Herpes: Why do some people experience more symptoms than others?

Author :- Rich Mancuso June 10, 2020, 9:56 a.m.
Herpes: Why do some people experience more symptoms than others?

Jessica woke to the blasting horn sound on her phone. She set the alarm this way on purpose - she's quite the heavy sleeper. Reaching over to the nightstand, desperately searching the snooze button like a fish flopping around on dry land, she didn't feel right. (Hits the snooze button). Something was off, and she knew it. "Oh, that's not right," she said to herself as her head was slightly spinning. Slowly she rolled over on her back staring at the ceiling and sighed. As she did this, she felt feverish and also felt some soreness in-between her legs. "Oh fu#*ing hell," she said to herself. She knew what this was. "Every damn month. What the hell is triggering this? Why does this keep happening, why me? How many pills do I have to take!"

Denise was in a hurry and running late; she needed to get ready for work and was clearly running out of time. While in the shower, she remembered about her date later that evening and decided to trim up her legs and vagina -just in case. The potential for sex was there so why not be prepared she thought."God, I hope he doesn't say anything dopey right before sex again." she mumbled to herself while smirking and shaking her head.

Later that afternoon, sitting at her desk during a conference call she felt some tingling and a little itchy. "Hmmm." she thought. "Maybe I shaved a little too hard this morning. I'll go take a look." While sitting in the bathroom and taking a long hard look, she didn't see anything. "Weird, not a damn thing." she thought. "Oh well, whatever." 

David decided to hit the gym after work because he had been putting it off for the past few days; work was keeping him late so he didn't have time. Later that evening while at the gym, he felt something odd at the base of his penis. "Is that a pimple? Weird. Huh, maybe it's an ingrown hair?" 

He walked into the bathroom stall for some privacy and took a look. "Well, it's either a pimple or an ingrown hair," he said to himself. Taking his two thumbs and placing them on either side of the tiny bump, he squeezes and pops it. "Owe. Hmm, I guess it was a pimple. What a weird spot to get one."

Believe it or not, these three scenarios are quite common for people who have herpes. The three stories presented are only a tiny percentage of the wide variety of symptoms a person may experience and most people are entirely unaware. But, if we are all human beings, why do so many people experience symptoms in so many different and varying degrees?

There is no I in herpes.

The herpes simplex virus has been around for millions of years and it has used this time to perfect its method of infection. It has exploited how humans communicate with one another with diabolical precision. Basically, the virus hasn't changed much except for the few strains of type one and two that have become antiviral resistant and some other small mutations; the virus has remained somewhat unchanged. The most significant variable here isn't the virus; it's us, human beings.

If you watch the news as much as I do, you have heard conversations about viruses like the Flu and other Coronaviruses. You have also heard terms such as "immunocompromised or autoimmune issues." People who fall into these categories do not have the most adequate ability to fight off infections that are caused by bacteria or viruses; sad but true. 

Herpes is a virus, one that creates a viral infection within the nervous system that can lay dormant {3} for long periods of time and cause recurrent disease. Most people who are seropositive never experience any symptoms. This is 80% of the population of people who have either types of herpes, HSV-1 and/or HSV-2. {1}

When people in this category experience symptoms, they are generally insignificant or unnoticeable. "Where did that pimple come from?" This is due to having a very favorable immune response to the virus. A proper reaction to herpes allows the immune system to identify most, if not all, of the 75 proteins that make up the virus. Thus, allowing it to create the proper antibody response that is necessary to fight the virus properly and keep it at bay.

It's regrettable to say, that approximately 20% of those infected with herpes simplex will suffer from frequent and uncomfortable symptoms. These can include; sharp pains, tingling sensations, severe neurologic pain, UTI's, BV, outbreaks, and recurrent painful ulcers. However, the intensity or duration of how someone will suffer from a herpes outbreak will depend solely upon their immune system's reaction to the virus.{4} A great deal of these individuals have an immune system that has failed to identify most of the 75 proteins, in order to effectively control the disease; due to these missing pieces of instructions. They may also have other issues that have caused this lack of response. Herpes is very sneaky.

