Genital Herpes: Type 1 Vs Type 2

Herpes simplex virus (HSV), more commonly known as herpes, is a common and contagious infection that causes sores on your genitals or mouth. There are two types that differ in symptoms, complications, and treatment. HSV type 1 (HSV-1) is transmitted by oral-to-oral contact and causes infection in or around the mouth (oral herpes), but it can also cause genital herpes. HSV-2 is mainly sexually transmitted and primarily causes genital herpes, but can also cause cold sores in rare cases. Both oral and genital herpes are often asymptomatic and many people don’t know they have the virus, but it can cause painful blisters or ulcers at the site of infection, ranging from mild to severe. Infection is lifelong and symptoms can recur over many years. While the infection can never be cured, there are genital herpes medications available to treat the severity and frequency of outbreaks.

Genital herpes can have mild symptoms that go unrecognized or be entirely asymptomatic. When symptoms do occur, they usually entail one or more genital or anal blisters or ulcers and often include fever, body aches, and swollen lymph nodes. After an initial flare-up, which is usually more severe than subsequent flare-ups, symptoms may recur in episodes. HSV-1 typically does not recur frequently, while symptoms are much more likely to recur in HSV-2. Recurrences are often less severe than the first episode and tend to decrease over time. Genital herpes medications can help manage these symptoms during a flare-up and it's entirely possible to lead a healthy and fulfilling sex life with herpes. 

Although most people live perfectly healthy lives with both HSV-1 and 2, there are risks with both types of virus. Genital herpes caused by HSV-2 can lead to a higher risk of getting HIV due to the irritation and inflammation of outbreaks making infection easier. Additionally, people with both HIV and HSV-2 infection are more likely to spread HIV to others. In immunocompromised people, such as those with HIV infection, herpes can have more severe symptoms and more frequent recurrences because the immune system isn’t as able to suppress the herpes virus in the body.

Additionally, neonatal herpes can occur when an infant is exposed to HSV during delivery. The risk is most prominent when a mother acquires HSV for the first time in late pregnancy. While neonatal herpes is rare, it is a serious condition that can lead to lasting neurologic disability or death. Care during pregnancy often involves screening for HSV and ensuring pregnant patients get appropriate genital herpes medications that can help control symptoms. With the proper medication regimen, all of these risks can be avoided.