Cure for Herpes

Genital herpes is a fairly common virus – sometimes sexually transmitted – and most people with genital herpes infection do not know they have it.

  • You can get genital herpes even if your partner shows no signs of the infection.
  • If you have any symptoms (like a sore on your genitals, especially one that periodically recurs) laboratory tests can help determine if you have genital herpes.
  • There is no cure for herpes, but treatment is available to reduce symptoms and decrease the risk of transmission to a partner.

HSV – Herpes Simplex Virus

HSV Statistics – HSV Information – Herpes Statistics – Herpes Information

Can we find a herpes cure?  Will there ever be a cure for herpes?

What is genital herpes?

Genital herpes is a sexually transmitted disease caused by the herpes simplex viruses type 1 (HSV-1) or type 2 (HSV-2).

How common is genital herpes?

Genital herpes infection is common in the United States. Nationwide, 16.2% of persons aged 14 to 49 years have HSV-2 infection. [1] The overall prevalence of genital herpes is likely higher than 16.2%, because an increasing number of genital herpes infections are caused by HSV-1. Increases in genital HSV-1 infections have been found in patient populations worldwide. [2]

HSV-2 infection is more common among women than among men (20.9% versus 11.5% in 14 to 49 year olds). Infection is more easily transmitted from men to women than from women to men.  HSV-2 infection is more common among non-Hispanic blacks (39.2%) than among non-Hispanic whites (12.3%) or Mexican Americans (10.1%). This disparity remains even among persons with similar numbers of lifetime sexual partners. For example, among persons with 2–4 lifetime sexual partners, HSV-2 is still more prevalent among non-Hispanic blacks (34.3%) than among non-Hispanic whites (9.1%) or Mexican Americans (13%). Most infected persons are unaware of their infection.  In the United States, an estimated 81.1% of 14–49 year olds infected with HSV-2 have never received a clinical diagnosis. [1]

The percentage of persons in the United States who are infected with HSV-2 decreased from 21.0% in 1988–1994 to 17.0% in 1999–2004. However, HSV-2 prevalence has changed very little since 2004.[3]

How do people get genital herpes?

Infections are transmitted through contact with lesions, mucosal surfaces, genital secretions, or oral secretions. HSV-1 and HSV-2 can also be shed from skin that looks normal. In persons with asymptomatic HSV-2 infections, genital HSV shedding occurs on 10% of days, and on most of those days the person has no signs or symptoms. [4] Generally, a person can only get HSV-2 infection during sexual contact with someone who has a genital HSV-2 infection. Transmission most commonly occurs from an infected partner who does not have a visible sore and may not know that he or she is infected.[5]

What are the symptoms of genital herpes?

Most individuals infected with HSV-1 or HSV-2 are asymptomatic, or have very mild symptoms that go unnoticed or are mistaken for another skin condition. As a result, 81.1% of infected individuals remain unaware of their infection. [1, 6] When symptoms do occur, they typically appear as one or more vesicles on or around the genitals, rectum or mouth. The average incubation period after exposure is 4 days (range, 2 to 12). [7] The vesicles break and leave painful ulcers that may take two to four weeks to heal. Experiencing these symptoms is referred to as having an “outbreak,” or episode.

Clinical manifestations of genital herpes differ between the first and recurrent outbreaks of HSV.  The first outbreak of herpes is often associated with a longer duration of herpetic lesions, increased viral shedding (making HSV transmission more likely) and systemic symptoms including fever, body aches, swollen lymph nodes, and headache. [8] Recurrent outbreaks of genital herpes are common, in particular during the first year of infection. Approximately half of patients who recognize recurrences have prodromal symptoms, such as mild tingling or shooting pains in the legs, hips and buttocks occurring hours to days before eruption of herpetic lesions. Symptoms of recurrent outbreaks are typically shorter in duration and less severe than the first outbreak of genital herpes. Although the infection can stay in the body indefinitely, the number of outbreaks tends to decrease over time. Recurrences are much less frequent for genital HSV-1 infection than for genital HSV-2 infection. [9]

What are the complications of genital herpes?

Genital herpes causes painful genital ulcers in many adults that can be severe and persistent in persons with suppressed immune systems, such as HIV-infected persons.   Both HSV-1 and HSV-2 can also cause rare but serious complications such as blindness, encephalitis (inflammation of the brain), and aseptic meningitis (inflammation of the linings of the brain). Development of extragenital lesions in the buttocks, groin, thigh, finger and eyes may occur during the course of infection. [8]

Some persons who contract genital herpes have concerns about how it will impact their overall health, sex life, and relationships. There can be can be considerable embarrassment, shame, and stigma associated with a herpes diagnosis and this can substantially interfere with a patient’s relationships. [7]Clinicians can address these concerns by encouraging patients to recognize that while herpes is not curable, it is a manageable condition. Three important steps that providers can take for their newly-diagnosed patients are: giving information, providing support resources, and helping define options. [10]Since a genital herpes diagnosis may affect perceptions about existing or future sexual relationships, it is important for patients to understand how to talk to sexual partners about STDs. One resource can be found here: www.gytnow.org/talking-to-your-partnerExternal Web Site Icon

There are also potential complications for a pregnant woman and her unborn child. See “How does herpes infection affect a pregnant woman and her baby?” below for information about this.

