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Many of our readers who regularly read our popular science articles are aware that “cold sores around the lips” are actually caused by herpes simplex virus infections. What many may not know is that this virus is not only responsible for infections around the lips, but it can also cause genital infections .
Today, let’s discuss the ins and outs of genital herpes simplex virus infections.
What is herpes simplex virus infection?
Genital herpes, also known as “genital herpes,” is a sexually transmitted disease caused by the herpes simplex virus (Herpes Simplex Virus, HSV) .
The virus is divided into two types: HSV-1 and HSV-2.
01 Herpes Simplex 1 Type (HSV-1, commonly known as cold sores)
It is more common, and according to WHO estimates, 3.7 billion (about 67%) people under the age of 50 are infected with HSV-1. After infection, most people develop cold sores around the lips, while a few develop herpes on the nostrils, around the eyes, and on the cheeks. However, in recent years, the incidence of genital herpes caused by HSV-1 has been on the rise, about 10% of genital herpes may be caused by HSV-1 infection .
02 Herpes Simplex 2 Type (HSV-2, commonly known as genital herpes)
It is a sexually transmitted infection, relatively less common, according to WHO estimates, there are 491 million people aged 15-49 (about 13%) infected with HSV-2, mainly causing genital herpes.
Once infected with either of these viruses, they persist for life, can be treated, but cannot be cured.
What are the symptoms of genital herpes?
The symptoms of genital herpes can vary from person to person, with many people not experiencing symptoms or only mild symptoms. Those with symptoms may experience:
Pain and itching: The infected area may have itching, burning sensation, or pain (sometimes manifested as pain during urination) ;
Blisters and ulcers: The infected area may develop small blisters , which evolve into painful ulcers , then the ulcers rupture, and finally scab and heal.
Systemic symptoms: During the initial infection, symptoms are often more severe, and some patients may experience fever, general body aches, and swollen lymph nodes .
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The first outbreak of herpes may last for several weeks . After healing, the virus becomes latent in the nervous system, remaining inactive until triggered to reactivate. Therefore, herpes simplex virus infections can recur frequently .
How is it contracted?
Both viruses are transmitted from person to person through skin contact or throughbody fluids , and are most likely to infect others when acute lesions are present. However, even without symptoms, the virus can be present in the skin and genital mucous membranes, and infection can occur even with the use of condoms or other barrier methods, a situation known as “ asymptomatic viral shedding “.
It is estimated that most genital herpes infections are transmitted by people who are unaware of their infection or by asymptomatic individuals.
For example, a cross-sectional study of adults living in New York City found that nearly 28% of people were infected with HSV-2, and 88% of those infected were previously unaware of their HSV infection.
01 HSV-1
You may have contracted this virus as a baby or young child, which can happen when an infected adult kisses and touches. In fact, at any time, you can contract the virus in the following ways:
● Kissing;
● Touching the skin near someone else’s mouth;
●
Sharing utensils, lip balm, or razors;
●
If oral sex is performed with someone who has cold sores, the herpes virus can be spread to the genitals.
02 HSV-2
People may contract HSV-2 in the following ways:
● Sexual intercourse, including vaginal and anal sex;
● Oral sex with an infected person (giving or receiving) ;
●
Skin-to-skin contact without ejaculation;
●
Touching open wounds, including during breastfeeding;
● If the mother has active genital herpes during childbirth, it can also be transmitted (spread) to the newborn.
You cannot contract genital herpes from objects like toilet seats. However, genital herpes can be transmitted through shared sex toys. (To be safe, please clean them before and after use, and do not share them. If you must share, use condoms to protect them.)
How do you know if you have genital herpes?
Early diagnosis of genital herpes usually depends on a doctor’s clinical judgment , such as the appearance of small blisters, pustules, or superficial ulcers in the genital area, accompanied by pain, itching, or a burning sensation. A definitive diagnosis must be made through laboratory testing .
Common laboratory testing methods include:
01 Virological testing
Including traditional viral cultures of secretions, polymerase chain reaction (PCR) , nucleic acid amplification tests (NAAT) , etc.
Physicians need to collect samples of herpes fluid or secretions from the lesion for testing. The best time to collect samples is early in the disease (such as during the first outbreak or recurrence) , preferably by取材 from the base of the lesion, such as by puncturing the blister with a needle, which can increase the accuracy of the test. This is the gold standard for diagnosing genital herpes .
02 Serological testing
It can detect HSV-1 and HSV-2 serotype-specific antibodies. HSV IgG can be detected as early as 2-3 weeks after the initial infection, and false-negative results may occur in new infections, so it is recommended to repeat testing within 12 weeks. Serological testing can be helpful in determining primary and recurrent infections .
Genital Herpes Treatment
01 Medication
At present, antiviral medications such as acyclovir, famciclovir, and valacyclovir can be used to treat genital herpes , however, these medications cannot eradicate the virus, nor can they prevent the spread of the virus, but for patients with the first outbreak, they can alleviate symptoms and shorten the course of the disease, and the effect is more certain when treatment is initiated within 24 hours of the outbreak . For some patients with atypical or milder symptoms, since the virus is mostly a self-limiting disease, the course can naturally regress when immunity is normal , and observation can also be maintained.
02 Daily life
In addition to medication, what methods can help alleviate pain and discomfort?
● Sit in warm water for 20 minutes, avoiding the use of soap and body wash;
● Keep the genital area clean and dry, avoiding tight clothing;
● Use pain relievers such as acetaminophen or ibuprofen, but avoid aspirin.
What causes recurrent outbreaks?
Once you have herpes simplex, it may recur frequently , but over time, the condition tends to become milder and the number of outbreaks decreases, HSV-2 recurrences are more common than HSV-1 .
Fatigue or stress, illness, fever, menstruation are often the causes of genital herpes outbreaks, and even surgery can trigger outbreaks in some people.
In addition to avoiding the above triggers, there are some measures that can help prevent recurrence:
01 Safe sex
Use a condom for every sexual encounter. Although condoms do not provide complete protection, they can greatly reduce the risk of transmission.
02 Avoid sexual contact
Avoid sexual contact when symptomatic or feeling unwell (including vaginal, anal, and oral sex) .
03 Sexual partner examination
If one party is diagnosed with genital herpes, the sexual partner should also be examined and treated .
Peer review expert Mou Tian
Obstetrician and Gynecologist at Distinct Health, Ph.D. from Peking University Health Science Center, Visiting Scholar at the University of Kansas Medical Center
References
Disclaimer: The article is intended to provide general health information. For personal medical issues, please consult a doctor. To reprint the article, please contact: medicine@distinctclinic.com.
