{
  "abstract": "Objective This systematic review aimed to explore the characteristics of men who have sex with men (MSM) with anorectal herpes simplex virus (HSV).Method Four bibliographical databases (Medline, Embase, EBSCO and Cochrane-CENTRAL) were searched in April 2025; manuscripts written in English that included MSM with a positive HSV test from the anorectal area and described at least one characteristic were included. Citations and abstracts were screened, and two authors independently reviewed full text manuscripts, extracted data and synthesised data narratively to generate themes. A risk of bias assessment was conducted using the Joanna Briggs toolkit (PROSPERO-ID: CRD420251002325).Results 17 manuscripts from the USA (n=9), the UK (n=6) and Australia (n=2) published between 1979 and 2024 were included. The manuscripts were case series (n=9), cross-sectional studies (n=4), case control studies (n=3) and a clinical trial (n=1) and included 432 MSM with anorectal HSV. This review highlighted demographic (younger age, living with HIV), behavioural (condomless anal, oral-anal, oral-penile sex, multiple sexual partners, fisting) and coinfection ( Treponema pallidum, Neisseria gonorrhoeae, Chlamydia trachomatis (including lymphogranuloma venereum), Mycoplasma genitalium, human papilloma virus, scabies, hepatitis B virus, Campylobacter spp, Shigella spp, Entamoeba histolytica, Giardia duodenalis) characteristics seen in MSM with anorectal HSV. Symptoms including anal pruritus, tenesmus, urinary dysfunction (urinary hesitancy, urinary retention), neurological symptoms (eg, paraesthesia), constitutional symptoms (eg, fever); and clinical signs including anal vesicles, anal ulceration, rectal ulceration and lymphadenopathy were reported.Conclusion This review provides insight into the characteristics, presenting symptoms and signs of MSM with anorectal HSV for future guidelines and research, and suggests that MSM with specific symptoms should receive empirical antiviral therapy.PROSPERO registration number CRD420251002325.",
  "authors": [
    {
      "affiliations": [
        "Sexual Health & HIV, University Hospitals Sussex NHS Foundation Trust, Brighton, UK"
      ],
      "name": "Mohammed Essa"
    },
    {
      "affiliations": [
        "Sexual Health & HIV, University Hospitals Sussex NHS Foundation Trust, Brighton, UK"
      ],
      "name": "Jodie Crossman"
    },
    {
      "affiliations": [
        "Sexual Health & HIV, University Hospitals Sussex NHS Foundation Trust, Brighton, UK"
      ],
      "name": "Sophie Ettinger"
    },
    {
      "affiliations": [
        "Library and Clinical Knowledge Team, University Hospitals Sussex NHS Foundation Trust, Brighton, UK"
      ],
      "name": "Julian Robinson"
    },
    {
      "affiliations": [
        "Sexual Health & HIV, University Hospitals Sussex NHS Foundation Trust, Brighton, UK"
      ],
      "name": "Alyazeed Haddadin"
    },
    {
      "affiliations": [
        "The Jefferiss Wing, Imperial College Healthcare NHS Trust, London, UK"
      ],
      "name": "David Goldmeier"
    },
    {
      "affiliations": [
        "Sexual Health & HIV, University Hospitals Sussex NHS Foundation Trust, Brighton, UK",
        "Brighton and Sussex Medical School, Brighton, UK"
      ],
      "name": "Daniel Richardson"
    }
  ],
  "title": "Anorectal herpes simplex virus in men who have sex with men: a systematic review",
  "uid": "cd561a45-aa4e-5ab9-8324-1b81322c19fa"
}