HHV2

Human herpesvirus 2 (HHV-2), also known as herpes simplex virus type 2 (HSV-2), is a double-stranded DNA virus in the genus Simplexvirus of the family Herpesviridae. It is one of the eight known human herpesviruses and is the principal cause of genital herpes, though infections may also affect the oral region. HHV-2 establishes lifelong latent infection in sensory ganglia.

Transmission of HHV-2 occurs primarily through sexual contact, including vaginal, anal, and oral sex. The virus can be transmitted even when there are no visible sores due to asymptomatic shedding. Primary infection ranges from mild to severe and often presents with painful genital ulcers, fever, malaise, and swollen lymph nodes; many infections are asymptomatic. Recurrent outbreaks are common and result from periodic reactivation of latent virus, typically in the sacral ganglia, with triggers including stress, illness, hormonal changes, and immunosuppression.

Diagnosis is typically made by detecting the virus or viral DNA in lesions using PCR from a lesion swab, or by viral culture. Type-specific serology (HSV-2–specific antibodies) can help determine exposure, especially when symptoms are absent or atypical. Differentiating HSV-2 from HSV-1 is important for prognosis and counseling.

There is no cure for HHV-2 infection. Antiviral medications—acyclovir, valacyclovir, and famciclovir—reduce the duration and severity of symptoms and can decrease viral shedding. Suppressive antiviral therapy may be recommended for people with frequent recurrences or during pregnancy to reduce neonatal risk.

Epidemiology and prevention: Global seroprevalence varies by region and population. Risk reduction strategies include consistent condom use, avoiding sexual contact during outbreaks, and counseling. There is no licensed vaccine as of now, though research is ongoing. Neonatal herpes risk is highest with primary maternal infection near the time of delivery.