All you need to know about genital herpes

All you need to know about genital herpes

Did you know that one-in-six Australian women are living with herpes "down under"?¹
Because genital herpes is usually transmitted through skin-to-skin contact, most commonly through sexual contact, the virus can spread easily from person-to-person. So that means that some people with genital herpes will have no noticeable symptoms, while others could experience their first outbreak within two-to-20 days after coming into contact with the virus.²

One-in-six Australian women has genital herpes,¹ and reports suggest that this figure is increasing, especially among Gen Y.³

Herpes expert, Professor Tony Cunningham, from Westmead Hospital, Sydney, says "Most of the time, the genital herpes virus lies inactive and often without symptoms. When re-activated, the virus travels down the nerve paths to the surface of the skin, causing an outbreak.⁴

"Even after the first outbreak of genital herpes, the virus stays in the body for life4 and it is possible to pass on the virus, with or without symptoms."²While there's currently no cure for genital herpes, doctors are researching better ways to treat the virus and its symptoms.

What is genital herpes?
- Genital herpes is a common infection caused by the herpes simplex virus, HSV-1 and HSV-2.⁴
- HSV-1 most commonly causes cold sores, but can also be transmitted to the genitals through direct skin-to-skin contact, often via oral sex. About 80 per cent of adults have HSV-1.⁴
- HSV-2 is responsible for most genital herpes and is commonly transmitted through sexual contact.⁴
- Approximately one-in-eight active Australians over the age of 25 has HSV-2.1 Of these, 20 per cent are aware that they have the virus, 60 per cent are unaware that they have it, but have symptoms, while another 20 per cent have no symptoms.⁵

Transmission of the virus
- Genital herpes is transmitted through skin-to-skin contact or sexual contact.⁴
- This may occur when a person has a recurrence, but it more commonly it occurs between episodes, when the virus is still found on the skin, but there are no symptoms.⁶
- Twenty per cent of people who have been exposed to HSV-1 or HSV-2 never develop any symptoms.⁶ Even without symptoms, these people are infectious and can transmit the infection at any time.⁶

Symptoms
- The first symptoms of genital herpes may occur two-to-20 days after first contact with the virus.²
- This first episode of genital herpes is often the most severe because the immune system has not had time to develop antibodies to protect against the virus.⁴
- Symptoms may include swollen lymph nodes (glands in the groin, neck and armpit), or flu-like symptoms (sore muscles, tiredness, headaches, fever and chills).⁴
- Other symptoms can include swelling, pain or itching around the genitals, possibly followed by painful red spots that can form small blisters. These blisters may burst to form open sores or ulcers, which crust over and heal. There may also be pain during urination.⁴
- Usually symptoms associated with the first episode heal in a few weeks.⁴
- Following the first episode, 95 per cent of individuals will have recurrences of the infection.⁷
- These are usually mild and short lived. Most people with herpes only have occasional recurrences, but some will have then every month or even more often.

Treatment
- Treatments for genital herpes can reduce the severity, frequency and duration of outbreaks.²
- There are currently three herpes antiviral medications available in tablet form - famciclovir, aciclovir and valaciclovir.²
- Antiviral medications help stop the virus from multiplying, effectively reducing the duration of outbreaks.⁴
- Genital herpes may be treated episodically or suppressively.²
- Episodic treatment involves treating each recurrence when it occurs.²
- Taking a two-day or a five-day episodic treatment at the first signs of an outbreak will help reduce the length and severity of symptoms.²
- Suppressive (preventative) treatment involves taking medication on a daily basis to reduce the chance of an outbreak occurring.²
- Continuous suppressive treatment is useful for those who are experiencing frequent recurrences. Most individuals taking suppressive treatment will either have no recurrences or very few minor episodes during treatment.²

If you've been diagnosed with and treated for genital herpes, the Australian Herpes Management Forum (AHMF) wants to hear from you. By taking five minutes to fill in a simple, anonymous survey, you could be helping to improve the treatment options for Australians with genital herpes.

To have your say on treating herpes "down under", go to ahmf.com.au/herpes-treatment-survey For more information on genital herpes, go to www.herpes.com.au

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References
¹ Cunningham AL, Taylor R, Taylor J, Marks C, Shaw J, Mindel A. Prevalence of infection with herpes simplex virus types 1 and 2 in Australia: a nationwide population based survey. Sex Transm Infect 2006; 82: 164-168.
² Ooi, C & Dayan, L. Genital herpes: an approach for general practitioners in Australia. Australian Family Physician 2002; 31:9.
³ Australian Government Department of Health and Ageing. National Sexually Transmissible Infections Strategy 2005-2008. 2005; Publication 3681.
⁴ Sacks, SL. The truth about herpes. 1997 4th Edition, Gordon Soules Book Publishers Ltd, West Vancouver, Canada.
⁵ Australian Herpes Management Forum. Guidelines for clinicians: Managing genital herpes [fact sheet]. Feb 2008.
⁶ Mertz GJ, Benedetti J, Ashley R, Selke SA, Corey L. Risk factors for the sexual transmission of genital herpes. Ann Int Med 1992; 116(3): 197-202.
⁷ Australian Herpes Management Forum. Guidelines for clinicians: Suppressive therapy for genital herpes [fact sheet]. Apr 2008.