When a person has an autoimmune condition or they are immunocompromised before becoming infected with herpes, many will suffer from frequent symptoms. It is this pre-existing condition or conditions, that can cause an inadequate response to the virus. So, when it comes to the idea that herpes is going to directly cause a person to contract other viruses and bacteria, it's not. It's all up to your immune response, not herpes (with the exception of herpes allowing a 2-3 fold increased risk of contracting HIV ).{2} One indirect cause could be theorized using the example of women who suffer Bacterial Vaginosis and /or yeast infections due to an imbalance caused by a herpes outbreak. Discussion here. 

Still, herpes does not cause you to be immunocompromised and is not an autoimmune issue.

If you do not have an autoimmune condition or are immune-compromised, but still suffer outbreaks, you simply have a very poor response to the virus. This doesn't mean your immune system is terrible or that it sucks, just the response to herpes does. Although, an argument could stand quite firm that a situation such as that, does indeed. . .suck.

Autoimmune or immuno-compromised?

An autoimmune disease is a condition in which your immune system mistakenly attacks your body's cells. In conditions like this (listed below), the immune system mistakes part of your body as foreign invaders instead of recognizing them as good cells. 

  1. Multiple sclerosis (MS)
  2. Rheumatoid arthritis (RA),
  3. Inflammatory bowel disease (IBD)
  4. Systemic lupus erythematosus (SLE)
  5. Type 1 diabetes 
  6. Addison's disease 
  7. Graves' disease 
  8. Sjögren's syndrome 
  9. Hashimoto's thyroiditis

Herpes is not a disease that causes the immune system to attack itself. Still, a lack of response to the virus caused by having autoimmune issues will indeed allow the virus to emerge and reproduce more often. 

What about herpes causing me to be immuno-compromised?

"Patients who are immunocompromised have a reduced ability to fight infections and other diseases. This may be caused by certain diseases or conditions, such as AIDS, cancer, diabetes, malnutrition, and certain genetic disorders. It may also be caused by certain medicines or treatments, such as anticancer drugs, radiation therapy, and stem cell or organ transplant, also called immuno-suppressed. An immune deficiency or be immunocompromised when their immune system is incapable of working at full capacity." {5} 

"Chronic conditions that affect the immune system include heart disease, lung disease, lupus, and diabetes. Other conditions that can leave a person immunocompromised include cancer, HIV/AIDS, malnutrition, and some rare genetic disorders, says Dr. Li. Chemotherapy and steroids can also lower immunity. "They suppress the body's ability to activate its immune defenses by destroying immune cells or by blunting the cell's ability to spot and kill bacteria," Dr. Li explains. {6}

Herpes simplex will trick the immune system {7} but it does not cause a person to become immunocompromised. "Oral and genital herpes can be uncomfortable, but they are generally not dangerous infections in healthy adults. Herpes does not affect the immune system." {8}

It's also paramount to remember herpes has many immune evasion strategies that it employs during the infection process. These strategies make herpes very successful at evading both innate (complement activation and adaptive (antibodies and T cells) immune responses. Because of these immune evasion strategies, it is possible that the immune cells in individuals suffering from recurrent disease may have missed many of the intended targets of herpes. {9} 

There is always going to be a percentage of people who have an immune system that did not see the virus properly simply due to the sneaky and aggressive behavior or herpes; it can and will happen. There is also the possibility that an individual may have been exposed to a strain of type one, or of type two that is antiviral resistant (more info here). If you are unsure whether or not you have any issues with your immune system, go get yourself tested! Perhaps a DNA test?

Type and strain explained here.


