Frequently Asked Questions About Genital Herpes

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What is genital herpes?

Herpes simplex virus infection, commonly referred to as herpes, can be caused by herpes simplex virus type 1 (HSV-1) or herpes simplex virus type 2 (HSV-2). HSV-1 is spread primarily by mouth-to-mouth contact and causes an infection in or around the mouth (oral or cold sores). HSV-2 is transmitted almost exclusively sexually and causes an infection in the genital or anal area (genital herpes). However, HSV-1 can also be transmitted to the genital area through orogenital contact and cause genital herpes.

How common is genital herpes?

According to estimates by the World Health Organization (WHO), in 2012 there were 19.2 million new cases of HSV-2 infection in adults and young people aged 15 to 49 years worldwide, with around 417 millions of existing cases. The highest number of cases is in the WHO African Region and the Americas Region. The reason the number of existing cases is so high is that there is no cure for herpes.

In the Region of the Americas, there were around 2.2 million new cases of HSV-2 infection in women and 1.3 million in men in 2012, adding to the 45.2 million cases already existing in women and 25.1 million cases already existing in men.

How is genital herpes transmitted?

HSV-1 is spread primarily by mouth-to-mouth contact and causes an infection in or around the mouth (oral or cold sores). HSV-2 is transmitted almost exclusively sexually, through contact with the genital surfaces, skin, ulcers, or fluids of a person infected with the virus, and causes an infection in the genital or anal area (genital herpes). However, HSV-1 can also be transmitted to the genital area through orogenital contact and cause genital herpes. Herpetic infections are highly contagious when there are symptoms, but transmission to other people is also possible without symptoms. In very rare circumstances, genital herpes can be passed from mother to child during childbirth.

How is genital herpes prevented?

There is currently no cure or vaccine for herpes. Condoms help reduce the probability of infection, although they do not eliminate it completely since outbreaks of genital herpes can occur in areas not covered by the condom. However, the use of condoms is still advisable since it can prevent other sexually transmitted diseases and unwanted pregnancies.

What are the symptoms of genital herpes?

Genital herpes infections are often asymptomatic or cause mild symptoms that go unnoticed. Most infected people do not know they have the infection. When there are symptoms, these usually appear 4 to 7 days after sexual contact, and are characterized by the presence of one or more vesicles or open sores called ulcers in the genital or anal region. In addition to genital ulcers, symptoms of a recent genital herpetic infection often include fever, body aches, and swollen lymph nodes.

After an initial genital HSV-2 infection, recurrent symptoms are common but are often less severe than those of the initial outbreak. The frequency of outbreaks decreases over time. People infected with HSV-2 may experience mild tingling or shooting pain in their legs, hips, and buttocks before genital ulcers develop. In people with genital herpes caused by HSV-1, symptoms may come back, but genital herpes caused by HSV-1 often does not recur frequently.

What problems does genital herpes cause?

Repeated symptoms of genital herpes can be painful, and infection can lead to social stigmatization and emotional distress. These factors can have a marked impact on quality of life and sexual relationships. However, over time, most people with herpes adjust to living with the infection.

Genital herpes nearly triples the risk of contracting HIV. Also, people with HIV infection at the same time as genital herpes are more likely to transmit HIV to other people. 60-90% of people with HIV infection also have genital herpes caused by HSV-2. Infection with HSV-1 or HSV-2 in people with HIV infection (and in other individuals with weakened immune systems) often produces more severe symptoms and more frequent relapses.

How does genital herpes affect a pregnant woman and her baby?

Mother-to-child transmission of HSV during childbirth is very rare, estimated to occur in 10 per 100,000 births worldwide, but it can lead to persistent disability or death. The risk of transmitting herpes to the newborn is greater when the woman contracts the initial infection with HSV in late pregnancy. Women who have genital herpes before becoming pregnant have a very low risk of transmitting HSV to the newborn.

How is genital herpes diagnosed?

Genital herpes infection is often diagnosed clinically by an appropriately trained healthcare professional through physical examination. However, laboratory tests are needed to differentiate HSV-1 from HSV-2. When there are no vesicles, confirmatory laboratory tests may also be necessary to rule out other causes of genital ulcers. There have been important advances in HSV-2 diagnostic methods such as the use of rapid molecular diagnostic tests, some of which have been prequalified by the WHO.

How is genital herpes treated?

Antiviral drugs are the most effective medication available to us to treat people with genital herpes infection. These drugs can help reduce the severity and frequency of symptoms but cannot cure the infection. Both HSV-1 and HSV-2 infection persist throughout life. Courtesy: https://www.paho.org/
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