Genital herpes is an infection by the herpes simplex virus (HSV) of the genitalia. Most people do not have mild symptoms and therefore do not know that they are infected. When symptoms do occur, they usually include small blisters that break open to form painful ulcers. Symptoms such as flu can also occur. Onset is usually about 4 days after exposure to symptoms lasting up to 4 weeks. After a further outbreak there may be an outbreak but generally lighter.
The disease usually spreads through direct genital contact with the skin surface or secretion of an infected person. This may occur during sex including oral sex. An active wound is not required for transmission to occur. HSV is classified into two types, HSV-1 and HSV-2. Although historically largely due to HSV-2, genital HSV-1 has become more common in developed countries. Diagnosis can occur by testing lesions using PCR or viral cultures or blood tests for specific antibodies.
Efforts to prevent infection include not having sex, using condoms, and only having sex with someone who is not infected. Once infected, there is no cure. Antiviral drugs may, however, prevent outbreaks or shorten outbreaks if they occur. Long-term antiviral use may also reduce the risk of further spread.
By 2015 about 846 million people (12%) have genital herpes. Women are more often infected than men. The rate of illness caused by HSV-2 has decreased in the United States between 1990 and 2010. Complications may rarely include aseptic meningitis, increased risk of HIV/AIDS if exposed, and spread to infants during labor resulting in neonatal herpes.
Video Genital herpes
Signs and symptoms
In men, lesions occur in the glans penis, penis or other parts of the genital area, on the inner thigh, buttocks, or anus. In women, lesions appear in or near the pubis, clitoris or other parts of the vulva, buttocks or anus.
Other common symptoms include pain, itching, and burning. Less common, but still common, symptoms include discharge from the penis or vagina, fever, headache, muscle aches (myalgia), swelling and enlargement of lymph nodes and malaise. Women often experience additional symptoms that include painful urination (dysuria) and cervicitis. Proctitis herpes (inflammation of the anus and rectum) is common for individuals who participate in anal intercourse.
After 2-3 weeks, the lesions develop into ulcers and then crust and heal, although lesions on the mucosal surface may never form crusting. In rare cases, the involvement of the sacral region of the spinal cord can lead to acute urinary retention and one-sided symptoms and signs of myeloradiculitis (myelitis and radiculitis combination): pain, sensory loss, abnormal sensation (paresthesia) and rash. Historically, this has been called Elsberg's syndrome, although this entity is not clearly defined.
Repetition
After the first episode of genital herpes caused by HSV-2, there will be at least one recurrence in about 80% of people, whereas the recurrence rate for genital herpes caused by HSV-1 is about 50%. Genital herpes caused by HSV-2 recurs at an average of four to six times per year, whereas HSV-1 infection occurs only once per year.
People with recurrent genital herpes can be treated with suppressive therapy, which consists of daily antiviral treatment using acyclovir, valacyclovir or famciclovir. Supressive therapy may be useful in those who have at least four recurrences per year but the quality of evidence is poor. People with lower recurrence rates may also have less recurrence with suppressive therapy. Supressive therapy should be stopped after a maximum of one year to reassess recurrence frequency.
Maps Genital herpes
Transmission
Genital herpes can be transmitted through release of the virus before and after visual signs of the symptoms.
Screening
Testing the blood of people, including those who are pregnant, who have no symptoms for HSV is not recommended. This is due to concerns of greater harm than benefits such as relationship problems in setting high test levels that may be false positives.
Treatment
In May 2018, genital herpes can not be cured. But there are some drugs that can shorten outbreaks including acyclovir, valacyclovir, and famciclovir.
Aciclovir is an antiviral drug and relieves pain and number of lesions in early cases of genital herpes. In addition, it reduces the frequency and severity of recurrent infections. It comes in the form of capsules, tablets, suspensions, injection, powder for injection, and ointment. Ointments are used topically and relieve pain, reduce healing time, and limit the spread of infection.
Valacyclovir is a prodrug converted to acyclovir once in the body. It helps relieve pain and discomfort and speeds wound healing. It only comes in the caplet and the advantage is that it has a longer duration of action than acyclovir. Examples of use are by mouth twice per day for ten days for primary lesions, and twice daily for three days for recurrent episodes.
Famciclovir is another antiviral drug belonging to the same class. Famciclovir is a prodrug converted into penciclovir in the body. The latter is active against viruses. It has a longer duration of action than acyclovir and only comes in tablets.
Epidemiology
About 16 percent of Americans between the ages of 14 and 49 are infected with genital herpes, making it one of the most common sexually transmitted diseases. More than 80% of those infected are unaware of their infection. Every year, 776,000 people in the United States get a new herpes infection.
Tests for herpes are not routinely included among STD screening. The perpetrators in the pornography industry are screened for HIV, chlamydia, and gonorrhea with a panel of options for hepatitis B, hepatitis C and syphilis tests, but not herpes. Herpes testing is still controversial because the results are not always accurate or helpful. Most sex workers and offenders will have herpes at some point in their careers, whether they use protection or not.
History
The public health laws of the early 20th century in the UK required compulsory care for sexually transmitted diseases but did not include herpes because it was not serious enough. Until the end of 1975, nursing textbooks did not include herpes because it was no worse than a common cold. After the development of acyclovir in the 1970s, drug company Burroughs Wellcome launched an extensive marketing campaign that publicized the disease, including creating a victim support group.
Research
There is an attempt to develop the vaccine, but the results so far have not been able to cure herpes or eliminate transmission.
References
External links
Source of the article : Wikipedia
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