Herpes triggers https://askingforafriend.us/articles/f/what-is-a-herpes-trigger


Herpes and the Coronavirus https://askingforafriend.us/articles/f/will-herpes-affect-contracting-the-corona-virus

{1} Prevelance of herpes 


Genital herpes infection is common in the United States. CDC estimates that, annually, 776,000 people in the United States get new genital herpes infections. {1} Nationwide, 11.9 % of persons aged 14 to 49 years have HSV-2 infection (12.1% when adjusted for age).{2} However, the prevalence of genital herpes infection is higher than that because an increasing number of genital herpes infections are caused by HSV-1. {3} Oral HSV-1 infection is typically acquired in childhood; because the prevalence of oral HSV-1 infection has declined in recent decades, people may have become more susceptible to contracting a genital herpes infection from HSV-1. {4}

  1. Satterwhite CL, Torrone E, Meites E, et al. Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008. Sex Transm Dis, 2013. 40(30):187-93
  2. McQuillan G, Kruszon-Moran D, Flagg EW, Paulose-Ram R. Prevalence of herpes simplex virus type 1 and type 2 in persons aged 14–49: United States, 2015–2016. NCHS Data Brief, no 304. Hyattsville, MD: National Center for Health Statistics. 2018
  3. Xu F, Sternberg MR, Kottiri BJ, et al. Trends in herpes simplex virus type 1 and type 2 seroprevalence in the United States. JAMA, 2006. 296(8): 964–73.
  4. Bradley H, Markowitz L, Gibson T, et al. Seroprevalence of herpes simplex virus types 1 and 2—United States, 1999–2010. J Infect Dis, 2014. 209(3):325-33.



Herpes simplex virus (HSV) infection is one of the most common viral sexually transmitted diseases worldwide. The first time infection of the mother may lead to severe illness in pregnancy and may be associated with virus transmission from mother to fetus/newborn. Since the incidence of this sexually transmitted infection continues to rise and because the greatest incidence of herpes simplex virus infections occur in women of reproductive age, the risk of maternal transmission of the virus to the fetus or neonate has become a major health concern. On these purposes the Authors of this review looked for the medical literature and pertinent publications to define the status of art regarding the epidemiology, the diagnosis, the therapy and the prevention of HSV in pregnant women and neonate. Special emphasis is placed upon the importance of genital herpes simplex virus infection in pregnancy and on the its prevention to avoid neonatal HSV infections.


How many people have herpes?

Even though numbers can fluctuate from year to year; depending on many factors, these numbers are still pretty staggering. The prevalence of HSV type one is almost more than 80% of the worlds population. Almost everyone has herpes. 


Genital herpes infection is common in the United States. CDC estimates that, annually, 776,000 people in the United States get new genital herpes infections

Thats over 2000 a day in the United States alone. https://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm#ref1 

Satterwhite CL, Torrone E, Meites E, et al. Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008. Sex Transm Dis, 2013. 40(30):187-93


{2} Herpes outbreaks can provides a way for HIV to enter the body. Even without visible sores, having genital herpes increases the number of CD4 cells (the cells that HIV targets for entry into the body) found in the lining of the genitals. 

CD4+ T cells, which HIV targets and infects, appears at the sites of healed genital HSV-2 lesions at concentrations 2 to 37 times greater than in unaffected genital skin. Moreover, the CD4+ T cells at healed lesion sites expressed higher levels of 2 cell-surface receptors—CCR5 and CXCR4—that HIV uses to enter T cells. Compared to control tissue, the sites of healed genital herpes lesions also had a significantly higher concentration of immune cells known to ferry HIV particles to CD4+ T cells, whether or not the patient was treated with acyclovir.









{3} https://www.livescience.com/60791-how-herpes-viruses-sleep-and-wake.html

{4} https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3437531/

{5} https://www.cancer.gov/publications/dictionaries/cancer-terms/def/immunocompromised

{6}  https://www.health.com/condition/infectious-diseases/what-is-immunocompromised

{7} https://www.sciencedaily.com/releases/2016/02/160204094928.htm

{8} http://www.ashasexualhealth.org/stdsstis/herpes/fast-facts-and-faqs/

{9} https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5394093/