American Medical Association Family Medical Guide - American Medical Association [253]
People who have genital herpes have an increased risk of becoming infected with HIV, the virus that causes AIDS (see page 909), because genital herpes can cause sores and bleeding, which can increase the risk of HIV infection by providing a site for the virus to enter the bloodstream.
Symptoms
Because genital herpes often produces no symptoms, most people who have the disease do not know they are infected. In other cases, pain, tenderness, and itching may develop near the penis or vulva about 2 to 6 days after exposure to the virus. The person may also have a fever, a headache, or feel generally ill. The first episode of genital herpes symptoms, called primary herpes, usually occurs within 2 to 3 weeks of exposure to the virus.
In primary herpes, groups of blisters begin to appear in the area that was exposed to the virus on an infected person. In women, blisters may form inside the vagina or on the cervix, where they are not visible. In both men and women, blisters can also develop on the thighs or buttocks. Eventually the blisters break open to form extremely painful, shallow, open sores, which last about 2 weeks. Some people experience severe symptoms in primary herpes, including sore, swollen lymph glands in the throat, armpits, and groin, and flulike symptoms including fever, chills, headache, and fatigue.
Because the virus remains in the body after the blisters subside, about half of people who develop genital herpes have recurring outbreaks over the following months or years. Stress, sexual intercourse, surgery, menstruation, other infections, and skin irritations such as sunburn or a rash may trigger outbreaks. The subsequent outbreaks are usually mild, last about a week, and often can be suppressed by taking daily doses of an antiviral medication. Some people have frequent outbreaks, while others have none. Outbreaks usually last longer and are more painful in women than in men and in people who have a weakened immune system, such as those who are infected with HIV.
The major risk for people who have genital herpes is transmitting the virus to another person. Although genital herpes is most contagious when blisters or open sores are present, a person can still spread the virus between outbreaks. The virus can infect the skin if the skin is cut, chafed, or burned, or if a rash or other sores are already present.
Diagnosis
A diagnosis of genital herpes is based on the symptoms, a physical examination, and the results of laboratory tests performed on samples of fluid taken from the open sores. Because people who are infected with the herpes simplex virus have an increased risk of contracting other STDs, doctors may also order tests for other STDs. To confirm the diagnosis, a doctor may order blood tests to check for antibodies (infection-fighting proteins) produced by the immune system to fight the herpes virus.
Treatment
There is no cure for genital herpes, but your doctor may prescribe an antiviral drug such as acyclovir, famciclovir, or valacyclovir, which may speed healing and reduce the period of time during which the disease is most contagious. Your doctor will recommend that you keep the affected area clean and dry during outbreaks, avoid touching the sores, wash your hands thoroughly if you touch the sores, and avoid sexual contact from the moment symptoms begin until the last sore has fully healed. If you have another STD, the doctor will recommend treatment for that infection as well. Ask your doctor when you can safely resume sexual activity.
Syphilis
Syphilis is a sexually transmitted disease (STD) caused by the bacterium Treponema pallidum. The bacteria are transmitted by direct contact with a syphilis sore during vaginal, oral, or anal sex, and the infection spreads throughout the body in the blood and lymphatic vessels. A pregnant woman can transmit the infection to her fetus, potentially causing serious birth defects or stillbirth.
People who have syphilis have an increased risk of becoming infected with HIV, the virus that causes AIDS (see page 909). Syphilis can cause