Genital herpes

Genital herpes is one of the most prevalent sexually transmitted infections (STIs). It is primarily caused by the herpes simplex virus type 2 (HSV-2). However, the herpes simplex virus type 1 (HSV-1), which is typically associated with oral herpes, can also be transmitted to the genital area through oral sexual contact. Additionally, transmission can occur from an infected mother to her newborn during childbirth, potentially resulting in severe health complications for the infant.

Clinical Presentation

Many individuals with genital herpes may be asymptomatic or exhibit very mild symptoms that go unnoticed. For those who do show symptoms, they typically manifest 3-7 days after exposure to the virus and may include:

• Erythematous bumps and blisters: Fluid-filled blisters that may be clear or yellowish, accompanied by redness and swelling.
• Burning sensation: Before the lesions appear, individuals may experience discomfort or itching in the affected area.
• Systemic symptoms: In some cases, patients may also experience fever, malaise, and swollen lymph nodes.

During the initial outbreak, symptoms tend to be more severe and can last 2-3 weeks. In contrast, recurrences are usually milder and shorter in duration, often lasting only a few days.

Sites of involvement

• Women: Lesions may appear on the labia, within the vagina and on the cervix.
• Men: Lesions commonly appear on the glans, foreskin, and frenulum area.
• Both genders: Can occur on the perineum, gluteal area and upper thighs.

Complications

Though rare, genital herpes can lead to serious complications, including:

• Urethritis: Characterized by urethral discharge and painful urination (dysuria).
• Meningitis: Symptoms include headache and neck stiffness.
• Cervicitis: In women, this may cause increased vaginal discharge and painful intercourse (dyspareunia).

Recurrences

After the primary infection subsides, the virus remains dormant in the body and may reactivate during times of stress, illness, or without any clear trigger.

Diagnosis

Diagnosis of genital herpes is typically made through:

• Clinical examination: Conducted by a qualified healthcare provider based on the patient’s symptoms.
• PCR testing: Detects the virus’s DNA in blood or lesions.
• Antibody testing: Blood tests confirm either a past or current infection.
• Histological examination: Microscopic analysis of the lesions.

Treatment

Treatment options include:

• Antiviral medications: These can speed healing and alleviate symptoms.
• Topical treatments: Local antiseptics and antibiotics may be used to reduce discomfort.
• Suppressive therapy: For individuals with frequent recurrences, a long-term antiviral regimen (6-12 months) may be advisable.

It is important to note that the virus remains in the body permanently, regardless of treatment.

Prevention and Recommendations

• Use condoms: Consistent condom use can significantly reduce the risk of transmission.
• Avoid sexual contact during outbreaks: Engaging in sexual activity during active outbreaks increases the likelihood of transmission.
• Inform partners: Keeping sexual partners informed allows them to take appropriate precautions.
• Regular STI screenings: Routine screenings are important for sexually active individuals.
• Good hygiene practices: Maintain cleanliness in the genital area and wash hands thoroughly after any contact.
• Avoid sharing personal items: Do not share towels, underwear, or other items that may come into contact with the genital area.