HSV

General Info

If you think you have a Sexually Transmitted Infection (STI) or that you have been exposed to an STI, such as Genital Herpes, STOP having sex immediately until you are tested and/or treated by a medical provider.

For more information about Sexually Transmitted Infections, visit: http://www.cdc.gov/std/default.htm

What is it?

  • Herpes is a lifelong sexually transmitted infection (STI) caused by the Herpes Simplex Virus (HSV).
  • Herpes is caused by Herpes Simplex Virus type 1 (HSV-1) or type 2 (HSV-2).
    • HSV-1 is primarily responsible for what are commonly called "cold sores" or "fever blisters" found around the lips and mouth.
    • HSV-2 is mainly responsible for genital herpes, which can cause one or more blisters on or around the genitals or rectum.
  • Even though HSV-2 is primarily responsible for genital herpes, studies have shown a significant increase in genital herpes caused by HSV -1, thought to be due to the increased practice of oral sex.
  • Outbreaks of genital lesions can occur repeatedly over the course of the infection.
  • In most situations, the outbreaks become less severe, less frequent, and are shorter over time.

How do I get it?

How is Herpes (HSV) spread?
  • Activities such as kissing and having sex (including oral and anal sex) can spread HSV.
  • The virus is transmitted through direct contact with an infected person's lesions (sores), mucosal surfaces, genital secretions, or oral secretions.
  • Sex is putting the penis into the vagina, rectum, or mouth; and/or putting the mouth on the penis, vagina, or rectum.
  • HSV can also be shed from skin that looks normal
  • Up to 90% of infected people may not have any signs or sypmtpms of HSV.
  • Infected people with no visible sore or symptoms can still transmit the virus to their partner(s).
If I have HSV and I'm pregnant, can I spread it to my baby?
  • Herpes can be passed from mother to child resulting in a potentially fatal infection (neonatal herpes).
  • During pregnancy there is a higher risk of transmitting herpes to a baby during the first outbreak - it is important that women avoid contracting herpes during pregnancy.
  • Women should be abstain from sexual intercourse during the third trimester with partners known or suspected of having genital herpes.
  • A woman with genital herpes may be offered antiviral medication from 36 weeks gestation through delivery to reduce the risk of a recurrent outbreak.
  • At onset of labor, all women should undergo careful examination and questioning to evaluate for presence of symptoms or lesions.
  • If herpes symptoms are present, a cesarean delivery is recommended to prevent HSV transmission to the infant.

How common is it?

  • Genital herpes (HSV-2) infection is common in the U.S.
  • The Centers for Disease Control and Prevention (CDC) estimates that 776,000 people in the U.S. get new herpes infections every year.
  • Among persons aged 14 to 49 years in the U.S., over 16% have are infected with HSV-2. The number of people with genital herpes is higher when HSV-1 is included in the calculations.
  • Genital HSV-1 infections are increasing in patient populations worldwide.
  • HSV-2 infections are more common among women than among men.
  • Infection is more easily transmitted from men to women than from women to men.
  • HSV-2 infection is more common among non-Hispanic blacks than among non-Hispanic whites or Mexican Americans.
  • Most infected persons are unaware of their infection.
  • In the U.S., over 80% of 14–49 year olds infected with HSV-2 have never received a clinical diagnosis.

What happens if I get it?

  • It is important to recognize that while herpes is not curable, it is a manageable condition.
  • Genital herpes causes painful genital ulcers (sores) in many adults
    • These ulcers can be severe and persistent in persons with suppressed immune systems (such as HIV-infected persons).
  • Genital herpes can cause sores in the skin or mucous membranes (lining of the mouth, vagina, rectum).
  • Genital sores caused by herpes can bleed easily - they can increase the risk of transmitting HIV (the virus that causes AIDS) if either partner is HIV-infected.
  • Both HSV-1 and HSV-2 can also cause rare but serious complications such as blindness, encephalitis (inflammation of the brain), and aseptic meningitis (inflammation of the linings of the brain).
  • Development of lesions on the buttocks, groin, thighs, fingers, and eyes may occur during the course of infection.
  • If a person with genital herpes touches their sores, they may transfer the virus to another part of their body.
  • There can be embarrassment, shame, and stigma associated with a herpes diagnosis which can interfere with a person's relationships.
  • Since a genital herpes diagnosis may affect perceptions about existing or future sexual relationships, it is important for patients to understand how to talk to sexual partners about STIs.

Signs and Symptoms

  • Most people infected with HSV-2 are not aware of their infection.
  • Most persons infected with HSV-1 or HSV-2 experience either no symptoms or have very mild symptoms that go unnoticed or are mistaken for another skin condition.
  • When symptoms do occur, they typically appear as one or more blisters on or around the genitals, rectum, or mouth.
  • The blisters break and leave painful sores that may take two to four weeks to heal. Experiencing these symptoms is sometimes referred to as having an “outbreak.”
  • The first time someone has an outbreak they may also experience flu-like symptoms such as fever, body aches and swollen glands.
  • Repeat outbreaks of genital herpes are common, in particular during the first year of infection.
  • Symptoms of repeat outbreaks are typically shorter in duration and less severe than the first outbreak of genital herpes.
  • Although the infection can stay in the body indefinitely, the number of outbreaks tends to decrease over a period of years.

Diagnosis and Treatment

How is HSV diagnosed?
  • Healthcare providers can diagnose genital herpes by visual inspection if the outbreak is typical.
  • Healthcare providers can take a sample from the sore(s) and test it by sending the sample to a laboratory for analysis.
  • Sometimes HSV infections can be diagnosed between outbreaks with a blood test.
  • IWTK does NOT perform testing for HSV/herpes.
Is Herpes treatable?
  • There is no treatment that can cure herpes.
  • Antiviral medications can prevent or shorten outbreaks during the period of time the person takes the medication.
  • Daily suppressive therapy  (daily use of antiviral medication) for herpes can reduce the chances of transmitting the virus to partners.

Prevention

  • Abstain from sexual contact.
  • Condoms may reduce the risk of getting HSV - use a condom correctly, every time you have sex (vaginal, anal, or oral), with every partner.
    • HSV can infect areas that are not covered by a condom, so condoms may not fully protect against HSV.
    • Outbreaks can occur in areas that are not covered by a condom.
  • Limit your sexual partners. The more sex partners you have, the greater your risk of encountering someone who has this or other STIs.
  • Persons with herpes should abstain from sexual activity with partners when sores or other symptoms of herpes are present.
  • It is important to know that even if a person does not have any symptoms, he or she can still infect sex partners.
  • Sex partners of infected persons should be advised that they may become infected and they should use condoms to reduce the risk.
  • Sex partners can seek testing to determine if they are infected with HSV.
  • There is no vaccine to prevent HSV/herpes.