Genital HerpesOverview

Genital herpes is a highly contagious sexually transmitted infection (STI) caused by the herpes simplex virus (HSV). There are two types of herpes simplex virus which are closely related but differ in the means of transmission: herpes simplex virus 1 is transmitted chiefly by contact with infected saliva and causes cold sores around the mouth, while herpes simplex virus 2 is transmitted sexually or from a mother's genital tract infection to her newborn and causes painful blisters on the thighs, genitals, or rectum that break open and turn into sores.

Both types of viruses can be transmitted very easily through direct contact. A person can get the cold sores of HSV1 by kissing or sharing eating utensils with an infected person. A person can get genital herpes or HSV2 by having intimate contact with an infected person. The virus can enter your body through a break in your skin or through the skin of your mouth, penis or vagina, urinary tract opening, cervix or anus. Herpes is most easily spread when blisters or sores can be seen on the infected person. But it can be spread at any time, even when there aren't any symptoms. Herpes can also be spread from one place on your body to another, for example from your genitals to your fingers, then to your eyes or to other parts of your body. A mother who has genital herpes can pass the infection on to her newborn if she delivers the baby vaginally.

In the United States, HSV is ubiquitous. HSV1 is usually acquired in childhood by contact with oral secretions containing the virus. HSV-2 becomes an issue when the individual becomes sexually mature. Approximately 80% of adults have antibodies to HSV-1, whereas antibodies to HSV-2 are found in approximately 20% of the population. The incidence of genital herpes has been estimated to be 500,000-1,000,000 cases per year with a prevalence of 40-60 million affected individuals.

Internationally, more than one third the world's population has recurrent clinical HSV infections. Reportedly, 13-40% of the world's population is seropositive for HSV-2 and 56-85% is seropositive for HSV-1, varying by country. Also, men are 20% more likely to develop recurrences of HSV-2 than are women.

Left untreated, genital herpes may have serious consequences. The most common complication of HSV infections is bacterial superinfection. In women with primary HSV-2 infection, aseptic meningitis is also common. The most significant complications include visceral infections and central nervous system complications.

Visceral infections (infections of the visceral organs), usually result from viremia (the presence of virus in the bloodstream), and multiple organ involvement is common. This may occur during otherwise asymptomatic primary infections. In most cases of disseminated herpes, the lesions are confined to the skin; however, fatal visceral dissemination can occur with or without vesicular skin lesions. The most common complication is HSV hepatitis. Disseminated herpes can also lead to herpetic esophagitis, adrenal necrosis, interstitial HSV pneumonitis, HSV cystitis, HSV arthritis, HSV meningitis, and HSV encephalitis.

Central nervous system complications include: aseptic meningitis which is a condition in which the layers lining of the brain, or meninges, become inflamed and a bacterial or viral source cannot be detected, ganglionitis (inflammation of a ganglion), myelitis (an inflammatory disease of the spinal cord), and herpes simplex encephalitis (a viral infection of the brain).