Gynecological conditions and HIV / AIDS

October 2005     View PDF     En español

Herpes

Genital herpes is a sexually transmitted infection, most commonly caused by herpes simplex virus 2 (HSV-2). Its close relative, HSV-1, causes herpes of the mouth, lips and skin, like cold sores. Genital herpes recur and there is no cure. Symptoms include single or multiple small blisters that open and become sores after a few days. Other symptoms include swelling of the vulva, fever and enlarged and tender lymph nodes in the stomach and groin area (abdomen).

The most common sites for herpes in women are the labia majora (the vagina’s “outer lips”), labia minora (the “inner lips”) and butt. Though herpes may lay dormant for long periods, it can appear again at anytime, especially for those with a weak immune system. Sexual contact should be avoided while sores are present because of the increased risk of passing herpes onto others. However, the virus may also shed when a person has no symptoms or sores.

For HIV-positive women, the painful sores in and around the genitals or anus tend to be more frequent, last longer and need higher doses of treatment. Having sores that persist for more than a month is considered an AIDS-defining illness.

Oral acyclovir (Zovirax) and famciclovir (Famvir) are used to treat herpes. Valacyclovir (Valtrex) requires fewer pills and thus is easier to incorporate into treatment regimens where many other pills are being used. However, it is not recommended for use in people with immune suppression. Some still use valacyclovir, however, and monitor carefully for side effects. For women with frequent outbreaks, daily acyclovir therapy may help prevent them. If herpes stops responding to acyclovir (sores don’t go away within two weeks), other therapies are available. These include intravenous foscarnet (Foscavir).

Many of the same tips provided for preventing yeast infections can help in making you more comfortable and aid in healing if you are experiencing a herpes outbreak. See the box for these tips.