The complications of herpes infection be it genital, oral, or ocular are caused by the herpes simplex virus (HSV) infection.

Do not mix up symptoms with complications. Simply put, symptoms are how the disease presents itself and complications are what damage the disease can cause to your body.

You can therefore summarize them as:

  • Complications of genital herpes caused by the HSV-2,
  • Complications of Oral or mouth herpes caused by HSV-1, and
  • Complications of ocular or eye herpes caused by HSV-1

Herpes complications

The complications of herpes simplex are rare. Still, for sake of knowledge and information, we explain its possible effects on the body below. They are mostly long-term.

1) Herpes makes you more prone to HIV (Human Immunodeficiency Virus)

The Herpes Simplex Virus Type 2 which causes genital herpes facilitates the spread of HIV (the virus responsible for AIDS). People who have the genital infection are more susceptible to being infected by HIV and more prone to the shedding of HIV.

2) Cervical cancer

Long-term genital herpes has been associated with cervical cancer of the uterus. Researchers doing a study on cancer in France discovered that women infected with both HPV and HSV-2 viruses were three times more prone to develop cervical cancer.

3) Bladder failure

Long-term infection of genital herpes causes neuropathy of the sacral nerve, where the herpes virus stays throughout life. This sacral nerve neuropathy can cause bladder failure.

The pudendal nerve, which originates from the sacral nerve, controls the function of the urinary bladder. Due to neuropathy of the sacral nerve, the pudendal nerve loses its control of the bladder.

4) Herpes virus and erythema multiforme

Erythema multiforme (EM) is an allergic skin reaction caused by the herpes simplex virus. It is characterized by mild inflammation of the skin and is seen more in children and young adults. It causes damage to blood vessels of the skin and the skin tissue. It is, however, self-limiting but can recur.

It is an immune-mediated reaction characterized by skin lesions and possible mucosal involvement. It is mostly caused by the herpes simplex virus, with HSV-1 being more predominantly responsible than HSV-2.

5) Stevens-Johnson Syndrome

This is an autoimmune disorder that presents as a painful rash on the skin, mucous membranes, and genitals.  It is a serious skin disorder affecting the skin and the mucous membrane, caused by the herpes virus.

It is characterized by painful red or purplish rash with blisters. It results in the shedding of the top layer of the skin. It can also be caused due to allergy to certain medications.

6) Hepatitis and hepatic failure

Hepatitis due to herpes is very rare and is believed to be caused by disseminated herpes simplex virus (HSV) infection.

HSV hepatitis can rarely result in acute liver failure (ALF). It carries a mortality rate of 80% if untreated.

7) Herpes complications in babies during pregnancy

About 20 percent of pregnant women have exhibited antibodies to the HSV-2 virus and of these only, 5 percent have reported any history of symptoms.

Herpes simplex virus (HSV) infections are transmitted from an infected mother to the baby during normal delivery. This is called neonatal herpes. To prevent this transmission to the newborn, infected women are advised to have a cesarean delivery.

The incidence of the infection being transmitted from the infected mother to the baby is approximately one per 3,000 to 20,000 live births. The risk is at its highest when a mother contracts the infection in the late stages of pregnancy.

Neonatal herpes can have serious complications in the newborn and requires immediate treatment.

If left untreated, the herpes simplex virus can adversely affect the brain and spinal cord function and can cause damage to the liver, lungs, and kidneys.

According to Medscape, “Neonatal HSV infection has a mortality rate of more than 80% if untreated and a significant morbidity rate of approximately 50% even when treated.”

Pregnant mothers with an active herpes infection during delivery are advised caesarian section to avoid passing on the infection to the newborn. If the herpes is not active, normal delivery is usually resorted to. However, the passing of the herpes infection to the newborn is rare. But, if the newborn is infected, the following complications may arise

  • The baby may die.
  • The newborn baby may suffer from damage to the nerves, skin, and eyes.
  • The delivery may be premature.
  • Herpes in newborns can cause encephalitis.
  • Newborns with herpes infection respond very well to anti-viral drug therapy.

8) Herpes Encephalitis

Herpetic encephalitis is a viral infection of the brain tissue caused by the oral herpes virus (HSV-1) and is very rare. The HSV-1 virus lies dormant in the trigeminal nerve.

Herpes encephalitis occurs as a result of the oral herpes virus spreading via the trigeminal nerve to the brain.

One out of a quarter to half a million herpes patients contract encephalitis. With treatment, the mortality rate is low at about 19%. Untreated patients suffer mortality of about 70%.

9) Herpes meningitis

Herpes meningitis is a viral infection of the meninges (membrane covering the brain) caused again by the herpes virus-2 (HSV-2) and is rare.

There is a 19% to 42% chance that HSV-2 meningitis will recur over his or her lifetime.

It is to be noted that HSV encephalitis is mostly caused by HSV-1, whereas meningitis is more often caused by HSV-2

10) Herpes pharyngitis

Sore throat is another complication of oral or mouth herpes and responds well to treatment.

Herpetic pharyngitis is caused by both herpes simplex virus types 1 and 2. This infection is commonly seen in children and young adults. Along with pharyngitis the person also develops swelling of the gums.

11) Bell’s Palsy

In Bell’s palsy, the person develops weakness and or paralysis of one side of the face, which is caused by the oral herpes virus. It results due to inflammation of the facial nerve caused by the HSV-1. It is temporary and self-limiting.

12) Herpes effect on the skin

Atopic eczema is an allergic inflammation of the skin where one of the allergens can be the herpes virus. Eczema due to herpes presents with blisters and sores. Patients with atopic eczema show an increased tendency to have hay fever and asthma.

13) Eye complications

25% of cases of ocular herpes develop stromal keratitis due to the inner layers of the cornea being infected by the herpes virus. It results in scarring of the cornea and can rarely result in blindness.

Besides corneal scarring, other eye complications include:

  • Glaucoma
  • Loss of vision
  • Risk of other eye infections

14) Pneumonia, Esophagitis, and Adrenal gland damage

These complications caused by the herpes virus arise when the immune system of the body has become compromised or weak.

Complications of Herpes are serious and not so serious. However, to reiterate, these herpes complications are rare but are seen.


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