What is the link between genital herpes and HIV?

Genital ulcerative disease caused by herpes make it easier to transmit and acquire HIV infection sexually. There is an estimated 2- to 4-fold increased risk of acquiring HIV, if exposed to that infection when genital herpes is present. [11-13] This is because genital herpes can cause ulcers or breaks in the skin or mucous membranes (lining of the mouth, vagina, and rectum), which provide protection against infections, including HIV.  Herpetic genital ulcers can bleed easily, and when they come into contact with the mouth, vagina, or rectum during sex, they increase the risk of HIV transmission.

How does genital herpes affect a pregnant woman and her baby?

Healthcare providers should ask all pregnant women if they have a history of genital herpes. Herpes infection can be passed from mother to child resulting in a potentially fatal infection (neonatal herpes), one of the most serious complications of genital herpes. During pregnancy there is a higher risk of perinatal transmission during the first outbreak than with a recurrent outbreak, thus it is important that women avoid contracting herpes during pregnancy. [14] Women should be counseled to abstain from intercourse during the third trimester with partners known or suspected of having genital herpes. [9]

A woman with genital herpes may be offered antiviral medication from 36 weeks gestation through delivery to reduce the risk of a recurrent outbreak. [15] Routine HSV screening of pregnant women is not recommended. However, at onset of labor, all women should undergo careful examination and questioning to evaluate for presence of prodromal symptoms or herpetic lesions. If herpes symptoms are present a cesarean delivery is recommended to prevent HSV transmission to the infant. [16, 9]

How is genital herpes diagnosed?

Numerous herpes diagnostic tests are available. Direct (or virologic) tests detect viable virus, viral antigen, or viral nucleic acid. Viral culture is currently the reference standard for diagnosing genital herpes. HSV culture requires collection of a sample from the sore and, once viral growth is seen, specific cell staining to differentiate between HSV-1 and HSV-2. Nucleic acid amplification techniques (NAATs), such as PCR, test for viral DNA or RNA and allow for more rapid and accurate results. [17] Indirect (or serologic) tests are blood tests that detect antibodies to the herpes virus. Several ELISA-based serologic tests are FDA approved and available commercially. Older assays that do not accurately distinguish HSV-1 from HSV-2 antibody remain on the market, so providers should specifically request serologic type-specific assays when blood tests are performed for their patients. HSV-1 ELISA results are considered to be reliable because HSV-1 is ubiquitous in most populations. However, false positive HSV-2 ELISA results are more often seen when testing is done in populations with a lower prevalence of HSV-2. [18]

For the symptomatic patient, testing with both direct and indirect assays can determine whether it is a new infection or a newly-recognized old infection. A primary infection would be supported by a positive virologic test and a negative serologic test, while the diagnosis of recurrent disease would be supported by positive virologic and serologic test results. [19]

CDC does not recommend screening for HSV-1 or HSV-2 in the general population. Several scenarios where type-specific HSV tests may be useful include

  • Patients with recurrent genital symptoms or atypical symptoms and negative HSV cultures;
  • Patients with a clinical diagnosis of genital herpes but no laboratory confirmation;
  • Patients who report having a partner with genital herpes;
  • Patients presenting for an STD evaluation (especially those with multiple partners);
  • Persons with HIV infection; and
  • MSM at increased risk for HIV acquisition. [9]

Is there a cure or treatment for herpes?

There is no cure for herpes. Antiviral medications can, however, prevent or shorten outbreaks during the period of time the person takes the medication.  In addition, daily suppressive therapy (i.e. daily use of antiviral medication) for herpes can reduce the likelihood of transmission to partners.

Several clinical trials have tested vaccines against genital herpes infection, but there is currently no commercially available vaccine that is protective against genital herpes infection. One vaccine trial showed efficacy among women whose partners were HSV-2 infected, but only among women who were not infected with HSV-1. No efficacy was observed among men whose partners were HSV-2 infected. A subsequent trial testing the same vaccine showed some protection from genital HSV-1 infection, but no protection from HSV-2 infection. [20]

Can we find an HSV cure?  Will there ever be a cure for HSV?

How can herpes be prevented?

