Genital Herpes

Genital herpes is a sexually transmitted disease (STD) caused by herpes simplex virus (HSV). There are two types of HSV.

• HSV type 1 most commonly infects the mouth and lips, causing sores known as fever blisters or cold sores. It may also cause sores to the genitals.
• HSV type 2 mainly infects the genitals, but it also can infect the mouth. Most genital herpes is caused by HSV-2.

Herpes viruses are released from the sores that the viruses cause. They may also be released between outbreaks from skin that does not appear to be broken or to have a sore. Most people get genital herpes by having sex with someone who is shedding the herpes viruses either during an outbreak or during a period with no symptoms. In the United States, 1 out of 5 teenagers and adults is infected with HSV.

Symptoms and Diagnosis

Most individuals with genital herpes have no or only minimal signs or symptoms. When signs do occur, they typically appear as one or more blisters on or around the genitals or rectum. The blisters break, leaving tender ulcers (sores) that may take two to four weeks to heal the first time they occur. Typically, another outbreak can appear weeks or months after the first, but it almost always is less severe and shorter than the first outbreak. Although the infection can stay in the body indefinitely, the number of outbreaks tends to decrease over a period of years.

Other symptoms that may accompany the first (and less often future) outbreak of genital herpes are fever, headache, muscle aches, painful or difficult urination, vaginal discharge, and swollen glands in the groin area.

Health care providers can diagnose genital herpes by visual inspection if the outbreak is typical, and by taking a sample from the sore(s) and testing it in a laboratory. HSV infections can be difficult to diagnose between outbreaks. Blood tests, which detect HSV-1 or HSV-2 infection, may be helpful, although the results are not always clear-cut.

Complications

Genital herpes infections usually do not cause serious health problems in healthy adults. In some people whose immune systems do not work properly, genital herpes outbreaks can be unusually severe and long lasting.

Occasionally, people with normal immune systems can get herpes infection of the eye, called ocular herpes. Ocular herpes is usually caused by HSV-1 but sometimes by HSV-2. It can occasionally result in serious eye disease, including blindness.

A woman with herpes who is pregnant can pass the infection to her baby. A baby born with herpes might die or have serious brain, skin, or eye problems. Pregnant women who have herpes, or whose sex partner has herpes should discuss the situation with her health care provider. Together they can make a plan to reduce her or her baby's risk of getting infected. Babies who are born with herpes do better if the disease is recognized and treated early.

Genital herpes, like other genital diseases that cause sores, is important in the spread of HIV infection.

Treatment

Although there is no cure for genital herpes, your health care provider might prescribe an antiviral medicine to treat your symptoms and to help prevent future outbreaks. This can decrease the risk of passing herpes to sexual partners. Medicines to treat genital herpes are

• Acyclovir (Zovirax)
• Famciclovir (Famvir)
• Valacyclovir (Valtrex)

References:

Centers for Disease Control and Prevention, USA.
National Institute of Allergy and Infectious Diseases, USA.