Herpes

For all types of herpes viruses, see Herpesviridae. For other uses, see Herpes (disambiguation).

Herpes
Other namesHerpes simplex
Oral herpes of the lower lip. Note the blisters in a group marked by an arrow.
Pronunciation
SpecialtyInfectious disease
SymptomsBlisters that break open and form small ulcers, fever, swollen lymph nodes[1]
Duration2–4 weeks[1]
CausesHerpes simplex virus spread by direct contact[1]
Risk factorsDecreased immune function, stress, sunlight[2][3]
Diagnostic methodBased on symptoms, PCR, viral culture[1][2]
MedicationAciclovir, valaciclovir, paracetamol (acetaminophen), topical lidocaine[1][2]
Frequency60–95% (adults)[4]

Herpes simplex, often known simply as herpes, is a viral infection caused by the herpes simplex virus.[5] Herpes infections are categorized by the area of the body that is infected. The two major types of herpes are oral herpes and genital herpes, though other forms also exist.

Oral herpes involves the face or mouth. It may result in small blisters in groups, often called cold sores or fever blisters, or may just cause a sore throat.[2][6] Genital herpes involves the genitalia. It may have minimal symptoms or form blisters that break open and result in small ulcers.[1] These typically heal over two to four weeks.[1] Tingling or shooting pains may occur before the blisters appear.[1]

Herpes cycles between periods of active disease followed by periods without symptoms.[1] The first episode is often more severe and may be associated with fever, muscle pains, swollen lymph nodes and headaches.[1] Over time, episodes of active disease decrease in frequency and severity.[1]

Herpetic whitlow typically involves the fingers or thumb,[7] herpes simplex keratitis involves the eye,[8] herpesviral encephalitis involves the brain,[9] and neonatal herpes involves any part of the body of a newborn, among others.[10]

There are two types of herpes simplex virus, type 1 (HSV-1) and type 2 (HSV-2).[1] HSV-1 more commonly causes infections around the mouth while HSV-2 more commonly causes genital infections.[2] They are transmitted by direct contact with body fluids or lesions of an infected individual.[1] Transmission may still occur when symptoms are not present.[1] Genital herpes is classified as a sexually transmitted infection.[1] It may be spread to an infant during childbirth.[1] After infection, the viruses are transported along sensory nerves to the nerve cell bodies, where they reside lifelong.[2] Causes of recurrence may include: decreased immune function, stress, and sunlight exposure.[2][3] Oral and genital herpes is usually diagnosed based on the presenting symptoms.[2] The diagnosis may be confirmed by viral culture or detecting herpes DNA in fluid from blisters.[1] Testing the blood for antibodies against the virus can confirm a previous infection but will be negative in new infections.[1]

The most effective method of avoiding genital infections is by avoiding vaginal, oral, manual, and anal sex.[1][11] Condom use decreases the risk.[1] Daily antiviral medication taken by someone who has the infection can also reduce spread.[1] There is no available vaccine[1] and once infected, there is no cure.[1] Paracetamol (acetaminophen) and topical lidocaine may be used to help with the symptoms.[2] Treatments with antiviral medication such as aciclovir or valaciclovir can lessen the severity of symptomatic episodes.[1][2]

Worldwide rates of either HSV-1 or HSV-2 are between 60% and 95% in adults.[4] HSV-1 is usually acquired during childhood.[1] Since there is no cure for either HSV-1 or HSV-2, rates of both inherently increase as people age.[4] Rates of HSV-1 are between 70% and 80% in populations of low socioeconomic status and 40% to 60% in populations of improved socioeconomic status.[4] An estimated 536 million people worldwide (16% of the population) were infected with HSV-2 as of 2003 with greater rates among women and those in the developing world.[12] Most people with HSV-2 do not realize that they are infected.[1]

  1. ^ a b c d e f g h i j k l m n o p q r s t u v w x y z "Genital Herpes – CDC Fact Sheet". cdc.gov. December 8, 2014. Archived from the original on 31 December 2014. Retrieved 31 December 2014.
  2. ^ a b c d e f g h i j Balasubramaniam, R; Kuperstein, AS; Stoopler, ET (April 2014). "Update on oral herpes virus infections". Dental Clinics of North America. 58 (2): 265–80. doi:10.1016/j.cden.2013.12.001. PMID 24655522.
  3. ^ a b Elad S, Zadik Y, Hewson I, et al. (August 2010). "A systematic review of viral infections associated with oral involvement in cancer patients: a spotlight on Herpesviridea". Support Care Cancer. 18 (8): 993–1006. doi:10.1007/s00520-010-0900-3. PMID 20544224. S2CID 2969472.
  4. ^ a b c d Chayavichitsilp P, Buckwalter JV, Krakowski AC, Friedlander SF (April 2009). "Herpes simplex". Pediatr Rev. 30 (4): 119–29, quiz 130. doi:10.1542/pir.30-4-119. PMID 19339385. S2CID 34735917.
  5. ^ "Herpes simplex virus". World Health Organization. Retrieved 21 November 2022.
  6. ^ Mosby (2013). Mosby's Medical Dictionary (9 ed.). Elsevier Health Sciences. pp. 836–37. ISBN 9780323112581. Archived from the original on 2017-09-06.
  7. ^ Wu, IB; Schwartz, RA (March 2007). "Herpetic whitlow". Cutis. 79 (3): 193–06. PMID 17674583.
  8. ^ Rowe, AM; St Leger, AJ; Jeon, S; Dhaliwal, DK; Knickelbein, JE; Hendricks, RL (January 2013). "Herpes keratitis". Progress in Retinal and Eye Research. 32: 88–101. doi:10.1016/j.preteyeres.2012.08.002. PMC 3529813. PMID 22944008.
  9. ^ Steiner, I; Benninger, F (December 2013). "Update on herpes virus infections of the nervous system". Current Neurology and Neuroscience Reports. 13 (12): 414. doi:10.1007/s11910-013-0414-8. PMID 24142852. S2CID 22139709.
  10. ^ Stephenson-Famy, A; Gardella, C (December 2014). "Herpes Simplex Virus Infection During Pregnancy". Obstetrics and Gynecology Clinics of North America. 41 (4): 601–14. doi:10.1016/j.ogc.2014.08.006. PMID 25454993.
  11. ^ Hoyle, Alice; McGeeney, Ester (2019). Great Relationships and Sex Education. Taylor and Francis. ISBN 978-1-35118-825-8. Retrieved July 11, 2023.
  12. ^ Looker, KJ; Garnett, GP; Schmid, GP (October 2008). "An estimate of the global prevalence and incidence of herpes simplex virus type 2 infection". Bulletin of the World Health Organization. 86 (10): 805–12, A. doi:10.2471/blt.07.046128. PMC 2649511. PMID 18949218.