Correct and consistent use of latex condoms can reduce the risk of genital herpes. [21–22] However, outbreaks can occur in areas that are not covered by a condom.

The surest way to avoid transmission of sexually transmitted diseases, including genital herpes, is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.

Persons with herpes should abstain from sexual activity with partners when sores or other symptoms of herpes are present. It is important to know that even if a person does not have any symptoms, he or she can still infect sex partners. Sex partners of infected persons should be advised that they may become infected and they should use condoms to reduce the risk. Sex partners can seek testing to determine if they are infected with HSV.

HPV (Human Papillomavirus)

HPV Statistics – HPV Information

Genital HPV Infection – Fact Sheet

What is genital HPV infection?

Genital human papillomavirus (also called HPV) is the most common sexually transmitted infection (STI). There are more than 40 HPV types that can infect the genital areas of males and females. These HPV types can also infect the mouth and throat. Most people who become infected with HPV do not even know they have it.

HPV is not the same as herpes or HIV (the virus that causes AIDS). These are all viruses that can be passed on during sex, but they cause different symptoms and health problems.

What are the signs, symptoms and potential health problems of HPV?

Most people with HPV do not develop symptoms or health problems from it. In 90% of cases, the body’s immune system clears HPV naturally within two years.  But, sometimes, HPV infections are not cleared and can cause:

  • Genital warts
  • Rarely, warts in the throat — a condition called recurrent respiratory papillomatosis, or RRP.  When this occurs in children it is called juvenile-onset RRP (JORRP).
  • Cervical cancer and other, less common but serious cancers, including cancers of the vulva, vagina, penis, anus, and oropharynx (back of throat including base of tongue and tonsils).

The types of HPV that can cause genital warts are not the same as the types that can cause cancers. There is no way to know which people who get HPV will go on to develop cancer or other health problems.

Signs and symptoms of HPV-related problems:

Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower. Health care providers can diagnose warts by looking at the genital area during an office visit. Warts can appear within weeks or months after sexual contact with an infected partner—even if the infected partner has no signs of genital warts. If left untreated, genital warts might go away, remain unchanged, or increase in size or number. They will not turn into cancer.

Cervical cancer usually does not have symptoms until it is quite advanced. For this reason, it is important for women to get regular screening for cervical cancer. Screening tests can find early signs of disease so that problems can be treated early, before they ever turn into cancer.

Other HPV-related cancers might not have signs or symptoms until they are advanced and hard to treat.  These include cancers of the vulva, vagina, penis, anus, and oropharynx (back of throat including base of tongue and tonsils). For signs and symptoms of these cancers, see www.cancer.govExternal Web Site Icon.

RRP is a condition in which warts grow in the throat. These growths can sometimes block the airway, causing a hoarse voice or troubled breathing.

How do people get HPV?

HPV is passed on through genital contact, most often during vaginal and anal sex. HPV may also be passed on during oral sex and genital-to-genital contact. HPV can be passed on between straight and same-sex partners—even when the infected partner has no signs or symptoms.

A person can have HPV even if years have passed since he or she had sexual contact with an infected person. Most infected persons do not realize they are infected or that they are passing the virus on to a sex partner. It is also possible to get more than one type of HPV.

Rarely, a pregnant woman with genital HPV can pass HPV to her baby during delivery. Very rarely, the child can develop juvenile-onset recurrent respiratory papillomatosis (JORRP).

How does HPV cause genital warts and cancer?

HPV can cause normal cells on infected skin to turn abnormal. Most of the time, you cannot see or feel these cell changes. In most cases, the body fights off HPV naturally and the infected cells then go back to normal. But in cases when the body does not fight off HPV, HPV can cause visible changes in the form of genital warts or cancer. Warts can appear within weeks or months after getting HPV. Cancer often takes years to develop after getting HPV.

How common are HPV and related diseases?

HPV (the virus). Approximately 20 million Americans are currently infected with HPV. Another 6 million people become newly infected each year. HPV is so common that at least 50% of sexually active men and women get it at some point in their lives.

Genital warts. About 1% of sexually active adults in the U.S. have genital warts at any one time.

Cervical cancer. Each year, about 12,000 women get cervical cancer in the U.S. Almost all of these cancers are HPV-associated.

Other cancers that can be caused by HPV are less common than cervical cancer. Each year in the U.S., there are about:

  • 1,500 women who get HPV-associated vulvar cancer
  • 500 women who get HPV-associated vaginal cancer
  • 400 men who get HPV-associated penile cancer
  • 2,700 women and 1,500 men who get HPV-associated anal cancer
  • 1,500 women and 5,600 men who get HPV-associated oropharyngeal cancers (cancers of the back of throat including base of tongue and tonsils) [Note: Many of these cancers may also be related to tobacco and alcohol use.]

