Even Without Symptoms, Herpes Virus Is Still Active

Q:  I have genital herpes and have outbreaks once to twice per year. My current partner does not. What can I do to reduce my risk of transmitting herpes to him?

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

Most individuals have no or only minimal signs or symptoms from HSV-1 or HSV-2 infection. When signs do occur, they typically appear as one or more blisters on or around the genitals or rectum. The blisters break, leaving tender ulcers (sores) that may take two to four weeks to heal the first time they occur.

Typically, another outbreak can appear weeks or months after the first, but it almost always is less severe and shorter than the first outbreak. Although the infection can stay in the body indefinitely, the number of outbreaks tends to decrease over a period of years.

To reduce risk of transmission of herpes, avoid sexual contact during active outbreaks and always use condoms.

You might also want to consider daily suppressive therapy to help reduce the amount of virus that your body sheds when you do not actively have lesions. Even though you may not be symptomatic or see herpes lesions, your body still releases the virus and wearing condoms and taking a daily medication may help to reduce transmission.

Suppressive therapy consists of taking a medication such as Valtrex or Acyclovir to help reduce how much of the herpes virus your body releases.

These recommendations are assuming that you have a normal immune system. If you have HIV or are otherwise immunocompromised from cancer or chemotherapy, you should discuss with your doctor additional ways to decrease risk of transmission and number of outbreaks.

Results of a nationally representative study show that genital herpes infection is common in the United States. Nationwide, at least 45 million people ages 12 and older, or one out of five adolescents and adults, have had genital HSV infection. Over the past decade, the percent of Americans with genital herpes infection in the US has decreased.

For more information, you can visit the web site of the Centers for Disease Control and Prevention (CDC) Division of STD Prevention.

Deidre L. Faust, MD, is a Staff Physician (Internal Medicine) at the Medical College of Wisconsin's Plank Road Clinic. Her column appears in the Milwaukee Journal-Sentinel.