Genital Herpes

Abstract

Genital herpes is an infection of the genitalia due to herpes simplex virus-1 (HSV-1) or herpes simplex-2 (HSV-2). Only about 20% of those affected have symptoms – blisters in the genital area accompanied by a burning or itching sensation and perhaps fever and headaches. In women the blisters can appear on the vulva, perineum, buttocks, cervix and vagina, while in men they can be on the penis, scrotum, groin and thighs and buttocks and around the anus. However, rashes may occur anywhere on the skin.

Following infection, the virus becomes dormant in nerve cells and can be reactivated in the future – it’s therefore a lifelong condition. As many as 90% of those infected with HSV-2 have a recurrence with symptoms within 1 year, whereas recurrences are less common in those infected with HSV-1. Recurrences generally become less frequent with time.

It’s a highly contagious disease and is acquired by direct contact with the mucosal surfaces or skin of infected individuals or via infected secretions. HSV-2 is usually transmitted during vaginal or anal intercourse, while HSV-1 is generally transferred from the mouth to the genital area. Spread can also happen from one site to another in the same person (auto-inoculation).

The disease is usually diagnosed by finding HSV DNA in a sample of fluid taken from the blistering rash or sore. Treatment involves anti-viral agents (acyclovir, valacyclovir or famciclovir) which reduce symptoms and also the likelihood of virus transmission. Analgesics for pain relief can be helpful as well as a topical anaesthetic when the pain is severe. The risks of acquiring the infection can be reduced by having few sexual partners, not having sex with someone who has herpes blisters or sores on their genitals, not receiving oral sex from someone with a cold sore and using condoms for penetrative sex.