Can Herpes Simplex Virus 1 (HSV1) cause genital lesions?

From the Guidelines

Yes, Herpes Simplex Virus 1 (HSV1) can cause genital lesions. While HSV1 traditionally causes oral herpes (cold sores), it can be transmitted to the genital area through oral-genital contact. According to a study published in 2012 1, at least 50% of new cases of herpes genitalis in developed countries are now caused by HSV-1. Genital HSV1 infections present with painful blisters or ulcers that typically last 2-3 weeks during the first outbreak, with subsequent recurrences usually being less severe and shorter in duration. Some key points to consider about genital HSV1 infections include:

• Treatment for genital HSV1 includes antiviral medications such as acyclovir, valacyclovir, or famciclovir, which can reduce symptoms and healing time but do not cure the infection 1.
• Genital HSV1 tends to recur less frequently than genital HSV2 infections, with fewer outbreaks per year on average.
• The virus remains dormant in nerve cells between outbreaks and can reactivate periodically.
• Using barrier methods like condoms can reduce but not eliminate transmission risk, and avoiding sexual contact during active outbreaks is recommended. It's worth noting that the epidemiology of HSV-1 infection has changed dramatically in recent decades, with HSV-1 becoming the most common cause of primary genital HSV infections in developed countries 1.

From the Research

Genital Lesions Caused by HSV1

• Herpes Simplex Virus 1 (HSV1) can cause genital lesions, as evidenced by studies that show the virus can be transmitted to the genital area through oral-genital contact 2.
• Genital HSV1 infection is becoming more common, and it can cause painful genital lesions, especially during the primary infection 3.
• A study found that among individuals with first-episode genital HSV1 infection, genital HSV1 shedding was detected on 12.1% of days at 2 months and declined significantly to 7.1% at 11 months 4.
• Genital lesions were rare, reported on 2.6% of days at 2 months and 3.8% at 11 months, indicating that while HSV1 can cause genital lesions, they are not always present 4.

Transmission and Shedding

• HSV1 can be transmitted to the genital area through oral-genital contact, and the virus can shed from the genital tract, even in the absence of lesions 4.
• A study found that persons with primary HSV1 infection had a higher risk of genital shedding compared to those with nonprimary infection 4.
• The frequency of genital HSV1 shedding declines rapidly during the first year after infection, but the virus can still be transmitted to others through asymptomatic shedding 4.

Diagnosis and Treatment

• The diagnosis of genital HSV1 infection is often clinical, based on the presentation of classic lesions and typical localized recurrences 5.
• The confirmation of the diagnosis can be obtained by virus isolation, and the most sensitive method is PCR, but viral culture techniques are the most widely used 5.
• Treatment for genital HSV1 infection typically involves the use of antiviral medications, such as acyclovir, valaciclovir, and famciclovir, which can help reduce the frequency and severity of symptoms 5, 3.