Description

💥 FREE MSRA PODCAST – Herpes Simplex Virus (HSV): The Essentials, Exam Tricks & Real-World Insights 💡
Your shortcut to mastering herpes simplex virus for the MSRA: fast, focused, and packed with everything you need to remember.

🧠 Key Learning Points

📌 Definition• Herpes simplex virus (HSV) is a highly contagious DNA virus—two main types: HSV-1 (oral, “cold sores”) and HSV-2 (genital, “herpes”), but both can affect either site.• Causes painful blisters/ulcers on skin or mucous membranes, with a tendency for lifelong, recurrent episodes.

📌 Causes & Transmission• HSV-1: Primarily oral-to-oral (kissing, shared items), but can cause genital infection (often oral sex).• HSV-2: Mainly sexually transmitted—genital to genital.• Key Fact: Virus spreads via direct contact—skin, saliva, genital secretions, and crucially, asymptomatic viral shedding (can transmit even without symptoms).

📌 Risk Factors• Unprotected sex• Multiple partners• Immunosuppression (HIV, steroids, chemo)• Previous HSV infection (type 1 ≠ type 2 immunity)• Direct contact with active lesions

📌 Pathophysiology• Virus enters through tiny skin/mucosal breaks → infects local cells → creates painful blisters/sores• Latency: HSV hides in sensory nerve ganglia (trigeminal for oral, sacral for genital), reactivates with triggers (stress, fever, sunlight, menstruation) causing recurrent outbreaks.

📌 Differential Diagnosis• Oral: Varicella zoster (shingles), coxsackie (hand, foot, mouth), aphthous ulcers• Genital: Syphilis, chancroid, aphthous ulcers, lichen planus, other viral/bacterial causes

📌 Epidemiology (UK Focus)• Common: Most adults carry HSV-1; HSV-2 less prevalent but increasingly diagnosed• Genital herpes: Traditionally HSV-2, but HSV-1 is rising as a cause (especially in young people and via oral sex)

📌 Clinical Features• Primary outbreak: Painful blisters/ulcers, can be extensive; fever, malaise, headache, tender nodes• Recurrent outbreaks: Shorter, milder, prodrome (tingling/itching); oral: cold sores, genital: local blisters/ulcers• Special: Gingivostomatitis in children (widespread oral ulcers, pain, dehydration risk)

📌 Diagnosis• Clinical appearance + history is often enough• Lab confirmation: – PCR from swab (gold standard—most sensitive, fast) – Viral culture (less sensitive, slower) – Serology (antibodies)—useful for past infection, not acute diagnosis

📌 Management (UK NICE/CKS-aligned)• Antivirals: Aciclovir, valaciclovir, famciclovir – Episodic: Short course at onset of symptoms – Suppressive: Long-term for frequent/severe recurrences (reduces outbreaks & transmission risk)• Supportive care: Analgesia, saline bathing, barrier creams, keeping area clean/dry• Patient education: Asymptomatic transmission, safe sex (condoms reduce but don’t eliminate risk)• Special cases: – Severe oral (gingivostomatitis): Oral aciclovir + chlorhexidine – Pregnancy: Primary HSV in late pregnancy → C-section + antivirals to prevent neonatal herpes

📌 Complications
• Neonatal herpes (rare but severe—especially with primary maternal infection late in pregnancy)
• Severe/disseminated infection in immunocompromised
• Herpes encephalitis, keratitis (eye), meningitis
• Psychological impact, recurrent discomfort

📌 Prognosis
• Lifelong infection—virus remains latent in nerves
• Major complications rare

📎 More MSRA Herpes Simplex Resources:
📝 Revision Notes: https://www.passthemsra.com/topic/herpes-simplex-virus-revision-notes-2/
🧠 Flashcards: https://www.passthemsra.com/topic/herpes-simplex-virus-flashcards-2/
💬 Accordion Q&A: https://www.passthemsra.com/topic/herpes-simplex-virus-accordion-qa-notes-2/
🚀 Rapid Quiz: https://www.passthemsra.com/topic/herpes-simplex-virus-rapid-quiz-2/🎓 Infectious Diseases for the MSRA: https://www.passthemsra.com/courses/infectious-diseases-for-the-msra/

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