalitis, and pneumonitis (Groves, 2016)
Find and identify your local or state statistics for your assigned STD from the
CDC website
As mentioned above, the state of Indiana does not require reporting of herpes or
trichomoniasis, so I was unable to find statistics specific to Indiana. Only positive cases
of chlamydia, gonorrhea, and syphilis are to be reported using the Indiana Confidential
Sexually Transmitted Disease (STD) Report (ISDH, 2019).
References
Centers for Disease Control and Prevention. (2017). Genital Herpes-CDC Facts Sheet.
Retrieved from https://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm
This study source was downloaded by 100000842670546 from CourseHero.com on 03-02-2022 12:21:34 GMT -06:00
https://www.coursehero.com/file/52527838/NR602-Week7-STD-GenitalHerpesdocx/
