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Genital Herpes/Herpes Simplex Virus

Genital Herpes is one of the most common sexually transmitted infections.  It is caused by the herpes simplex virus 1 (HSV-1) or herpes simplex 2 (HSV-2). There is no cure for the virus but antiviral medication can relieve symptoms and help sores heal faster.


For more information on symptoms, causes, treatments and prevention see the Overview section.

Information for Health Professionals

Genital herpes is one of the most common sexually transmitted infections (STIs). It is caused by the herpes simplex viruses type 1 (HSV-1) or type 2 (HSV-2). In the past most genital herpes was caused by HSV-2 but now HSV-1 is as common in the genital area.

 

Symptoms can vary greatly from person to person. Most people never have symptoms, or the symptoms are so mild that people do not know they are infected. 

In some people, the disease causes outbreaks of itchy and painful blisters in the genital area. The blisters rupture and turn into oozing shallow sores that may take up to 3 weeks to heal. Sometimes people, especially women, experience flu-like symptoms, such as fever, headache, and muscle aches. Women may also notice an abnormal vaginal discharge and pain when they urinate.
 
After the first (primary) outbreak, the herpes virus stays in the nerve cells close to the spine and becomes inactive. It usually becomes active again from time to time (recurrent outbreaks), traveling down the same nerve and causing more sores. Things like stress, illness, a new sex partner, or menstruation may trigger a new outbreak. As time goes on, the outbreaks happen less often, heal faster, and don't hurt as much. 

Once you have been exposed to genital herpes, it usually takes 2 to 14 days to have your first outbreak. Occasionally, a person will first experience symptoms months or even years after being infected. This can make it very difficult to identify the sex partner who was the source of the infection. 

Genital herpes infections can be severe in people with impaired immune systems, such as people with HIV.

 

Genital herpes is caused by a virus—either the herpes simplex virus type 1 (HSV 1) or the herpes simplex virus type 2 (HSV 2). Either virus can cause sores on the lips (cold sores) and sores on the genitals. HSV 1 more often causes cold sores, while HSV 2 and     HSV 1 cause genital sores. 

Since the same virus that causes genital herpes also can cause cold sores, HSV can be spread from a genital sore to the lips or from a cold sore to the genital area. HSV can be spread to or from the genitals, anus, or mouth during sexual activities or through any direct contact with herpes sores. 

Newborns can also be infected with herpes at birth - this usually happens when a woman has her primary outbreak (the first time she is infected with HSV) close to the time of delivery and the baby is delivered through the vagina. 

You are most likely to spread HSV when you have a sore or blister during either a primary or recurrent outbreak. However, there is always a small chance of the virus becoming active even though you may not have blisters or sores present and the virus can be passed at this time.

 

Genital herpes can affect many body systems and cause other health problems, especially the first time a person becomes infected (primary outbreak). Complications are generally rare, but can include:


  • Herpes infection in other areas of the body, such as the lips, the hands and fingers, the anus and the eyes.
  • Meningitis, an infection of the fluid (cerebrospinal fluid, or CSF) and tissues (meninges) that surround the brain and spinal cord.
  • Encephalitis, an inflammation of the brain.- Inflammation of the lower spinal cord and surrounding nerves, possibly resulting in an inability to urinate, constipation, and loss of feeling and muscle strength in the legs.
  • Widespread infection, including viral infections of the liver, lungs, and joints. This mostly occurs in people who have impaired immune systems.

While this is very rare, newborns may also be infected with HSV at birth. Because their immune systems are not fully developed, newborns with herpes infection can have serious health problems affecting many body systems. It may take up to 3 weeks after a newborn is infected before he or she becomes ill.

 

Genital herpes is usually diagnosed based on your medical history and a physical examination. You health professional may ask you questions about your symptoms and your risk factors, which are things that make you more likely to get a disease.

If this is your first outbreak, your doctor may take a sample of tissue from the sore for testing. You may also have a blood test. Testing is done to confirm the diagnosis of HSV, although herpes tests cannot always show if you have a primary genital herpes outbreak or you have been infected in the past. Occasionally a test result can be negative even though the person has herpes.

 

Herpes infections cannot be cured - once you are infected with HSV, the virus remains in your body for the rest of your life. However, antiviral medication (such as acyclovir, famciclovir or valacyclovir) can relieve pain and itching and help sores heal faster.

Treatment works best if it is started as soon as possible after an outbreak begins; this is especially true for outbreaks that come back again and again. If you have frequent outbreaks, you may wish to take medicine on a regular basis to reduce the number and severity of outbreaks.

After the first outbreak, some people have just a few more outbreaks over their lifetime, while others may have 4 to 6 outbreaks a year. Usually the number of outbreaks decreases after a few years. Most people who get herpes never get any sores.

 

Finding out that you have herpes may cause you to feel bad about yourself or about sex. Counseling or a support group may help you feel better.

 
SOURCE: Genital Herpes/Herpes Simplex Virus ( )
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