Genital Herpes Summary

Genital herpes simplex virus (HSV) infection is a lifelong infection with no known cure.

  • HSV-1 is most often associated with oral infections1
  • HSV-2 is most often associated with genital infections1

Either type can infect a person anywhere on the skin. The only known hosts of this virus are humans. HSV-2 enters the body through the skin or mucous membranes by direct sexual contact with the secretions or mucosal surfaces of an infected person.

Signs and Symptoms

Symptoms of genital herpes occur anywhere below the waist or above the thigh. Some individuals do not have any symptoms, while others may not recognize symptoms or may attribute them to other conditions.1,2

Signs/Symptoms may include1,2:

Classic signs/symptoms Other common signs/symptoms
Sores or blisters Bumps or pimples
Tingling or itching Burning
Redness Discharge
Aches and pains in the genital area Pain with urination
Flu-like symptoms Urinary frequency and urgency

About Viral Shedding3,4

Viral shedding occurs when HSV-2 is released on the surface of the skin/mucosa. It can be measured by polymerase chain reaction (PCR) or culture.

  • Clinical shedding is shedding during the presence of a genital herpes lesion
  • Subclinical shedding* is shedding in the absence of lesions; may include days with symptoms (eg, prodrome)
  • Asymptomatic viral shedding* is shedding in the absence of signs or symptoms

*Many clinicians use these terms interchangeably.

Facts about Genital Herpes

  • Up to 70% of transmission may have occurred in couples who reported no signs or symptoms of genital herpes at the time of sexual contact5
  • Physical signs or symptoms of recurrent genital herpes typically last up to 14 days, while primary genital herpes may last up to 21 days6
  • Clinicians should be aware that many cases of genital herpes may present atypically (read more about diagnosis and testing)2
  • Newly diagnosed patients may have a recurrence soon after the initial episode – median time to first recurrence in patients with a confirmed first episode is 47 days in men (n=101) and 49 days in women (n=225)7
  • The psychosocial impact of first-episode genital herpes on individuals' lives can result in feelings of depression (82%), fear of rejection (75%) and feelings of isolation (69%)8

 

  1. Beauman JG. Genital Herpes: A Review. Am Fam Physician 2005;72:1527-34, 1541-2.
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  2. National Institutes of Health Web site. Genital herpes. Available at:
    http://www3.niaid.nih.gov/healthscience/healthtopics/genital_herpes/symptoms.htm. Accessed on November 21, 2007.
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  3. Wald A, Zeh J, Selke S, et al. Virologic characteristics of subclinical and symptomatic genital herpes infections. N Engl J Med. 1995;333:770-775.
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  4. Koelle DM, Wald A. Herpes simplex virus: the importance of asymptomatic shedding. Journal of Antimicrobial Chemotherapy (2000) 45, 1-8.
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  5. Mertz GJ, Benedetti J, Ashley R, Selke SA, Corey L. Risk factors for the sexual transmission of genital herpes. Ann Intern Med. 1992;116:197-202.
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  6. Sachs S, Genital herpes simplex virus infection and treatment. In: Sachs S, Ed. Clinical Management of Herpes Viruses. Amsterdam:
    IOS Press;1995:chapter 3.
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  7. Benedetti J, Corey L, Ashley R. Recurrence rates in genital herpes after symptomatic first-episode infection. Ann Intern Med. 1994;121:847-854.
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  8. Catotti DN, Clarke P, Catoe KE. Herpes revisited: still a cause of concern. Sex Trans Dis. March-April 1993:77-80.
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