Facts About Genital Herpes
The news was devastating…and it made her cry to hear me say it: “I’m sorry, but the test for herpes simplex virus was positive.” I passed the tissues and a prescription…
Herpes simplex virus, or HSV, is the most prevalent sexually transmitted virus worldwide, and the fact is, it has no cure. The main one that people think about when this subject comes up is the genital herpes infections caused by HSV type 2. The oral herpetic outbreaks that we call “cold sores” are caused by HSV type 1. Type 1 can also affect the genital area after direct oral-genital contact, but typically the outbreaks will not be recurrent in that location as they are with type 2
As many as 26% of girls and women over the age of 12 years have evidence of prior exposure to HSV 2, and that is simply an estimate. Many people, both male and female, have absolutely no idea that those recurrent “bumps” or ulcers on their genital skin are actually caused by this virus. Their health care provider may miss the signs and symptoms of an initial herpes outbreak, and even direct culture of an ulcer can miss up to half. The best way to know whether or not previous exposure has occurred is to test the blood for evidence of an immune response to herpes virus. The lab can differentiate between type 1 and type 2.
The treatment is in fact not really a treatment at all since it doesn’t get rid of the HSV from the body – the medications known as anti-virals merely modify the immune response and lessen the duration and intensity of any given outbreak of skin lesions. The virus hides in the nerve roots and reappears at times of stress or other cause of immune-suppression. Women typically notice recurrent lesions around the time of menses.
There is hope though. A vaccine for HSV is being evaluated, and that will certainly go far toward making this much less prevalent an issue in our population, but unfortunately, a vaccine does nothing to help those who have already been exposed. They are left to deal with the issue as best they can. One way to keep the outbreaks to a minimum and to reduce the chances that viral particles will be shed from the skin even when a lesion is not visible is to take a daily dose of antiviral medication. This prophylactic therapy does have an impact on number of outbreaks per year and lowers partner-to-partner transmission rates, so it is worth considering. If outbreaks are rare, a person might prefer to simply use the antiviral medication on an as-needed basis, which is fine.