Complications

The severity of symptoms depends on where and how the virus enters the body. Except in very rare instances and in special circumstances, the disease is not life threatening, although it can be very debilitating and cause great emotional distress.

Effects of Herpes Virus on Pregnancy

Depending on specific factors, HSV can have serious effects on both a pregnant woman and her child. It should be noted, however, that about 1 million pregnancies occur each year in women who have been infected with HSV-2, but complications occur in less than 4 in 1,000 infected pregnant women.

Infants may acquire congenital herpes from a mother with an active, possibly inapparent herpes infection at the time of birth. Aggressive treatment with antiviral medication is required, but may not be effective in the case of systemic herpes.

text continues below

Effects on the Brain and Central Nervous System

Herpes Encephalitis. Each year in the U.S., herpes accounts for 2,100 cases of encephalitis, a rare but extremely serious brain disease. HSV-1 is almost always the culprit, except in newborns. In about 70% of infant herpes encephalitis, the disease occurs when a latent HSV-2 virus is activated. Untreated, herpes encephalitis is fatal in over 70% of cases. Respiratory arrest can occur within the first 24 - 72 hours. Fortunately, rapid diagnostic tests and treatment with acyclovir have significantly improved both survival rates (up to about 80%) and reduced complication rates (to nearly 40%). For those who recover, nearly all suffer some impairment, ranging from very mild neurological changes to paralysis. Recovery from HSV encephalitis is dependent on the patient's age, the level of consciousness, duration of the disease, and the promptness of treatment. The best chances for a favorable outcome occur in patients who are treated with acyclovir within 2 days of becoming ill.

Herpes Meningitis. Herpes meningitis, an inflammation of the membranes that line the brain and spinal cord, occurs in up to 10% of cases of primary genital HSV-2. Women are at higher risk for herpes meningitis than men are. Symptoms include headache, fever, stiff neck, vomiting, and sensitivity to light. Fortunately, herpes meningitis usually resolves without complications, lasting for only 2 - 7 days, although recurrences have been reported.