summary
Infection with the herpes simplex virus (HSV), known as shingles, is common throughout the world. HSV type 1 (HSV-1) is usually spread by mouth-to-mouth contact and causes infection in or around the mouth (oral herpes), but it can also cause genital herpes. hsv-2 is primarily sexually transmitted and causes genital herpes.
Both oral and genital herpes are mostly asymptomatic or unrecognized, but can cause painful blisters or ulcers at the site of infection, ranging from mild to severe. the infection is lifelong and symptoms may recur for many years. Some medications are available to reduce the severity and frequency of symptoms, but they cannot cure the infection.
Recurring symptoms of oral and genital herpes can be distressing. genital herpes can also be stigmatizing and have an impact on sexual relationships. however, over time, most people with any type of herpes adjust to living with the infection.
scope of the problem
In 2016 (latest available estimates), 3.7 billion people under the age of 50, or 67% of the population, had HSV-1 infection (oral or genital). most hsv-1 infections are acquired during childhood.
Genital herpes caused by hsv-2 affects approximately 491 million (13%) people between the ages of 15 and 49 worldwide (2016 data). hsv-2 infects women almost twice as often as men because sexual transmission is more efficient from male to female. the prevalence increases with age, although the greatest number of new infections occur in adolescents.
signs and symptoms
Oral herpes infection is mostly asymptomatic, but symptoms may include painful blisters or open sores (ulcers) in or around the mouth (cold sores). infected people often experience a tingling, itching, or burning sensation around the mouth before the sores appear. these symptoms may recur periodically and the frequency varies from person to person.
Genital herpes can be asymptomatic or have mild symptoms that go unnoticed. when symptoms do occur, genital herpes is characterized by one or more genital or anal blisters or ulcers. In addition, symptoms of a new infection often include fever, body aches, and swollen lymph nodes. after an initial episode, which can be severe, symptoms may recur. genital herpes caused by hsv-1 does not normally recur frequently. with hsv-2, recurrent symptoms are common. however, recurrences are usually less severe than the first episode and tend to lessen over time.
transmission
hsv-1 is spread primarily through contact with the virus on sores, saliva, or surfaces in or around the mouth. Less commonly, HSV-1 can be transmitted to the genital area through oral-genital contact to cause genital herpes. can be transmitted from normal-appearing skin or oral surfaces; however, the greatest risk of transmission is when there are active sores. people who already have hsv-1 are not at risk for reinfection, but are still at risk for hsv-2.
hsv-2 is spread primarily during sexual intercourse through contact with the genital or anal surfaces, skin, sores, or fluids of someone infected with the virus. hsv-2 can be transmitted even if the skin looks normal and is often transmitted in the absence of symptoms.
In rare circumstances, herpes (hsv-1 and hsv-2) can be passed from mother to child during childbirth and cause neonatal herpes.
possible complications
hvs-2 and hiv infection
hsv-2 infection increases the risk of contracting hiv infection approximately threefold. In addition, people with both HIV and HSV-2 infection are more likely to transmit HIV to others. HSV-2 infection is among the most common infections in people living with HIV.
serious illness
In immunosuppressed people, including those with advanced HIV infection, herpes may have more severe symptoms and more frequent recurrences. rare complications of hsv-2 include meningoencephalitis (brain infection) and disseminated infection. Rarely, HSV-1 infection can lead to more serious complications, such as encephalitis (infection of the brain) or keratitis (infection of the eye).
neonatal herpes
Neonatal herpes can occur when a baby is exposed to HSV during childbirth. Neonatal herpes is rare, occurring in about 10 of every 100,000 births worldwide. however, it is a serious condition that can lead to long-lasting neurological disability or death. The risk of neonatal herpes is higher when a mother first acquires HSV late in pregnancy.
treatment
Antiviral drugs, such as acyclovir, famciclovir, and valacyclovir, are the most effective drugs for people infected with HSV (see WHO recommendations). these can help reduce the severity and frequency of symptoms, but they cannot cure the infection.
prevention
People with symptoms of oral herpes should avoid oral contact with other people (including oral sex) and sharing objects that have come in contact with saliva. People with symptoms of genital herpes should refrain from sexual activity while experiencing symptoms. Both HSV-1 and HSV-2 are most contagious when sores are present, but can also be spread when no symptoms are felt or seen.
For sexually active people, consistent and correct use of condoms is the best way to prevent genital herpes and other STIs. however, hsv infection can still occur through contact with genital or anal areas that are not covered by a condom. medical male circumcision may provide partial lifelong protection against hsv-2 infection, as well as hiv and human papillomavirus (hpv).
People with symptoms suggestive of genital herpes should be offered hiv testing.
Pregnant women with symptoms of genital herpes should tell their health care providers. preventing acquisition of hsv-2 infection is particularly important for women in late pregnancy, when the risk of neonatal herpes is greatest.
who responds
which is working to increase awareness of hvs infection and its symptoms, improve access to antiviral medications, and promote hiv prevention efforts for people with genital herpes, such as pre-exposure prophylaxis (prep). ).
who and its partners are also supporting research to develop new strategies for the prevention and control of hvv infections, such as vaccines and topical microbicides.
