HerpesHealth.ca:The herpes virus in your body

Genital Herpes: The Facts

The herpes virus in your body

The herpes virus enters your body through the thin skin of the genital area and travels along a nerve pathway to a bundle of nerves at the base of the spine called the dorsal root ganglion [?] . There it remains inactive, causing no harm and no symptoms, until something triggers it to “wake up” and become active. Sometimes, the triggers may be stress, lack of sleep, fever, sun exposure or menstruation. At other times, there may appear to be no reason at all for the virus to become active.^1,4

When the virus “wakes up”, it leaves the dorsal root ganglion and travels back along a nerve to the surface of the skin, where it multiplies rapidly to form fluid-filled blisters which break, causing wet, open and painful sores. This is when symptomatic viral shedding [?] occurs and at this time the virus is most contagious and easily transmitted.^1,4

Periodically, the virus will become active and return to the surface of the skin, where it multiplies and “sheds” but does not cause sores or any noticeable signs or symptoms. This is known as asymptomatic viral shedding [?] . Even though there are no blisters or sores, the virus is contagious and can be transmitted at this time.^2,9-11 In fact, 70% of genital herpes transmissions occur during periods of asymptomatic viral shedding.⁸ It is also important to know that viral shedding (with or without symptoms) can occur anywhere from just below the waistline down to the upper thighs including the buttocks, not just the genitals.^9,10

Following an outbreak or a period of asymptomatic viral shedding, the virus returns to the dorsal root ganglion and becomes inactive again. Although your immune system cannot get rid of the herpes virus, it does help to reduce the severity of your symptoms.⁴

References

1. Whitley RJ, Kimberlin DW and Roizman B. Herpes Simplex Viruses. Clinical Infectious Diseases 1998;26:541-55.

2. Gupta R and Wald A. Genital Herpes: antiviral therapy for symptom relief and prevention of transmission. Expert Opin Pharmacother 2006;7(6):665-675.

3. Aoki FY. Canadian Guidelines on Sexually Transmitted Infections 2006 Edition, Health Canada.

4. Sacks SL. The Truth About Herpes. 4th ed. West Vancouver, BC: Gordon Soules Book Publishers Ltd.;1997.

5. Ebel C, Wald A. Managing Herpes: How to Live and Love With a Chronic STD. Research Triangle Park, NC: American Social Health Association;2002.

6. Ribes JA, Steele AD, Seabolt JP et al. Six-Year Study of the Incidence of Herpes in Genital and Nongenital Cultures in a Central Kentucky Medical Center Patient Population. J Clin Micro 2001;39(9):3321-3325.

7. Patrick DM, Dawar M, Cook DA et al. Antenatal seroprevalence of herpes simplex virus type 2 (HSV-2) in Canadian women. Sex Transm Dis 2001;28(7):424-428.

8. Mertz GJ, Benedetti J, Ashley R et al. Risk Factors for the Sexual Transmission of Genital Herpes. Annals of Internal Medicine 1992;116:197-202.

9. Wald A, Zeh J, Selke S et al. Virologic Characteristics of Subclinical and Symptomatic Genital Herpes Infections. NEJM 1995;333(12):770-775.

10. Wald A, Zeh J,Selke S et al. Genital Shedding of Herpes Simplex Virus among Men. Journal of Infectious Diseases 2002;186(Suppl 1):S34-S39.

11. Corey L, Wald A, Patel R et al. Once-Daily Valacyclovir to Reduce the Risk of Transmission of Genital Herpes. NEJM 2004;350(1):11-20.

12. Cuisini M and Ghislanzoni M. The importance of diagnosing genital herpes. J Antimicro Chemo 2001;47(Topic T1):9-16.

13. Steben M, Sacks SL. Genital herpes: The epidemiology and control of a common sexually transmitted disease. Can J Hum Sex 1997;6(2):127-134.

14. Wald A, Langenberg AGM, Link K et al. Effect of condoms on reducing the transmission of herpes simplex virus type 2 from men to women. JAMA 2001;285(24):3100-3106.

15. Van der Laar MJ, Termorshuizen F, Slomka MJ et al. Prevalence and correlates of herpes simplex virus type 2 infection: Evaluation of behavioural risk factors. Int J Epidemiol 1998;27(1):127-134.