Certain populations are at higher risk for some HPV-related health problems. This includes gay and bisexual men, and people with weak immune systems (including those who have HIV/AIDS).

RRP is very rare. It is estimated that less than 2,000 children get juvenile-onset RRP every year in the U.S.

How can people prevent HPV?

There are several ways that people can lower their chances of getting HPV:

  • Vaccines can protect males and females against some of the most common types of HPV that can lead to disease and cancer. These vaccines are given in three shots. It is important to get all three doses to get the best protection. The vaccines are most effective when given at 11 or 12 years of age.
    • Girls and women: Two vaccines (Cervarix and Gardasil) are available to protect females against the types of HPV that cause most cervical cancers. One of these vaccines (Gardasil) also protects against most genital warts. Gardasil has also been shown to protect against anal, vaginal and vulvar cancers. Either vaccine is recommended for 11 and 12 year-old girls, and for females 13 through 26 years of age, who did not get any or all of the shots when they were younger. These vaccines can also be given to girls beginning at 9 years of age. It is recommended to get the same vaccine brand for all three doses, whenever possible.
    • Boys and men: One available vaccine (Gardasil) protects males against most genital warts and anal cancers. Gardasil is recommended for 11 and 12 year-old boys, and for males 13 through 26 years of age, who did not get any or all of the shots when they were younger.
  • For those who choose to be sexually active, condoms may lower the risk of HPV. To be most effective, they should be used with every sex act, from start to finish. Condoms may also lower the risk of developing HPV-related diseases, such as genital warts and cervical cancer. But HPV can infect areas that are not covered by a condom – so condoms may not fully protect against HPV.
  • People can also lower their chances of getting HPV by being in a faithful relationship with one partner; limiting their number of sex partners; and choosing a partner who has had no or few prior sex partners. But even people with only one lifetime sex partner can get HPV. And it may not be possible to determine if a partner who has been sexually active in the past is currently infected. That’s why the only sure way to prevent HPV is to avoid all sexual activity.

How can people prevent HPV-related diseases?

There are ways to prevent the possible health effects of HPV, including the two most common problems: genital warts and cervical cancer.

  • Preventing genital warts: A vaccine (Gardasil) is available to protect against most genital warts in males and females (see above).
  • Preventing Cervical Cancer: There are two vaccines (Cervarix and Gardasil) that can protect women against most cervical cancers (see above). Cervical cancer can also be prevented with routine cervical cancer screening and follow-up of abnormal results. The Pap test can find abnormal cells on the cervix so that they can be removed before cancer develops. An HPV DNA test, which can find HPV on a woman’s cervix, may also be used with a Pap test in certain cases. Even women who got the vaccine when they were younger need regular cervical cancer screening because the vaccine protects against most, but not all, cervical cancers.
  • Preventing Anal Cancers:  A vaccine (Gardasil) is available to protect against most anal cancers in males and females. Screening for anal cancer is not routinely recommended because more information is still needed to find out if screening and follow-up interventions prevent these cancers.  However, some experts recommend yearly anal Pap tests to screen for anal cancer in gay and bisexual men and in HIV-positive persons. This is because anal cancer is more common in those populations.
  • Preventing Penile Cancers: There is no approved screening test to find early signs of penile cancer.
  • Preventing Oropharyngeal Cancers: There is no approved test to find early signs of oropharyngeal cancer[see www.cancer.orgExternal Web Site Icon]
  • Preventing RRP: Cesarean delivery is not recommended for women with genital warts to prevent juvenile-onset RRP (JORRP) in their babies. This is because it is not clear that cesarean delivery prevents JORRP in infants and children.

Is there a test for HPV?

The HPV tests on the market are only used to help screen women at certain ages and with certain Pap test findings, for cervical cancer. There is no general test for men or women to check one’s overall “HPV status,” nor is there an approved HPV test to find HPV on the genitals or in the mouth or throat.

Is there a treatment for HPV or related diseases?

There is no treatment for the virus itself, but there are treatments for the diseases that HPV can cause:

Visible genital warts can be removed by the patient him or herself with prescribed medications. They can also be treated by a health care provider. Some people choose not to treat warts, but to see if they disappear on their own. No one treatment is better than another.

Cervical cancer is most treatable when it is diagnosed and treated early. But women who get routine Pap tests and follow-up as needed can identify problems before cancer develops. Prevention is always better than treatment. [see www.cancer.orgExternal Web Site Icon]

Other HPV-related cancers are also more treatable when diagnosed and treated early. [seewww.cancer.orgExternal Web Site Icon]

RRP can be treated with surgery or medicines. It can sometimes take many treatments or surgeries over a period of years.

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