Both subclinical and symptomatic reactivation is more common in HSV-2 infection than in HSV-1 infection. Sixty percent of patients with primary genital HSV-2 infection experience recurrences in the first year. Herpes simplex virus (HSV) infections are the most common cause of genital ulcers in adults but acquisition and chronic infection are more commonly asymptomatic than symptomatic. Herpes simplex virus (HSV) infections are the most common cause of genital ulcers in adults but acquisition and chronic infection are more commonly asymptomatic than symptomatic. HSV-2 infection enhances HIV-1 acquisition, as well as transmission. Over the last decade, the concept of subclinical shedding in the genital tract has taken on increasing importance. Is oral sex more prevalent now than it was about 30 years ago? It seems unlikely that this practice has been invented by current youth, as occasionally portrayed by the news media, since ancient texts, including the Kama Sutra written between the 1st and 6th century ad, describe it. While the propensity for both clinical and subclinical reactivation is dramatically lower for genital HSV 1 than for genital HSV 2, the neonatal data suggest that when reactivation recurs among HSV 1 infected women during delivery, the virus is more likely to be transmitted with an estimated relative risk of 60. Krantz I, Lowhagen G B, Ahlberg B M. et al Ethics of screening for asymptomatic herpes virus type 2 infection.
HSV is a chronic infection, with periods of asymptomatic viral shedding and unpredictable recurrences of blister-like lesions. Either type of herpes virus can invade both oral genital areas of the body. HSV-1 reactivates more frequently in the oral than in the genital area. It is more common for oral HSV-1 to be transmitted to the genitals through oral sex, than it is for HSV-2 to be transmitted to the mouth. As common as these clinical entities are, however, most HSV-1 infections are asymptomatic. Viral reactivation from latency and subsequent antegrade translocation of virus back to skin and mucosal surfaces produces a recurrent infection. Herpes simplex virus can invade and replicate in both neurons and glia, resulting in necrotizing encephalitis and widespread hemorrhagic necrosis throughout infected brain parenchyma but particularly the temporal lobe. Herpes simplex virus type 2 (HSV-2) is one of the most prevalent sexually transmitted infections worldwide. Viral reactivation may be asymptomatic or may be associated with prodrome (tingling or burning), nonspecific symptoms or lesions, or a classic genital ulcer. Thus, even persons with established infection and a functional immune system can experience both subclinical genital HSV shedding and lesional recurrences, which suggests that the virus can evade even mature host immune responses.
Genital herpes simplex virus infection is a recurrent, lifelong disease with no cure. The natural history includes first-episode mucocutaneous infection, establishment of latency in the dorsal root ganglion, and subsequent reactivation. Most infections are transmitted via asymptomatic viral shedding. Classic outbreaks consist of a skin prodrome and possible constitutional symptoms such as headache, fever, and inguinal lymphadenopathy. Genital herpes simplex virus type 2 recurs six times more frequently than type 1. In fact, many more people are infected than actually have classically appearing herpes (i.e. HSV-2 is primarily sexually transmitted, so it is less common than HSV-1 in children. HSV-2 is primarily associated with infections of the anogenital region, although both viruses can infect any area. Most initial infections go unnoticed, so reactivation lesions are usually the first lesions reported by patients.
Herpes Virus HSV-1 And HSV-2 Transmission And Transmissibility
In both oral and genital herpes, after initial infection, the viruses move to sensory nerves, where they continue living in a latent form for the rest of the life of the host. Genital herpes, however, is often asymptomatic, although viral shedding may still occur during periods of remission and therefore it is possible to transmit the disease during remission. Recurrent oral infection is more common with HSV-1 infections than with HSV-2. HSE is thought to be caused by the retrograde transmission of virus from a peripheral site on the face following HSV-1 reactivation, along a nerve axon, to the brain. Most HSV is acquired from an infected but asymptomatic person. Both condom use and valacyclovir reduce transmission of genital herpes in serodiscordant couples 7 (this observation was not replicated in HIV/HSV-2 discordant couples 10 ). Acute immunosuppression: may reactivate HSV within 2 wks of immunosuppression onset. Genital herpes is an infection caused by either the Type 1 (HSV-1) or Type 2 (HSV-2) herpes simplex virus. Genital herpes is more common in females, African-Americans, and persons who use cocaine. Herpes simplex virus type 2 (HSV-2) infection is almost always sexually transmitted, and causes genital ulceration. Such virus is predominantly associated with subclinical shedding 14. In children, bacterial conjunctivitis is more common than viral and is mainly caused by H. A history of infectious conjunctivitis and of itch both made the probability of current bacterial involvement less likely. HSV conjunctivitis is usually caused by infection with herpes simplex type 1 (HSV-1). Reactivation classically causes epithelial keratitis (inflammation of the superficial surface of the cornea). HSV-1 is transmitted chiefly by contact with infected saliva, whereas HSV-2 is transmitted sexually or from a mother s genital tract infection to her newborn. HSV-1 reactivates more frequently in the oral rather than the genital region. Both subclinical and symptomatic reactivation are more common with HSV-2 compared to HSV-1.
Genital Herpes: A Review
Herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) have considerable overlap in their glycoproteins, but unique glycoproteins exist for each virus that allow differentiation with the use of restriction enzyme analysis. HSV-2 more readily establishes latent infection in sacral ganglion than does HSV-1. Thus, both symptomatic and asymptomatic reactivation of HSV-2 infection is more frequent in the genital area than is HSV-1 infection. 11, 12, 13 HSV-2 infection is also more common among homosexual or bisexual men than among heterosexual men, and it is more common among HIV-positive men than among HIV-negative men: Both homosexual men and HIV-positive men have a 20 higher prevalence of antibodies to HSV-2 than do heterosexual men and HIV-negative men. A. Primary Infection;- Man is the only natural host to HSV, the virus is spread by contact, the usual site for the implantation is skin or mucous membrane. HSV is spread by contact, as the virus is shed in saliva, tears, genital and other secretions, By far the most common form of infection results from a kiss given to a child or adult from a person shedding the virus. Many individuals never experience any clinically apparent reactivation although more than half would be intermittently shedding virus in saliva, tears, semen or genital ( cervical, urethral, prostatic ) secretions.