About Herpes

Overview

The term "herpes" actually refers to two types of the virus: herpes simplex virus 1 (HSV-1) and herpes simplex virus 2 (HSV-2). They are two very similar viruses, differing mainly in their preferred location on the body. HSV-1 tends to infect the mouth area, while HSV-2 is more often a genital infection. But even this distinction does not always hold true. Herpes can cause painful blisters that erupt to leave stinging open lesions. It is transmitted through skin contact.

Prevalence

Approximately 58 percent of people in the United States are infected with HSV-1, while 17 percent have HSV-2, according to the National Health and Nutrition Examination Surveys. About 90 percent of people who have HSV-2, however, do not realize they are infected. The more sexual partners a person has, the greater the risk they face of becoming infected with HSV-2. Among Americans with two to four sexual partners in their lifetime, 22 percent have HSV-2.

HSV-1

For 90 percent to 95 percent of oral herpes cases, HSV-1 is the cause. The remaining cases are the result of HSV-2. In most people, however, outbreaks recur infrequently if at all. Others get periodic cold sores. Despite the name, these sores are not related to the common cold. They can be triggered by a range of factors, including stress, fatigue and being generally rundown, all of which can follow a bout with a cold or the flu. HSV-1 also is responsible for about 20 percent of genital herpes. In those cases, it's spread through oral sex. In addition, infants can contract oral HSV-1 from people who can't resist giving them a big kiss.

HSV-2

About 80 percent of genital herpes cases are due to HSV-2. Symptoms can appear anywhere in the genital area, including the penis, scrotum, pubic area and thighs in men, and the labia, vulva and groin area in women. It also can affect the buttocks and anal region of both men and women. If sores appear around or in the urethra, then the infection can cause burning during urination. An outbreak often starts with a prodrome, a tingly sensation on the skin before other symptoms appear. Red spots then appear and turn into blisters, which last a few days. They break open, leaving painful open lesions. Symptoms should disappear within a week or two.

Prevention

Herpes can be hard to avoid. Many people carry oral HSV-1 from childhood. Condoms afford some protection against genital herpes, but are not 100 percent effective because the virus often infects areas not covered by a condom. People can cut down on the spread on herpes by avoiding sex when prodromes or outright symptoms are present. This, too, is only partially effective, because some symptoms are too mild to be noticed, and the virus is occasionally shed even in the complete absence of symptoms. A person with herpes may be able to reduce the chances of spreading the virus by taking daily suppressive doses of an antiviral medication, but this approach is still under study.

Treatment

There is no cure for herpes. The virus is considered to be permanent. Treatment is aimed at minimizing symptoms and, possibly, reducing the frequency of outbreaks. The antiviral medications acyclovir, valacyclovir and famciclovir are effective on both counts. Some people take them as episodic therapy, meaning they take the medication as soon as they feel the onset of symptoms to head off the outbreak or reduce its symptoms. Others take suppressive therapy, which is a daily low dose of the antiviral medication intended to prevent outbreaks from happening.