Genital Herpes: Viral Infection and Manifestation
Herpes Simplex Virus (HSV) Types and Genital Infection
Genital herpes is primarily caused by two types of herpes simplex virus: HSV-1 and HSV-2. HSV-2 is more frequently associated with genital infections, while HSV-1 is more commonly linked to oral herpes (cold sores), although it can also cause genital infections.
Viral Replication and Initial Infection
The virus enters the body through mucous membranes or breaks in the skin during sexual contact. Following entry, the virus replicates within cells at the site of infection. This replication process can lead to inflammation and the formation of characteristic lesions.
Symptomatic and Asymptomatic Infection
Individuals infected with HSV can experience symptomatic or asymptomatic infections. Symptomatic infections are characterized by visible lesions and other symptoms. Asymptomatic infections involve viral shedding without any noticeable signs or symptoms.
Primary Infection: Signs and Symptoms
The first outbreak, or primary infection, can present with a range of symptoms including:
- Painful blisters or sores in the genital area, buttocks, or inner thighs
- Flu-like symptoms such as fever, headache, and body aches
- Swollen lymph nodes in the groin
- Pain or difficulty urinating
- Vaginal discharge (in women)
Recurrent Outbreaks: Characteristics
After the primary infection, the virus remains dormant in nerve cells. Recurrent outbreaks can occur, typically being milder and shorter in duration than the primary infection. Some individuals experience prodromal symptoms, such as tingling, itching, or burning, before an outbreak.
Factors Influencing Outbreak Frequency and Severity
Several factors can influence the frequency and severity of recurrent outbreaks, including:
- Stress
- Illness
- Menstruation (in women)
- Compromised immune system
- Sun exposure
Diagnosis of Genital Herpes
Diagnosis is typically based on a physical examination of the lesions and laboratory tests, such as:
- Viral culture
- Polymerase chain reaction (PCR) testing
- Antibody blood tests
Management and Treatment
Antiviral medications can help to reduce the severity and duration of outbreaks, as well as reduce the frequency of recurrences. These medications include acyclovir, valacyclovir, and famciclovir.