What is genital herpes?

Genital herpes is an infection caused by the herpes simplex virus or HSV. There are two types of HSV, and both can cause genital herpes. HSV type 1 most commonly infects the lips, causing sores known as fever blisters or cold sores, but it also can infect the genital area and produce sores. HSV type 2 is the usual cause of genital herpes, but it also can infect the mouth. A person who has genital herpes infection can easily pass or transmit the virus to an uninfected person during sex.

Both HSV 1 and 2 can produce sores (also called lesions) in and around the vaginal area, on the penis, around the anal opening, and on the buttocks or thighs. Occasionally, sores also appear on other parts of the body where the virus has entered through broken skin.

HSV remains in certain nerve cells of the body for life, and can produce symptoms off and on in some infected people.

According to the U.S. Centers for Disease Control and Prevention, 45 million people in the United States ages 12 and older, or 1 out of 5 of the total adolescent and adult population, are infected with HSV-2.

Nationwide, since the late 1970s, the number of people with genital herpes infection has increased 30 percent. The largest increase is occurring in young teens. HSV-2 infection is more common in three of the youngest age groups which include people aged 12 to 39 years.

Causes of Genital Herpes

HSV-1 and HSV-2 can be found in and released from the sores that the viruses cause, but they also are released between outbreaks from skin that does not appear to be broken or to have a sore. Generally, a person can only get HSV-2 infection during sexual contact with someone who has a genital HSV-2 infection. Transmission can occur from an infected partner who does not have a visible sore and may not know that he or she is infected.

HSV-1 can cause genital herpes, but it more commonly causes infections of the mouth and lips, so-called "fever blisters." HSV-1 infection of the genitals can be caused by oral-genital or genital-genital contact with a person who has HSV-1 infection. Genital HSV-1 outbreaks recur less regularly than genital HSV-2 outbreaks.

Treatment for genital herpes

Currently, there is no treatment to cure herpes; however, there is no cure for any virus at this point. There are three antiviral medications that can be use to treat herpes. They are Zovirax, Valtrex and Famvir.

Each of these medications can be used during a recurrence to help speed the healing process of an outbreak. All three drugs are FDA approved for daily, suppressive therapy to help reduce the frequency of outbreaks.

· Zovirax is also available in the form of an ointment, but the medication has been proven to be much more effective when taken orally.

· Valtrex , when taken daily (suppressive therapy) by a person with recurrent genital herpes, can reduce the risk of transmission to a partner.

According to the manufacturers, the most common short-term side effects reported were nausea and headaches. These medications have never been noted to cause any long-term side effects. Using medication to treat genital herpes is not required. However, if a person would like to use antivirals, speaking with a health care provider can help determine which treatment may be right for them.

You can speak to your doctor about the proper medications for you. Over-the-counter creams and/or ointments are not recommended for genital herpes.

Prevention

Any sexually active person may contract genital herpes. However, herpes can be prevented and there are ways to reduce risk.

· If someone has a symptom around the mouth (oral herpes), she or he should not perform oral sex until all signs have healed.

· If someone has signs or symptoms around the genital region (genital herpes), he or she should not have sexual activity until all signs have healed.

· When there are no symptoms present, using latex condoms for genital-to-genital contact reduces the risk of transmission.

· One antiviral medication for herpes, valacyclovir (Valtrex®), has recently been shown to reduce the risk of herpes transmission. When taken daily by a person with a history of recurrent genital herpes, valacyclovir can reduce the risk of transmission to a partner who does not have the virus by 50%. It's likely that a combination of suppressive valacyclovir and condoms provides greater protection than either method alone.

· Microbicides/Spermicides have not been proven to reduce the risk of transmission. If used, they should be used with a condom, not in place of one.

· Partner communication. It is important for both partners to become educated about herpes and to make decisions together about which precautions are best.

· If your partner has herpes, using condoms for sexual activity and not having sex while symptoms are present will reduce the risk of transmission.

Pregnacy and Herpes

It is important to avoid contracting herpes during pregnancy as herpes can be life threatening to an infant. It is rare for infants to contract herpes. Twenty percent to 25 percent of pregnant women have genital herpes. Less than 0.1 percent of babies contract genital herpes. A mother helps the baby by passing her antibodies to the infant during pregnancy. Women who acquire genital herpes before becoming pregnant have a low risk of passing the virus to their baby.

A woman who contracts genital herpes during the third trimester of pregnancy is at a higher risk of passing herpes to the baby because she has not had time to build up antibodies to the virus. Most mothers with genital herpes have normal vaginal deliveries. The doctor should do a thorough visual exam at the onset of labor.

If a woman has symptoms at the time of delivery, a Caesarean section is recommended. If an infant does contract herpes during delivery, the symptoms tend to show within two to three weeks after birth. Medication may help prevent or reduce the lasting damage to an infant if treated early.

After birth, herpes can be passed to a baby by receiving a kiss from someone with a cold sore on the mouth (oral herpes).