Herpes Simplex (HSV)

Human Herpes Family of Viruses

1. HSV-1: Oral Herpes Simplex

2. HSV-2: Genital Herpes Simplex

3. HSV-3: Varicella Zoster Virus

4. HSV-4: EBV (Glandular Fever)

5. HSV-5: Cytomegalovirus (CMV) 

6. HSV-6: Roseola virus, 6th disease

7. HSV-7: Roseola virus, 6th disease

8. HSV-8: Kaposi's Sarcoma, associated with HIV

HSV 1 &2

Exam Cram

• Herpes Simplex Virus refers to the HSV-1 and HSV-2 in the human herpes family

• Presents with painful vesicles peri-orally or around the genitals

• Management: topical or oral aciclovir

Outline

Background

• 80% of individuals have a dormant HSV infection

Assessment

History

• Potentially history of immunocompromise

Examination

• Painful vesicles around mouth or genitals

Investigations

• HSV PCR swab

• Serology: anti-HSV antibiodies

Diagnosis

Diagnostic criteria: painful vesicle + positive PCR

Management

1. Topical aciclovir

2. Oral aciclovir

3. If more than 6 episodes over past 12 months: aciclovir 400mg BD for 12 months

Med Reg Notes

Oral Sex

Due to oral sex HSV 1 & 2 have become cross contaminated and so HSV1 is not only found on the mouth and HSV2 not only found in the genitals!

Pregnancy

HSV-2 genital lesions: 

• Acute treatment: 4 weeks PO acyclovir

• Birth: start acyclovir 400mg TDS from week 36

• C-Section birth if active lesions or prodromal symptoms at time of birth

Dendritic Ulcers

HSV can infect the eye producing a dendritic ulcer seen under fluorescein. 

Management: topical or oral aciclovir

References and Resources

1. https://www.hopkinsmedicine.org/health/conditions-and-diseases/herpes-hsv1-and-hsv2/oral-herpes

Written in 2025