Genital herpes

Explanation

This is an infection of the external genitals with the herpes simplex virus (HSV). HSV type 2 is usually responsible for genital herpes, while herpes of the mouth and lip region (herpes labialis) is usually caused by HSV type 1.

Transmission and symptoms

A typical sign of HSV infection is the formation of blisters in the affected body region, which burst open in the course of the infection, form an ulcer and then heal within about 1 - 4 weeks. A special feature of HSV infections is the fact that the virus persists in the host's body for life. After infection, it is taken up by the offshoots of sensitive nerve cells and migrates in them to the nucleus of the nerve cell. The virus DNA remains permanently in the nucleus of the nerve cell. If the disease is reactivated, the virus is multiplied in the nerve cell and released into the surroundings at the end of the nerve fibre. There, skin cells are infected and the course of the disease as described above is repeated. A known trigger for reactivation is emotional stress.

Transmission occurs through close contact with the mucous membrane when the virus has just been reactivated and has multiplied in the skin cells. A typical skin lesion in the carrier does not always have to be visible.

Due to the lifelong persistence of the virus, its distribution within the population is relatively high and increases with increasing age. Contact with HSV-2 could be detected in about 7% of women aged 15 - 19 years; in the 40 - 44 age group, the rate was 28%.

Diagnosis

Diagnosis is usually made on the basis of the typical skin changes. In case of doubt, virus detection can be done through special cell cultures or by direct DNA detection.

Therapy

For genital herpes, systemic treatment with the antiviral agent Aciclovir to be taken in the form of tablets over a period of 5 days is recommended. Purely local therapy with creams of the kind used for lip herpes is not recommended due to their low level of effectiveness.