HSV Infection Information

Herpes simplex viruses (HSV) cause most viral infections in humans, falling short only to flu and cold viruses, according to the University of South Carolina's School of Medicine. The word "herpes" is derived from the Greek word "herpein," which means "to creep." This is reflective of the insidious nature of HSV--including the way some of these viruses quietly inhabit the human nervous system and sporadically cause painful symptoms.

HSV Overview

• Of the 25 HSV types, eight are known to cause symptoms in humans more than others. Getting infected with HSV is a lifetime affair; the virus makes its way to certain nerve ganglia, where it lays dormant until something triggers it to reactivate. HSVs are classified by the part of the body in which they reside. The herpes simplex 1 virus (HSV-1) that causes oral herpes lives in the trigeminal ganglia at the top of the spine, closest to the face, while the herpes simplex 2 virus (HSV-2) resides in the basal ganglia closest to the base of the spine, which is why lesions erupt in the genital area. The herpes zoster virus causes shingles, and is the second presentation of chicken pox caused by the varicella-zoster virus; after initial symptoms go away, this particular HSV moves into parts of the ganglia where it can actively replicate. Currently, there are no medical cures that can remove HSV from the human body permanently; however there are medical treatments that can assuage and prevent symptoms.

Oral Herpes

• The HSV-1 that causes oral herpes--also known as fever blisters and cold sores--is extremely common in the U.S. population. American Social Health Association statistics indicate that between 50 and 80 percent of people are infected with HSV-1, and by the time they reach age 50, almost 90 percent are infected. This HSV is usually acquired at some point during childhood when someone receives a kiss from a friend or relative who is infected with HSV-1. Outbreaks can occur between one and two weeks after being infected with HSV-1 but sometimes symptoms are not noted until three weeks later. Oral herpes outbreaks typically affect the lips or mouth area, but can be noted around the nose and on the chin; rarely do they occur inside the mouth, according to the Mayo Clinic. HSV-1 infections generally resolve on their own between seven and 10 days, although when lesions are present, they are very painful--and unattractive.

  Recurrences of oral herpes are noted in roughly a quarter of people, ASHA says. Someone with unhealed lesions can transmit HSV-1 to another person through a kiss, face-to-face contact or by sharing infected items, such as razors and eating utensils. HSV-1 can also be the cause of genital herpes, if someone with an outbreak performs oral sex on a partner.

Genital Herpes

• Ninety percent of cases of genital herpes are caused by HSV-2 through direct genital contact (sexual intercourse), according to Mayo Clinic data. An initial outbreak of genital herpes usually takes place within two weeks after being infected with the virus--although the Centers for Disease Control warns that up to 90 percent of people are unaware that they have genital herpes and don't note an initial outbreak. The first outbreak of genital herpes is usually the most severe, accompanied by symptoms such as headache, aching joints, fever and a tingling or painful sensation in the skin where the outbreak will occur. First outbreaks resolve in between two and four weeks, says the CDC. Most people who experience initial outbreaks can expect five to six more in the same year.

  Genital herpes is easy to acquire unknowingly. The Mayo Clinic notes that 70 percent of genital herpes cases were transmitted when the infected person had no outward signs of the infection. This is because the HSV is asymptomatically shed through minuscule passageways in the infected person's skin even in the absence of an obvious outbreak. Mayo Clinic experts state that many people don't notice genital herpes symptoms because they are so mild as to be undetectable--small lesions may be misidentified as an insect bite or pimple. This is because most people infected with oral herpes caused by HSV-1 have built up antibodies to other types of HSV.

Herpes Zoster

• Herpes zoster, or shingles, can occur in anyone who's had chicken pox before, although the Mayo Clinic notes that shingles more commonly affect people over 50 or those with weakened immune systems. As with genital herpes, those who experience shingles can also note flu-like symptoms such as fever, chills, headache, and aching joints and muscles. Shingles lesions typically erupt unilaterally (on one side of the body), often with clusters of blisters extending around one side of the breastbone to the other side of the back near the spine. But shingles can also be noted on other parts of the body, even the face.

  A single outbreak of shingles can resolve on its own in a few weeks without the need for medical treatment. Because this is a very painful condition that can lead to painful post-outbreak complications such as postherpetic neuralgia and even certain neurological conditions, some patients may opt for medical treatment, which sometimes includes use of a narcotic to control pain.

Treating HSV Infections

• Oral and genital herpes and shingles can be treated with the oral antiviral medications acyclovir, famciclovir and valacyclovir, which go by the trade names Zovirax, Famvir and Valtrex, respectively. Antiviral drugs work by reducing the rate at which HSV replicates and can have a profound effect in reducing the severity and duration of symptoms, particularly for those who experience multiple outbreaks of oral or genital herpes or a severe case of shingles. Mayo Clinic experts recommend that anyone with genital herpes who experiences frequent outbreaks or who is sexually active with uninfected partners take these medications on a daily basis as a form of suppressive therapy.