Genital herpes: a hidden epidemic

FDA Consumer, March-April, 2002 by Linda Bren

In one study of more than 400 monogamous couples in which one partner had genital herpes and the other didn't, condoms were found to offer significant protection against HSV-2 infection in women, says study leader Anna Wald, M.D., medical director of the virology research clinic at the University of Washington in Seattle. Since women shed the virus from a wide genital area, condoms may be less protective for men than for women, says Wald, whose study was published in the June 27, 2001, issue of the Journal of the American Medical Association. However, more studies are needed to address how well condoms work for men, she says.

Lambskin or other natural membrane condoms should not be used for disease protection because the naturally occurring pores in the material are large enough to allow some viruses to pass through. The FDA recommends latex condoms or polyurethane condoms for those sensitive to latex.

Partners can be infected with different strains of herpes, but are highly unlikely to reinfect each other, says Ashley. Even if they did, each person's symptoms are unlikely to change. "You're not going to be suddenly having twice the attacks because you have [your partner's] strain too."

The virus is not transmitted through the air, nor are there any documented cases of a person getting genital herpes from an inanimate object such as a toilet seat or hot tub. "Herpes doesn't do well in chlorinated water," says Ashley. "The virus can be present in a hot tub, but it won't be active." The virus doesn't survive well in the environment, even on a wet towel, says

Ashley. However, she advises to avoid sharing razors, especially with someone who has an active cold sore. The virus can be transmitted from the razor to the skin. Other viruses, such as hepatitis C, also can be transmitted by sharing razors.

Spreading herpes from one part of your body to another (autoinoculation) is possible, but unusual. To be safe, wash your hands with soap if you touch a herpes sore.

Treatment

Although there is no cure for genital herpes, there are medications that significantly reduce the frequency and duration of outbreaks and have few side effects in most people.

In 1985, the FDA approved Zovirax (acyclovir), the first genital herpes drug, which is now available in a generic form. More recently, the FDA approved two other drugs to treat genital herpes: Famvir (famciclovir) and Valtrex (valacyclovir).

All three of these oral antiviral drugs can be taken either episodically--when a person has an outbreak or feels one coming on, or suppressively--daily to help prevent the recurrence of outbreaks. Acyclovir and valacyclovir are also FDA-approved to treat an initial episode of genital herpes to help heal the lesions and to lessen the pain.

When taken episodically at the first sign of a tingling or itching sensation, an antiviral drug may prevent an outbreak altogether. "Once an outbreak occurs, if the treatment is started soon enough, the drugs can lessen the severity and shorten the healing time," says the FDA's Kukich. When taken suppressively, the drugs don't always prevent outbreaks, but help them to occur less frequently.