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Innermost Secrets / Innermost Living / Body Clock
Skip Navigation LinksHerpes Simplex
Page modified at: 21/02/2010

Herpes Simplex (Genital Herpes)Herpes Simplex is a life-long incurable viral infection and is one of the most common sexually transmitted diseases
Viruses have highly variable complex DNA/RNA structure, which account for the different strains within the same family of viruses.  It is highly contagious and can be passed on even when there are no apparent symptoms.

 

 
Clinical diagnosis is sometimes difficult as patients do not always present with lesions.  It is estimated that while more than one in five Americans older than the age of 12 (50 million) are infected with genital herpes 80% are unaware of the infection.
The etiology of genital herpes is the herpes simplex virus of which there are two strains: Type 1 (HSV-1) and type 2 (HSV-2). Both are closely related but differ in epidemiology.  
Infections may be primary or non-primary and disease episodes may be initial or recurrent.
 
How is Herpes Simplex spread?
HSV-1 is transmitted chiefly by contact with infected saliva
HSV-2 is transmitted sexually or from a mother's genital tract infection to her newborn
 
How do I reduce the risk of catching Herpes Simplex?
Condoms may be partially effective in preventing acquisition of HSV, especially in preventing transmission from infected males to their female sex partners. The efficacy of male condoms in preventing transmission from infected females to uninfected male partners has not been demonstrated, and the efficacy of female condoms to reduce HSV transmission during intercourse has not been assessed.
 
How do I reduce the risk of passing Herpes Simplex on to others?
Practicing safer sex  may help  to prevent the infection being passed on to others.  The surest way to avoid transmission of sexually transmitted diseases, including HSV, is to abstain from sexual contact or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.  
Genital ulcer diseases, like Herpes Simplex  can occur in both male and female genital areas that are covered or protected by a latex condom, as well as in areas that are not covered. Correct and consistent use of latex condoms can reduce the risk of genital herpes, as well as syphilis  and chancroid, only when the infected area or site of potential exposure is protected.
Avoiding alcohol and drug use may also help prevent transmission of HSV because these activities may lead to risky sexual behavior. It is important that sex partners talk to each other about their HIV status and history of other STDs so that preventive action can be taken.
Transmission of an STD, including syphilis cannot be prevented by washing the genitals, urinating, and/or douching after sex. Any unusual discharge, sore, or rash, particularly in the groin area, should be a signal to refrain from having sex and to see a doctor immediately.
Aciclovir, famciclovir, and valaciclovir al suppress symptomatic and asymptomatic viral shedding. These drugs have been shown in clinical trials to reduce asymptomatic HSV shedding by about 80 - 90%.
There are no vaccines currently approved for prevention of genital herpes although trials are ongoing.
 
What are the symptoms of Herpes Simplex?
Men and women with Herpes Simplex infection are usually asymptomatic and unaware of the infection though some will have characteristic lesions on their skin or may experience pain when the infection is active.
Men and Women might notice:

    * Nothing – 80% are silent
    * Local symptoms such as painful ulceration, dysuria, vaginal or urethral discharge.
    * Systemic symptoms such as fever and myalgia (muscle pain) are much more common in primary than in initial or recurrent disease.
    * Blistering and ulceration of the external genitalia (+/- cervix/rectum)
    * Tender inguinal lymphadenitis, usually bilateral – painful lymph glands in the groins

In first episodes, lesions and lymphadenitis are usually bilateral. In recurrent disease, it is usual for lesions to affect favoured sites. They may alternate between sides but are usually unilateral for each episode. Lymphadenitis occurs in around 30%.
 
What happens if Herpes Simplex isn't treated?
Herpes Simplex cannot be cured but treatment may reduce the period of time when the condition is active and causing symptoms. It is also important to treat pregnant women with active Herpes as it can be passed on to the baby during a vaginal birth and Caesarean Section may be more appropriate.  Rare but serious consequences of infection include:

    * Autonomic neuropathy (nerve damage), resulting in urinary retention.
    * Autoinoculation to fingers and adjacent skin e.g. on thighs
    * Aseptic meningitis

How can I reduce the risk of catching Herpes Simplex ?
Practising safer sex reduces the risk of infection with Herpes Simplex.
Suppressive antiviral therapy with valaciclovir 500 mg once daily reduces the rate of acquisition of HSV-2 infection and clinically symptomatic genital herpes in serodiscordant couples.
 
How do I reduce the risk of passing Herpes Simplex on to others?
Testing and treating (if appropriate) all sexual contacts helps to prevent the infection being passed on to others.
 
How do I get testing or treatment for Bacterial Herpes Simplex?
If you think you might have HSV it's important to be tested . Cultures are helpful if the patients present early enough but viral shedding only lasts a few days and often the lesion has crusted or disappeared by the time the patients is seen. Thus, a negative culture would not definitely rule out herpes. Measuring HSV DNA by PCR assay is more sensitive for detecting HSV in a lesion than a viral culture and will distinguish between HSV-1 and HSV-2.
 
NHS:Testing is free on the NHS from genitourinary medicine clinics, sexual health clinics, many contraception clinics, your GP and pharmacies. You can find a clinic to help with Herpes Simplex by phoning directory enquiries and asking for genitourinary medicine, sexually transmitted disease or venereal disease or locate one using our NHS Genitourinary Medicine Clinic page in the Sexual Health Section of our website.
 
PRIVATE:Alternatively you can have confidential private testing based on an internet ordered urine home sample kit.   Telephone 0345 2303386 or use the  Confidential Text Service 07786202070
 
How is Bacterial Herpes Simplex treated?
Herpes Simplex cannot be cured but antiviral drugs may shorten active periods of the infection.

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