Genital herpes, like the rest of sexually transmitted infections, has grown in recent years.

Genital herpes is the name assigned to the genital clinical manifestations due to infection by a virus of the herpes family (Herpesviridiae) that has two serotypes: herpes simplex virus type 1 and type 2 (HSV-1 and HSV-2).

It is the most common cause of genital ulcers and in recent years it has experienced the same growing trend as other sexually transmitted infections .

Relationship between cold sores and genital herpes

Both HSV-1 and HSV-2 can cause genital and oral lesions, although cold sores are more often caused by HSV-1 and genital by HSV-2 .

How are these viruses transmitted?

The transmission of herpes simplex occurs, as explained by Mariam de la Poza, member of the Study Group and Recommendations on Infectious Diseases in Primary Care of the Catalan Society of Family and Community Medicine (Camfic) , “by direct contact with the skin , mucosa or secretions of an infected person, even if they do not have apparent lesions”.

The contagion occurs mainly through sexual relations (vaginal, oral or anal ), but it can also be, although much less frequently, through other routes, such as vertical transmission (from mother to child during childbirth ).

What are the most common symptoms?

The incubation period of the virus ranges from 2 to 12 days and local and general manifestations may appear.

General manifestations

Among the most common general symptoms attributable to genital herpes are malaise and headache (headache). It can also cause fever.

Local demonstrations

Tingling and itching in the affected area are usually the initial symptoms. “First an erythema appears, on which grouped vesicles appear that erode. It ends up evolving into an ulcer , which is characterized by being painful,” de la Poza describes.

These manifestations can be seen in different locations of the genitalia: vulva , cervix, glans , penis , foreskin , buttocks, leg, and anal, perianal, or rectal region.

“The manifestations usually last between 15 and 20 days and disappear even if we do not treat ourselves,” explains the expert. “But they tend to come back , which is what we know as recurrences, which generally last 8 to 12 days without treatment, usually appear in the same place as the first one, and are more typical of HSV-2.”

These recurrences are due to the fact that “once the virus is acquired, it can remain confined to nerve cells and from there go to the skin and produce recurrences,” explains the internist.

De la Fuente adds that genital herpes can be complicated, although exceptionally : “In very rare cases it can cause meningoencephalitis (inflammation of the meninges and the brain), which is very serious.”

The condom, effective prevention but with limitations

Avoiding contact with active lesions is the main recommendation to prevent the transmission of genital herpes. In addition, it must be taken into account, according to de la Poza, “that contagiousness is higher during the first year, especially in the case of HSV-2.” For this reason, “it is recommended not to have sexual intercourse while there are herpetic lesions or symptoms such as itching, discomfort or pain in the affected area.”

The use of condoms is also recommended , but the family doctor clarifies that, in the case of herpes, “its protection is limited.”

After the diagnosis of this infection, the evaluation and treatment of sexual partners of the affected person who are symptomatic is recommended. “Those asymptomatic are evaluated and receive advice,” he reports.

Treatment of genital herpes

The treatment of genital herpes is based, according to the SEMI representative, on ” absolutely effective antiviral drugs , especially at the beginning.” This therapy accelerates healing, decreases the intensity of symptoms, prevents complications and reduces the risk of transmission, but “it does not reduce the risk of relapses and does not eliminate the virus,” stresses de la Poza.

What relationship does this virus have with HIV?

There is a proven relationship between genital herpes and the human immunodeficiency virus (HIV) , which causes AIDS. The lesions caused by herpes create a pathway for HIV to get past the defenses of the immune system. Hence, it is estimated that people with HSV-2 have up to three times the risk of becoming infected with HIV than those who are not infected with this herpes virus.

What to do if we suspect that we may have genital herpes?

The sooner the infection is treated, the better recovery will be and transmission will be reduced. “If you suspect genital herpes, as well as any other sexually transmitted infection, you should go to your primary care doctor to receive adequate treatment,” concludes de la Poza.

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