Genital herpes is a common viral infection caused by the herpes simplex virus (HSV). Once a person is infected, the virus remains in the body for life. The virus can exist in a “dormant” state for periods of time without causing symptoms.
Understanding Herpes Dormancy
Dormancy, also known as latency, is the period when the herpes simplex virus retreats to nerve cells, specifically the dorsal root ganglia, where it remains inactive. During this time, the virus is not actively replicating or causing visible lesions. The virus can remain dormant for an indefinite period, potentially for years or even decades, without causing any noticeable problems or symptoms. This dormant state does not mean the virus is gone or cured; it simply means it is not actively causing an outbreak. While most infected cells are inactive during latency, a few might “wake up” without necessarily causing an outbreak.
Factors Influencing Reactivation
The dormant virus can reactivate and travel back down the nerve pathways to the skin surface, leading to an outbreak. Several common triggers can prompt this reactivation, including:
Physical and emotional stress, which can weaken the immune system.
Illnesses like colds or the flu, fever, and a weakened immune system due to other infections, certain medications, or conditions such as HIV.
Hormonal changes, such as those occurring during menstruation or pregnancy.
Physical irritation or trauma to the genital area, like friction from sexual intercourse, or even excessive sun exposure.
Transmission While Dormant
Even when no visible sores or symptoms are present, it is possible to transmit the herpes virus. This phenomenon is known as “asymptomatic shedding” or “viral shedding,” where the virus is present on the skin surface and can be transmitted. While the risk of transmission is highest during an active outbreak, shedding can occur periodically during periods of apparent dormancy. Most genital herpes infections are transmitted by individuals unaware they have the infection or who are asymptomatic when transmission occurs. Asymptomatic shedding happens more frequently during the first 12 months after acquiring HSV-2 infection. Consistent use of condoms and open discussion with partners can help reduce transmission risk during dormant periods.
Living with Dormant Herpes
Living with dormant herpes means understanding that while the virus is lifelong, many people experience minimal impact on their daily lives. Management strategies for outbreaks, if they occur, include prescription antiviral medications such as acyclovir, valacyclovir, and famciclovir. These medications can help sores heal faster, reduce the frequency and severity of recurrent outbreaks, and lessen the duration of symptoms. For individuals experiencing frequent outbreaks, daily suppressive therapy with antiviral medication can reduce recurrences by 70% to 80% and may even prevent outbreaks altogether. This therapy also significantly reduces the risk of transmitting the virus to a sexual partner. Open communication with healthcare providers and partners is important for managing the condition and making informed decisions about treatment and prevention.