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Infectious Diseases

Herpes type 1 and 2

03/17/2006

Question:

I have had HSV 1 since I was a child. When I was younger I had frequent and quite severe outbreaks however over the past few years as an adult I have been having 1 outbreak every 18 moths to 2 years. About 8 months ago I contracted HSV 2 in the genital area and possibly orally as I also had oral sex with this person. So I now have HSV 1 and 2. I have only experienced prodromal systems in the groin area with no notable blisters but I know I have both types as I tested positive for both types of antibodies. The prodromal systems lasted 3-4 months on and off in the groin area and I have only had these symptoms again once recently in line with constant oral outbreaks. I did experience blisters on my gums after the oral sex. Four months ago I developed seborrhoeic dermatitis in the groin area which has shown no sign of going away despite trying everything but have been told that that has nothing to do with herpes my by GP. Over the past 3-4 months I have also been having constant outbreaks in and around my mouth sometimes with notable blisters other times I just experience prodromal symptoms despite being on Valtrex. I am wondering if these constant outbreaks my be due to the fact that I might have HSV 1 and 2 orally I never remember having such constant outbreaks as a child. It has gotten to the point that I am to scared to get in a relationship because I can’t even kiss anyone (even my 2 year old) due to the constant outbreaks. I am hoping that you are able to shed some light on why I might be experiencing the constant outbreaks and let me know if there is anything I can do to reduce there frequency. Thank-you for your time in answering this question. Please Help Scared and desperate

Answer:

Genital herpes is an infection of the genitals, buttocks, or anal area caused by herpes simplex virus (HSV). There are two types of HSV. HSV type 1 most commonly infects the mouth and lips, causing sores known as fever blisters or cold sores. It is also an important cause of sores to the genitals. HSV type 2 is the usual cause of genital herpes, but it also can infect the mouth. According to the Centers for Disease Control and Prevention, 1 out of 5 American teenagers and adults is infected with HSV-2. Women are more commonly infected than men. In the United States, 1 out of 4 women is infected with HSV-2. Since the late 1970s, the number of people with genital herpes infection has increased 30 percent nationwide. The largest increase has been among teens and young adults. If you have genital herpes infection, you can easily pass or transmit the virus to an uninfected partner during sex. Most people get genital herpes by having sex with someone who is shedding the herpes virus either during an outbreak or during a period with no symptoms. People who do not know they have herpes play an important role in transmission. You can transmit herpes through close contact other than sexual intercourse, through oral sex or close skin-to-skin contact, for example. The virus is spread rarely, if at all, by objects such as a toilet seat or hot tub. People with herpes should follow a few simple steps to avoid spreading the infection to other places on their body or other people. Avoid touching the infected area during an outbreak, and wash your hands after contact with the area. Do not have sexual contact (vaginal, oral, or anal) from the time of first genital symptoms until symptoms are completely gone. Although there is no cure for genital herpes, your health care provider might prescribe an antiviral medicine to treat your symptoms and to help prevent future outbreaks. This can decrease the risk of passing herpes to sexual partners. Medicines to treat genital herpes are Acyclovir (Zovirax) Famciclovir (Famvir) Valacyclovir (Valtrex) Because herpes can be transmitted from someone who has no symptoms, using these precautions is not enough to prevent transmission. Recently, the Food and Drug Administration approved Valtrex for use in preventing transmission of genital herpes. It has to be taken continuously by the infected person, and while it significantly decreases the risk of the transmission of herpes, transmission can still occur. Do not have oral genital contact in the presence of any symptoms or findings of oral herpes. Using barriers such as condoms during sexual activity may decrease transmission, but transmission can occur even if condoms are used correctly. Condoms may not cover all infected areas.

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Response by:

Pamposh   Kaul, MD Pamposh Kaul, MD
Assistant Professor
College of Medicine
University of Cincinnati