Herpes tests are done to find the herpes simplex virus SV infection can cause small, painful sores that look like blisters on the skin or the moist tissue lining (mucous membranes) of the throat, nose, mouth, urethra, rectum, and vagina. A herpes infection may cause only a single outbreak of sores, but in many cases the person will have multiple outbreaks.
Though there are many types of herpes viral infections such as shingles or chickenpox, only two types are generally considered STDs.
HSV type 1 causes cold sores (also called fever blisters) on the lips. HSV-1 is generally spread by kissing or by sharing eating utensils (such as spoons or forks) when sores are present. HSV-1 can also cause sores around the genitals. HSV type 2 causes sores in the genital area (genital herpes), such as on or around the vagina or penis. HSV-2 also causes the herpes infection seen in babies who are delivered vaginally in women who have genital herpes. HSV-2 is generally spread by sexual contact. HSV-2 can sometimes cause mouth sores, but 99% of HSV type 2 infections happen around the genitalia.
Chronic, in medicine, means long-term. However, many people never have symptoms even though they are carrying the virus. Many people with HSV have recurring genital herpes. When a person is initially infected the recurrences, if they do occur, tend to happen more frequently. Over time the remission periods get longer and longer. Each occurrence tends to become less severe with time.
HSV-1 and HSV-2 can be found in and released from the sores that the viruses cause, but they also are released between outbreaks from skin that does not appear to have a sore by viral sloughing. Typically, a person will only get HSV-2 infection during sexual contact with a person who has a genital HSV-2 infection. Transmission can occur from an infected partner who does not have a visible sore and may not know that he or she is infected.
HSV-1 can cause genital herpes, but it more commonly causes infections of the mouth and lips, so-called “fever blisters.” HSV-1 infection of the genitals can be caused by oral-genital or genital-genital contact with a person who has HSV-1 infection. Genital HSV-1 outbreaks recur less regularly than genital HSV-2 outbreaks.
Oral herpes is usually caused by HSV-1. The highest incidence of first infection occurs between 6 months and 3 years of age. The incidence in children varies among regions and countries, with the highest rates occurring in crowded and unsanitary regions. Studies suggest that by age 5 more than a third of children in low-income areas are infected compared to 20% of children in middle-income areas. However, by the time Americans of all economic backgrounds reach age 60, about 60 - 85% have become infected with HSV-1.
Although the prevalence of genital herpes is declining in the United States, it still remains in epidemic proportions. According to the U.S. Centers for Disease Control and Prevention, at least 45 million Americans age 12 and over, about 1 in 5 teenagers and adults, are infected with HSV-2.
While HSV-2 remains the main cause of genital herpes, in recent years the percentage of cases of genital herpes caused by HSV-1 has significantly increased because of of oral-genital sex. Except for people in monogamous relationships with uninfected partners, everyone who is sexually active is at risk for genital herpes.
Risk factors for genital herpes include a history of a prior sexually transmitted disease, early age for first sexual intercourse, a high number of sexual partners, and poor socioeconomic status. Women are more susceptible to HSV-2 infection because herpes is more easily transmitted from men to women than from women to men. About 1 in 4 women, compared to 1 in 8 men, have genital herpes People with compromised immune systems, notably patients with HIV, are at very high risk for HSV-2. These patients are also at risk for more severe complications from herpes. Other immunocompromised patients include those taking drugs that suppress the immune system and transplant patients.
The following are examples of people who are at particularly risk for specific forms of herpes. Health care providers, including doctors, nurses, and dentists. This group is at higher than average risk for herpetic whitlow, herpes that occurs in the fingers. Wrestlers, rugby players, and other athletes who participate in direct contact sports without protective clothing. These individuals are at risk for herpes gladiatorum, an unusual form of HSV-1 that is spread by skin contact with exposed herpes sores and usually affects the head or eyes.
Discomfort and inconvenience are usually the worst problems associated with herpes. People with a weakened immune system, such as those with advanced HIV infection, may have more severe outbreaks and complications. Like other STDs, if left untreated, herpes can increase a person's chance of getting or spreading HIV and other diseases. If you have symptoms, get examined and have proper laboratory testing as soon as possible to avoid any complications and discuss treatment options.
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