| Key Questions |
New Evidence |
| 1a. Does screening for HSV in asymptomatic adolescents and adults reduce symptomatic recurrences and transmission of disease? |
No studies evaluated this question. |
| 1b. Does screening for HSV in pregnant women reduce neonatal HSV and complications? |
No studies evaluated this question. |
| 2. Can risk factors identify groups at higher risk for HSV infection? |
No studies evaluated this question. |
| 3a. What are the HSV screening tests and their performance characteristics? |
New technologies include polymerase chain reaction (PCR) and glycoprotein-G based, type-specific HSV serological tests; 2 type-specific HSV serological tests have been FDA approved and are available commercially; all have sensitivity and specificity consistent with the "gold standard" screening test (Western Blot Assay); PCR is more sensitive than viral cell culture and is the "gold standard" for diagnosing CNS HSV infection. |
| 3b. What is the optimal time to screen during pregnancy? |
No studies evaluated this question. |
| 3c. What is the role of screening partners? |
No studies evaluated this question. |
| 4. What are the harms of screening? |
A qualitative assessment of the psychosocial impact of a serological diagnosis of HSV-2 in individuals without a previous history of infection included strong emotional and psychological responses. |
| 5a. How effective are interventions in reducing symptomatic recurrences and transmission in adolescents and adults? |
Once-daily valacyclovir reduces sexual transmission of genital HSV in heterosexual monogamous couples; different antiviral agents and doses effectively suppress HSV recurrences compared with placebo; the safety of antivirals and placebo were comparable in trials and adverse experiences were reported as infrequent and generally mild (e.g., headache and nausea); condoms provide partial prevention of sexual HSV transmission for both men and women; vaccines are not effective in preventing or reducing transmission of genital HSV. |
| 5b. How effective are interventions in reducing neonatal infection and complications? |
Antiviral use in late pregnancy reduces HSV recurrence and viral shedding; its effect on neonatal infections has not been determined. |
| 6. What are the harms of interventions? |
A pregnancy registry of antivirals indicated no increase in birth defects; no data on harms were identified. |
Notes: CNS, central nervous system; FDA, Food and Drug Administration; HSV, herpes simplex virus. |
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