Living with genital herpes: how effective is antiviral therapy?

Twenty-five percent of American women and 20% of American men have genital herpes. Most of these individuals have never been diagnosed because of the prevalence of atypical clinical presentation and subclinical infection. This chronic, recurrent infection poses a significant public health challenge, particularly in women of childbearing age, who are at risk of transmitting the virus to their infants during pregnancy and birth, as well as to their discordant sexual partners. Antiviral therapy decreases the rate of recurrent episodes, decreases asymptomatic shedding of the virus, reduces the risk of transmission to sexual partners, and reduces the rate of operative delivery in women with a history of genital herpes. This article reviews the literature to explore evidence-based strategies for addressing the physical and psychological sequelae of herpes simplex virus infection and for accurately diagnosing and managing neonates who acquire this infection perinatally.