What is are the signs and symptoms of reactivation of genital herpes simplex virus (HSV) infections?

Updated: Feb 27, 2019
  • Author: J Michael Klatte, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

Recurrences are more common with HSV-2 infections than with HSV-1 infections (5 vs 1 per y). Individuals with HSV-2 infection generally have high rates of recurrence in the first and second years followed by a substantial decrease in subsequent years (median, 2 per y). About 25% of individuals have at least one recurrence in 5 years. Recurrences often follow stressful events, illness, trauma, and menstruation.

Most reactivations are asymptomatic (1% of individuals with previous HSV-2 infection have asymptomatic viral shedding on any given day). [50]

When symptomatic reactivation occurs, genital lesions are typically few. Tender lymphadenopathy, dysuria, vaginal discharge, and systemic symptoms are less common.


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