Genital Herpes

What is genital herpes?
Genital herpes is caused by an infection with the herpes simplex virus type 2 (HSV-2).
Herpes simplex virus type 1 (HSV-1) also causes genital herpes in some people, but it is most commonly associated with herpes sores around the mouth called “cold sores” or “fever blisters”.

How common is genital herpes?
Genital herpes is a common infection in the US, affecting more than 50 million people.1
Currently, about 1 in 6 people aged 14-49 in the U.S. has HSV-2.1 There are more people in the U.S. living with herpes than any other STI; this is because herpes infection is incurable and people who are infected with the herpes simplex virus (HSV) are infected for life.

How is genital herpes spread?
Genital herpes is spread through vaginal, anal, and oral sex, as well as skin to skin contact. Genital herpes can also spread from a mother to her baby during delivery. HSV-2 is released from the skin in the genital area even when there are no blisters or ulcers present. So, an infected person is contagious, whether or not that person has ever noticed genital herpes sores on their skin. Since skin throughout the genital region can shed the virus, a condom does not provide adequate protection from infection with HSV.

Does a genital herpes infection cause symptoms?
Often, people infected with HSV-2 present with no symptoms or have mild symptoms of the infection. Most people experience some symptoms, but do not know that their mild symptoms are caused by HSV infection. These groups of people continue shedding the virus and are responsible for the majority of the transmissions of this infection.2, 3

What are the symptoms of genital herpes?
Symptoms of infection may include pain with urination and very painful outbreaks of blisters and ulcers. When an infected person develops an outbreak of genital blisters and ulcers, the first outbreak is usually larger and more painful than later outbreaks.

Are there any treatments available for genital herpes?
Currently, there is no cure for HSV infection. Once a person is infected with HSV, they are infected for life. Outbreaks can occur years after the initial infection. Medications are available that will help shorten the outbreaks of blisters and ulcers when they do occur. They may also decrease the number and reduce the severity of the outbreaks.

What complications can result from genital herpes infection?
Because genital herpes is a lifelong infection, genital ulcer outbreaks can continue to occur in an infected person for their entire life. This can be both painful and embarrassing.

Another long term complication in women is the potential effect of herpes on a newborn. Rarely, an infected mother can pass HSV to her baby during delivery. If a woman is having an outbreak of genital herpes ulcers at the time of labor, a C-section is usually performed to protect the baby from direct exposure to the sores.

Does genital herpes affect the spread of HIV?
Yes, people who are infected with HSV are at a higher risk of getting HIV than those people without HSV infection. Having a genital herpes infection appears to increase a
person’s risk of acquiring HIV infection by 2- to 8- fold.4,5,6 People with HSV may also spread HIV more easily than those without HSV infection.4

Can genital herpes be prevented?
Yes, sexual transmission of genital herpes can be prevented by refraining from sexual activity until a person is in a lifelong, mutually monogamous relationship with an uninfected partner.

Pregnant women who have had genital herpes should tell their healthcare providers about the infection to prevent the spread of HSV to their babies.

 

Note the multiple, small ulcers near the tip of the penis.

References:
1. Xu F, Sternberg MR, Kottiri BJ, et al. Trends in herpes simplex virus type 1 and type 2 seroprevalence in the United States. JAMA. 2006;296(8):964-973.
2. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2010. MMWR 2010;59(RR-12):1-114. Available at:
http://www.cdc.gov/std/treatment/2010/STD-Treatment-2010-RR5912.pdf. Accessed April 2015
3. Looker KJ, Garnett GP. A systematic review of the epidemiology and interaction of herpes simplex virus types 1 and 2. Sex Transm Infect 2005; 81: 103–107.
4. Corey L, Wald A, Celum CL, Quinn TC. The effects of herpes simplex virus-2 on HIV-1 acquisition and transmission: a review of two overlapping epidemics. JAcquir Immune Defic Syndr. 2004;35(5):435-445.
5. Freeman EE, Weiss HA, Glynn JR, Cross PL, Whitworth JA, Hayes RJ. Herpes simplex virus 2 infection increases HIV acquisition in men and women: systematic review and meta-analysis of longitudinal studies. AIDS 2006;20:73-83.
6. Brown JM, Wald A, Hubbard A, et al. Incident and prevalent herpes simplex virus type 2 infection increases risk of HIV acquisition among women in Uganda and Zimbabwe. AIDS. 2007;21(12):1515-1523.

 

 

Updated: May 2015

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