Genital herpes Health Article

Treatment

Genital herpes cannot be cured. However, antiviral treatment can relieve the symptoms. Medication can quickly relieve the pain and discomfort during an outbreak, and can shorten healing time. Medications have been shown to speed healing and relieve symptoms in first attacks more than in recurrent episodes of genital HSV-1 and HSV-2 infections.

If necessary, patients can use daily suppressive therapy, which may reduce the frequency of recurrence in patients with frequent genital herpes outbreaks.

For maximum benefit during recurrences, start therapy as soon as the tingling, burning, or itching begins, or as soon as you notice blisters.

Possible side effects from herpes medications include:

• Fatigue
• Headache
• Nausea and vomiting
• Rash
• Seizures
• Tremor

Some people need medication through a vein (intravenous) for severe herpes infections that can involve the brain, eyes, and lungs. These complications sometimes develop in people with a compromised immune system.

Warm baths may relieve the pain of genital lesions. Gentle cleansing with soap and water is recommended. If you develop a secondary infection of the skin lesions by bacteria, you can use a topical or oral antibiotic.

Support Groups

See: Herpes genital - support group

Expectations (prognosis)

Once you are infected, the virus stays in your body for the rest of your life. Some people never have another episode, and others have frequent recurrences. In most recurrences, no obvious trigger is identified. Many people, however, find that attacks of genital herpes occur with the following conditions:

• Fatigue
• General illness (from mild illnesses to serious conditions, such as operations, heart attacks, and pneumonia)
• Immunosuppression due to AIDS or medication such as chemotherapy or steroids
• Menstruation
• Physical or emotional stress
• Trauma to the affected area, including sexual activity

In people with a normal immune system, genital herpes remains a localized and bothersome infection, but is rarely life-threatening.

Complications

Various complications are associated with herpes infection. The herpes virus is of special significance to women because research has found that it can cause cancer of the cervix. The risk increases when HSV is present in combination with human papilloma virus (HPV, the virus responsible for genital warts (condyloma).

For pregnant women, HSV-1 or HSV-2 on the outside of the genitals or in the birth canal is a threat to the infant. Infection of the newborn can lead to herpetic meningitis, herpetic viremia, chronic skin infection, and even death.

Herpes infection also poses a serious problem for people who have a weakened immune system because they have AIDS, are undergoing chemotherapy or radiation therapy, or take high doses of cortisone. These people may develop infections of various organs, including:

• Encephalitis (rare)
• Herpetic esophagitis (herpes infection of the esophagus)
• Herpetic keratitis (herpes infection of the eye)
• Herpetic hepatitis (herpes infection of the liver)
• Incontinence
• Persistent infection of the mucous membranes and skin of the nose, mouth, and throat
• Pneumonitis (herpes infection of the lung)
• Recurrent disease
• Spread of the virus to other organs of the body
• Transverse myelopathy (damage that extends across the spinal cord)

Calling your health care provider

Call for an appointment with your health care provider if you have any symptoms of genital herpes, or if you develop fever, headache, vomiting, or widespread symptoms during or after an outbreak of herpes.

Prevention

Condoms remain the best way to protect against catching genital herpes during sexual activity. Using a condom correctly and consistently will help prevent the spread of the disease.

The use of latex condoms is mandatory. Do not use animal membrane condoms, because the virus can go through them. The female condom has been tested and shown to successfully reduce transmission risk as well.

Recent data show that using an antiherpes drug can help prevent spreading the virus to others.

Otherwise, prevention is difficult, due to the fact that the virus can be spread to others even when the infected person has no obvious symptoms (asymptomatic shedding). People with genital herpes should avoid sexual contact when they have active lesions.

In addition, people with known genital herpes, but without current symptoms, should inform their partner that they have the disease. This precaution allows both parties to use barrier protection to prevent the spread of the illness.

Pregnant women with the herpes simplex infection should have weekly viral cultures of the cervix and outer genitals as the delivery date approaches. If the viral culture is positive for herpes, or active lesions are present at delivery, a cesarean delivery (C-section is recommended to avoid infecting the newborn.

Vaccines against herpes have been developed but are still considered experimental drugs. Vaccines are not, however, a cure or treatment for people who already have herpes.