Herpes Simplex Virus and the Alimentary Tract Eric A. Lavery, MD , and Walter J. Coyle , MD Corresponding author infections of the gastrointestinal tract in both immuno- Walter J. Coyle, MD Division of Gastroenterology and Hepatology Scripps Clinic compromised and immunocompetent patients. Torrey Pines, 10666 North Torrey Pines Road, N203, La Jolla, CA 92037, USA. E-mail:
[email protected] Background Current Gastroenterology Reports 2008, 10: 417– 423 HSV is a member of the Herpesviridae family of viruses, Current Medicine Group LLC ISSN 1522-8037 which also includes varicella zoster virus (VZV), cyto- Copyright © 2008 by Current Medicine Group LLC megalovirus (CMV), Epstein-Barr virus (EBV), and human herpesvirus (HHV) 6, 7, and 8 [ 2• ]. Members of this family contain linear, double-stranded DNA within a Herpes simplex virus (HSV) infection is well known as protein capsid, which is surrounded by a tegument and an a sexually transmitted disease. However, relatively little outer glycoprotein layer [ 2• , 3•• ]. HSV-1 and HSV-2 have has been published concerning the presentations and 70% genomic homology but tend to affect different areas treatment of HSV infection within the gastrointestinal of the body. HSV-1 tends to cause most oral and esopha- tract, where HSV most commonly affects the esophagus geal herpetic lesions; it is commonly acquired during in both immunocompromised and immunocompetent childhood, though it has been associated with proctitis in patients. HSV proctitis is not uncommon and occurs a minority of cases. HSV-1 is primarily transmitted via primarily in males having sex with males. In patients oral secretions and has a higher seroprevalence in lower with normal immune systems, gastrointestinal HSV socioeconomic communities.