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Genital herpes

• Overview
• Symptoms
• Treatment
• Prevention

Alternative Names:

Herpes - genital; Herpes simplex - genital; Herpesvirus 2; HSV-2

Treatment:

Genital herpes cannot be cured. However, treatment can relieve the symptoms. Medication can rapidly decrease the pain and discomfort associated with an outbreak and can shorten healing time as well.

Three oral agents are currently being prescribed, including acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex).

These medications have been shown to speed the healing and resolution of symptoms in first attacks more than in recurrent episodes of genital HSV-1 and HSV-2 infections. These medications do not cure the herpes infection. Instead, they suppress the symptoms.

If necessary, daily suppressive therapy can be used, and has been shown to reduce the frequency of recurrence among patients with frequent genital herpes outbreaks.

For maximum benefit during recurrences, therapy should be started as soon as the tingling, burning, or itching starts, or as soon as the blisters are noticed. Possible side effects from these medications include: nausea and vomiting, rash, headache, fatigue, tremor, and very rarely, seizures.

Intravenous acyclovir is sometimes needed for severe herpes infections that can involve the brain, eyes, and lungs. These complications typically develop in immunocompromised individuals.

Foscarnet (Foscavir), a powerful anti-viral agent, is the first choice for treatment of herpes strains that have become resistant to acyclovir and similar drugs. Administered intravenously, the drug can have several toxic effects, such as reversible impairment of kidney function or bringing on seizures.

Given these serious side effects, foscarnet is saved only for severe and resistant herpes infections. As with other antiviral drugs, this medication does not cure herpes.

Warm baths may relieve the pain associated with genital lesions. Gentle cleansing with soap and water is recommended. If secondary infection of the skin lesions by bacteria occur, a topical or oral antibiotic can be used.

Support Groups:

Joining a support group in which members share common experiences and problems can help the stress associated with this illness. See herpes genital - support group .

Expectations (prognosis):

Once infected, the virus stays in the body for the rest of the individual's life. Some never have another episode, and some have frequent recurrences. In most recurrences, no obvious trigger is identified. Many people, however, find that attacks of genital herpes occur in conjunction with the following conditions:

• general illness (from mild illnesses to serious conditions, such as operations, heart attacks, pneumonia and so on)
• fatigue
• physical or emotional stress
• immunosuppression, due to AIDS or such medication as chemotherapy or steroids
• trauma to the affected area, including sexual activity
• menstruation

In individuals with normal immune systems, genital herpes remains a localized and bothersome infection, but seldom a life-threatening infection.

Complications:

• recurrent disease (common)
• encephalitis (rare)
• spread of the virus to other organs of the body in immunosuppressed people
• transverse myelopathy (damage that extends across the spinal cord)
• incontinence

Calling your health care provider:

Call for an appointment with your health care provider if you have any symptoms suggestive of genital herpes, or if fever, headache, vomiting, or widespread symptoms develop during (or after) an outbreak of herpes.

• Review Date: 2/13/2006
• Reviewed By: Monica Gandhi, M.D., M.P.H., Assistant Professor, Division of Infectious Diseases, UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network.

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