inPractice® - Primary Care Essentials

Author: Jin S. Suh, MD, FACP; Humberto R. Jimenez, PharmD, BCPS, AAHIVP (More Info)
Editors in Chief: Daniel R. Kuritzkes, MD; Joseph J. Eron, Jr., MD
Last Reviewed: 8/1/21 (What's New)

Diagnosis of HSV infection is confirmed only by laboratory testing. HSV DNA detection with PCR assays are the preferred modality, although viral culture remains important to identify acyclovir resistance
Serologic testing can be used to diagnose HSV if recurrent genital symptoms are continually negative (PCR/culture), clinical signs of HSV infection with laboratory confirmation, or when a partner has documented HSV. Routine serologic screening for HSV-2 may be considered as a part of HIV management (Management Guidelines)^{[CDC OI]}
- Preferred therapies for orolabial lesions and initial or recurrent genital HSV include valacyclovir, famciclovir, or acyclovir (Table 2) (Management Guidelines)^{[CDC OI]}