Venereology
Genital Herpes
Information About Genital Herpes
Genital herpes is a sexually transmitted viral infection mainly caused by herpesvirus type 2 (HSV 2). Various risk factors for the transmission of genital herpes include multiple sexual partners, individual history of other sexually transmitted diseases and beginning sexual life at a young age.

Genital herpes virus is transmitted after close contact with the person carrying the virus. The virus enters the body from minor skin or mucosal infections, permeates the dermis and enters the peripheral sensory nerves. This is why the virus can be transmitted even when using a condom, as the affected area may not be completely covered by the condom and thus the virus is transmitted from one person to another. If one of the two sex partners has genital herpes that is on the rise, it is preferable that there is no sexual intercourse. Genital herpes can also be transmitted through oral sex.
 
In women, genital herpes is more common than in men. It is estimated that 1 in 4 women gets affected by herpes 2. This is probably due to the fact that transmission from man to woman is easier than the opposite. Women are more affected because their genital area is warmer and wetter.

What Is The Clinical Picture Of Genital Herpes?
According to statistics, genital herpes is the most common sexually transmitted disease in terms of frequency, and according to surveys, only 10-25% of HSV 2 positive people are aware of the infection they suffer from.

The clinical picture of genital virus differs from patient to patient, and in many cases the atypical clinical picture may be mistaken for fungal vaginosis or injury. Symptoms may be different in the same individual if the virus hits for the second or third time. Typically, men feel tingling in the penis and women in the vagina. Later on, small bubbles on the genital area or the rectum that swell and develop into blisters filled with fluid. After a couple of days, the blisters open on their own and a "crust" is created.

When the blisters break, it causes pain and itching. Herpes is located within the skin wounds causing it and contact with wounds spreads the virus. Sometimes the symptoms are so drastic that they can cause pain in the whole body, headache, and even fever. Blisters hurt for about ten days, then dry and the area is cured. If the infection is not prevented within the first 24 hours, it will take at least 14 days to completely clear the infected area.

How Is Diagnosis In Genital Herpes Performed?
Clinical diagnosis of genital herpes should be carried out in principle by a dermatologist in conjunction with laboratory tests, which may determine, inter alia, HSV1 or HSV2, since HSV1 is more rarely recovered than HSV2. For the laboratory diagnosis of genital herpes, the following three methods are used:
  • Cultivation: It is a difficult and time-consuming method, which, however, has a high specificity and low sensitivity.
  • Immediate immunofluorescence: A fast and economical method with a high specificity but low sensitivity.
  • Polymerase Chain Reaction (PCR): It is the most sensible method and doctors try to establish it even in routine tests despite its large cost.
How Is Genital Herpes Treated?
If the patient comes to the doctor within the first five days of the onset of symptoms, antiviral medicines such as asciclovir, famciclovir, valacyclovir and brivudine are administered orally. Note that these drugs do not eliminate the virus, but restrict the spread of the virus elsewhere or speed up the treatment. Simultaneously with antivirals, painkillers such as paracetamol or aspirin are given to help with pain, itching and possible fever, as well as local anesthetic creams, which are also intended to relieve pain.

Finally, for the relief of symptoms, it is recommended that the patients:
  • Keep the affected area clean and dry to prevent contamination.
  • Place cold patches in the affected area, not only to relieve pain, but also to get blisters out faster.
  • Continually wash their hands, especially when they come into contact with the wound.
  • Avoid complete sexual intercourse until the active infection completely disappears.
  • Always wear a condom in case of sexual contact.
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