Herpes simplex virus 2

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Herpes simplex virus 2 (HSV-2) is a common virus that mainly causes genital herpes. It stays in the body for life and is part of the herpes virus family.

There are two global lineages of HSV-2. Sometimes HSV-1 genetic material can be found in HSV-2 when a person has both viruses.

What it does
- HSV-2 hides in nerve cells near the spine and can wake up again and again, releasing virus into the genital area even when there are no sores.
- Many people have no noticeable symptoms, but the virus can still be spread.

How common and how it spreads
- In the United States, more than about 1 in 6 people are infected.
- It is mainly spread through sexual contact and can be transmitted even without visible sores because the virus can be shed secretly.
- Symptoms can be mild or mistaken for other problems (like a yeast infection).

Virus shedding and transmission
- The virus is shed from the genital area on many days, not just when there are outbreaks. This hidden shedding accounts for much of the transmission.
- In studies, people with outbreaks shed the virus on about 12–28% of days; people without symptoms shed on about 10% of days.

Treatment and prevention
- Antiviral medicines, such as valaciclovir (valtrex), can reduce viral shedding and symptoms.
- In studies, taking daily valaciclovir reduced subclinical shedding by about 71% and increased the number of days with no shedding.
- Medicine also lowered the chance of noticeable symptoms.
- Using condoms and antiviral therapy can lower, but not completely eliminate, the risk of passing the virus to a partner.

Bottom line
HSV-2 mostly causes genital herpes and can be spread even when there are no symptoms. Antiviral medicines help reduce shedding and symptoms, and practicing safe sex helps reduce transmission. If you think you could have HSV-2, talk to a healthcare provider for testing and treatment options.