2/17/2024 0 Comments Female to male hiv transmission![]() Although multiple FDA-cleared assays exist for HSV detection, these tests vary in sensitivity from 90.9% to 100% however, they are considered highly specific ( 445– 447). HSV NAAT assays are the most sensitive tests because they detect HSV from genital ulcers or other mucocutaneous lesions these tests are increasingly available ( 442– 444). ![]() HSV-2 genital herpes infection increases the risk for acquiring HIV twofold to threefold therefore, all persons with genital herpes should be tested for HIV ( 441). Both type-specific virologic and type-specific serologic tests for HSV should be available in clinical settings that provide care to persons with or at risk for STIs. Type-specific serologic tests can be used to aid in the diagnosis of HSV infection in the absence of genital lesions. Therefore, prognosis and counseling depend on which HSV type is present. Recurrences and subclinical shedding are much more frequent for HSV-2 genital herpes infection than for HSV-1 genital herpes ( 439, 440). If genital lesions are present, clinical diagnosis of genital herpes should be confirmed by type-specific virologic testing from the lesion by NAAT or culture ( 186). Diagnostic ConsiderationsĬlinical diagnosis of genital herpes can be difficult because the self-limited, recurrent, painful, and vesicular or ulcerative lesions classically associated with HSV are absent in many infected persons at the time of clinical evaluation. Management of genital HSV should address the chronic nature of the infection rather than focusing solely on treating acute episodes of genital lesions. Consequently, most genital herpes infections are transmitted by persons unaware that they have the infection or who are asymptomatic when transmission occurs. The majority of persons infected with HSV-2 have not had the condition diagnosed, many of whom have mild or unrecognized infections but shed virus intermittently in the anogenital area. However, an increasing proportion of anogenital herpetic infections have been attributed to HSV-1, which is especially prominent among young women and MSM ( 186, 437, 438). Most cases of recurrent genital herpes are caused by HSV-2, and 11.9% of persons aged 14–49 years are estimated to be infected in the United States ( 436). Two types of HSV can cause genital herpes: HSV-1 and HSV-2. Genital herpes is a chronic, lifelong viral infection.
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