In general, the risk of HSV-2 infection is correlated with markers of increased sexual exposure: early age of first intercourse, larger numbers of lifetime sexual partners, history of other sexually transmitted infections, and increasing age ( 27, 57, 82). Immunosuppressed Patientsĭemographic and behavioral factors associated with a higher risk of genital herpes infection may be important in selecting candidates for antibody screening tests as they become available. While recurrent episodes are shorter and more localized than first episodes, the chronic nature of this disease and the unpredictable occurrence of recurrences result in persistent psychosocial or psychosexual distress for many patients ( 20, 34). Approximately 85% of women and nearly all men with symptomatic acquisition of genital HSV-2 infection will have a recurrence within the first year at an average rate of 4 to 5 episodes per year ( 12). Following the initial genital infection, HSV becomes latent in the sacral nerve ganglia and can reactivate to cause recurrent genital lesions. This partial immunity results in milder episodes with lower frequency of constitutional signs and symptoms and shorter duration of lesions. “Nonprimary first episodes” of HSV-2 genital herpes occur in persons with antibodies to HSV-1. Meningitis accompanies these symptoms in 10% of men and up to 30% of women with primary infections ( 24). For some adults, particularly those without prior antibodies to either HSV-1 or HSV-2, acquisition of primary genital herpes can cause painful ulcerative lesions and systemic manifestations, including headache, malaise, and fever lasting up to 3 weeks. Genital herpes infections can be associated with serious morbidity.

On1 effects 12.1.1