Types of Human Herpes Virus

• HHV-1   HSV 1 (herpes simplex virus 1)
• HHV 2   HSV 2 (Herpes simplex virus 2)
• HHV-3   VZV (varicella-zoster virus) also known as herpes shingles virus, chickenpox virus, or Herpes zoster virus
• HHV-4   EBV (Ebstein barr virus, lymphocryptovirus)
• HHV-5   CMV (cytomegolovirus)
• HHV-6   Human B-cell lymphotrophic virus or roseolovirus
• HHV-7   that causes symptoms similar to the HHV-6
• HHV-8   It is a type of rhadinovirus

Herpes is spread through direct contact. So, a genital herpes infection will stay in the area it originated unless transferred elsewhere via direct contact or skin-to-skin transference. Herpes won't just show up on its own somewhere else on the body. Because herpes is spread through direct contact, it is important to avoid contact with infected areas. If a herpes infection is not localized, further complications may occur. Herpes is equally common in males and females.

HSV-1 can cause genital herpes, but it more commonly causes infections of the mouth and lips, so-called "fever blisters." HSV-1 infection of the genitals can be caused by oral-genital or genital-genital contact with a person who has HSV-1 infection. Genital HSV-1 outbreaks recur less regularly than genital HSV-2 outbreaks. Most of the people who are infected with HSV-2 have no symptoms of disease or they do not recognize their symptoms. Only about one third of people who first become infected with HSV-2 have symptoms. These symptoms often include fever, headache, genital pain, genital discharge, and blisters. Even if you have no symptoms, genital herpes can be diagnosed by testing your blood for an antibody to HSV-2. When signs do occur, they typically appear as one or more blisters on or around the genitals or rectum. The blisters break, leaving tender ulcers (sores) that may take two to four weeks to heal the first time they occur. Typically, another outbreak can appear weeks or months after the first, but it almost always is less severe and shorter than the first episode. Although the infection can stay in the body indefinitely, the number of outbreaks tends to go down over a period of years.

Once the virus infects you, it moves from the skin or membranes around the genitals to the central nervous system, where it remains for life. The virus can “wake up” or reactivate to cause a recurrence of the disease. When reactivation occurs, the virus travels down the nerves to the skin. It may cause blisters, genital itching, tenderness, burning, tingling, or redness, but it usually just makes copies of itself with no symptoms.

Diagnosis of Genital Symptoms

Because many patients with genital herpes have atypical symptoms or culture-negative genital lesions, HSV-2 infection can be challenging to diagnose. To aid in the diagnosis of genital symptoms, type-specific HSV-2 serology tests should be available in conjunction with virological tests in clinical settings where patients are evaluated for STDs. Serology tests may be useful for the following clinical presentations: (1) culture-negative recurrent lesions, (2) history suggestive of herpes or atypical herpes in the absence of genital lesions, (3) suspected primary herpes or first presentation of genital symptoms, if culture or antigen detection testing is negative or not available. Because it takes up to six weeks for most patients to develop antibodies, negative test results are less reliable when they are conducted soon after acquisition.

Results of a nationally representative study show that genital herpes infection is common in the United States. Nationwide, at least 45 million people ages 12 and older, or one out of five adolescents and adults, have had genital HSV infection. Between the late 1970s and the early 1990s, the number of Americans with genital herpes infection increased 30 percent.

Genital HSV-2 infection is more common In Women (approximately one out of four women) than in men (almost one out of five). This may be due to male-to-female transmissions being more likely than female-to-male transmission.

How do people get genital herpes?

HSV-1 and HSV-2 can be found in and released from the sores that the viruses cause, but they also are released between outbreaks from skin that does not appear to be broken or to have a sore. Generally, a person can only get HSV-2 infection during sexual contact with someone who has a genital HSV-2 infection. Transmission can occur from an infected partner who does not have a visible sore and may not know that he or she is infected.

HSV-1 can cause genital herpes, but it more commonly causes infections of the mouth and lips, so-called "fever blisters." HSV-1 infection of the genitals can be caused by oral-genital or genital-genital contact with a person who has HSV-1 infection. Genital HSV-1 outbreaks recur less regularly than genital HSV-2 outbreaks.

Is Genital Herpes Serious?

HSV-2 usually produces only mild symptoms or signs or no symptoms at all. However, HSV-2 can cause recurrent painful genital sores in many adults, and HSV-2 infection can be severe in people with suppressed immune systems. Regardless of severity of symptoms, genital herpes frequently causes psychological distress in people who know they are infected. In addition, HSV-2 can cause potentially fatal infections in infants if the mother is shedding virus at the time of delivery. It is important that women avoid contracting herpes during pregnancy because a first episode during pregnancy causes a greater risk of transmission to the newborn. If a woman has active genital herpes at delivery, a cesarean delivery is usually performed. Fortunately, infection of an infant from women with HSV-2 infection is rare. In the United States, HSV-2 may play a major role in the heterosexual spread of HIV, the virus that causes AIDS. Herpes can make people more susceptible to HIV infection, and it can make HIV-infected individuals more infectious.

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