CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Herpes simplex - genital - Management
Basis for recommendation
CKS identified no national guidelines for assessing genital herpes in primary care. These recommendations are based on expert opinion [Sen and Barton, 2007], pragmatism, and good clinical practice.
- Diagnosis in GUM
- The clinical diagnosis of genital herpes may not be easy or reliable in primary care, as symptoms and signs vary in frequency and severity between different people, and can mimic other medical conditions [Gupta et al, 2007].
- Taking a history
- Several prevalence studies (mainly from the US) have shown a higher number of sexual partners, young age of first sexual intercourse, and a history of other sexually transmitted infections to be positively associated with herpes simplex virus (HSV) type 2 infection [Wald, 2004].
- Carrying out an examination
- If it is necessary to diagnose genital herpes in primary care, a viral culture or polymerase chain reaction for HSV is essential. It is estimated that even an experienced clinician will fail to identify 30–70% of cases of genital herpes based on history alone [Wald, 2004]. Viral culture has a specificity of virtually 100%, but the quality of specimens, storage of samples, and mode and length of transport influence sensitivity [BASHH, 2007].
© NHS Institute for Innovation and Improvement