Summary

• Infection with HSV-1 or HSV-2 can cause oral, genital, and ocular ulcers. Most have unrecognised disease.
• Highly variable symptoms and signs range from tingling and burning with the eruption of vesicular lesions to painful ulcerations
• Symptoms of genital herpes range from asymptomatic to recurrent dysuria, tingling and burning without lesions, to recurrent genital ulcerations.
• Symptoms of herpes labialis include tingling and burning followed by development of vesicular then ulcerative lesions involving the oropharynx and perioral mucosa.
• Aciclovir, famciclovir, and valaciclovir are effective at shortening the duration and severity of an outbreak.
• Daily suppressive therapy reduces recurrences by 80% and reduces transmission risk.
• HSV type-specific antibody tests are used to diagnose infection with or without lesions and distinguish between type 1 and 2.