This statistic shows the percentage of U.S. Americans who had herpes simplex virus type two, commonly known as genital herpes, from 1999 to 2016, by ethnicity. In 2015-2016, around *** percent of Mexican-Americans had genital herpes.
This statistic shows the percentage of U.S. Americans who had herpes simplex virus type one, commonly known as oral herpes, from 1999 to 2016, by ethnicity. In 2015-2016, around ** percent of Mexican-Americans had oral herpes.
This statistic shows the percentage of U.S. Americans who had herpes simplex virus type one, commonly known as oral herpes, in 2015-2016, by age. As of that time, almost 60 percent of those aged 40 to 49 years had oral herpes.
This statistic shows the percentage of U.S. Americans who had herpes simplex virus type two, commonly known as genital herpes, in 2015-2016, by gender. As of that time, around 16 percent of females and 8 percent of males had genital herpes.
This statistic shows the percentage of U.S. Americans who had herpes simplex virus type two, commonly known as genital herpes, in 2015-2016, by age. As of that time, around 21 percent of those aged 40 to 49 had genital herpes.
Herpes Treatment Market Size 2024-2028
The herpes treatment market size is forecast to increase by USD 1.14 billion at a CAGR of 4.43% between 2023 and 2028.
The herpes treatment market is experiencing significant growth due to the increasing prevalence of herpes infections and a large patient pool. The market encompasses various interventions for managing Herpes Simplex Virus (HSV) infections, including antiviral drugs and vaccines. According to the World Health Organization, approximately 3.7 billion people under the age of 50 are infected with herpes simplex type 1, and over 491 million people have herpes simplex type 2. Moreover, the older population is witnessing a rising prevalence rate of shingles, which is a complication of the varicella-zoster virus, leading to an increased demand for antiviral medications and therapies. This trend is expected to continue, making the herpes treatment market a lucrative investment opportunity for pharmaceutical companies.
What will be the Size of the Herpes Treatment Market During the Forecast Period?
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The market encompasses various interventions for managing Herpes Simplex Virus (HSV) infections, including antiviral drugs and vaccines. Genital herpes infections, caused by HSV-1 and HSV-2, are a significant health and wellness concern worldwide. Antiviral drugs, such as Acyclovir, Valacyclovir, and Famciclovir, are commonly used for treating both oral and genital herpes infections. These medications inhibit the virus from replicating, reducing the severity and duration of symptoms.
Phase 1/2 clinical trials are ongoing for developing new therapeutic approaches, including gene therapy and mRNA therapeutics, to tackle HSV infections more effectively. HSV infections can be transmitted through saliva, vaginal secretions, and semen, making prevention and treatment crucial for the hospital population. The market for herpes treatment is driven by the increasing healthcare expenditure and the growing need for effective antiviral drugs and potential vaccines against Varicella-zoster viruses.
How is this Herpes Treatment Industry segmented and which is the largest segment?
The herpes treatment industry research report provides comprehensive data (region-wise segment analysis), with forecasts and estimates in 'USD billion' for the period 2024-2028, as well as historical data from 2018-2022 for the following segments.
Product
Vaccination
Drug therapy
Type
Herpes zoster
Herpes simplex
Geography
North America
US
Europe
Germany
UK
France
Asia
Japan
Rest of World (ROW)
By Product Insights
The vaccination segment is estimated to witness significant growth during the forecast period. The market encompasses various interventions, including antiviral medications like Acyclovir Oral Suspension, and the exploration of innovative approaches such as gene therapy and mRNA therapeutics. Acyclovir and its derivatives, Famciclovir and Valacyclovir, are commonly used for managing herpes simplex virus (HSV) infections caused by HSV-1 and HSV-2. These infections can manifest in different forms, including herpetic gingivostomatitis, and can lead to symptoms such as odynophagia and irritation In the saliva, vaginal secretion, and semen. Genetic retinal diseases, such as herpes simplex virus retinitis, pose a significant challenge In the field of ophthalmology. Rational Vaccines, a biotech company, is currently conducting a Phase 1/2 clinical trial for RVx-001-PSS, a live-attenuated vaccine for preventing HSV-1 and HSV-2 infections.
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The vaccination segment was valued at USD 2.11 billion in 2018 and showed a gradual increase during the forecast period.
Regional Analysis
North America is estimated to contribute 40% to the growth of the global market during the forecast period. Technavio's analysts have elaborately explained the regional trends and drivers that shape the market during the forecast period. The market In the North American region is primarily driven by the demand for drugs and vaccines used In the management of Oral herpes, caused by HSV-1 infection, and Genital herpes, caused by HSV-2 infection. Acyclovir Oral Suspension is a widely used antiviral medication for the treatment of herpes. The market's growth is also fueled by the increasing prevalence of herpes among the geriatric population due to weakened immune systems. Complications such as Postherpetic Neuralgia (PHN) and fibromyalgia further necessitate effective treatment options. In the pipeline, Rational Vaccines' RVx-001-PSS is undergoing Phase 1/2 clinical trials for the prevention of HSV-1 and HSV-2 infections.
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Virios Therapeutics' IMC-1 is another potential treatment for
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Abbreviations: SE = standard error; HSV = Herpes Simplex Virus; VZV = Varicella Zoster Virus; HHV = Human Herpesvirus; inf. = infectious; immune. = immunization; Spec. = Specified; NOS = not otherwise specified; Unspec. = Unspecified.NA = not available due to observations ≤10 admissions suppressed in compliance with Agency for Healthcare Research and Quality guidelines.a) Toxic encephalitis not shown here (overall hospitalization rate = 0.03 per 100,000 population).Encephalitis sex, age, and region-specific population ratesa.
This statistic shows the percentage of U.S. Americans who had herpes simplex virus type one, commonly known as oral herpes, in 2015-2016, by gender. As of that time, around 51 percent of females and 45 percent of males had oral herpes.
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The global genital herpes vaccine market size was valued at approximately USD 1.2 billion in 2023 and is projected to reach around USD 3.5 billion by 2032, exhibiting a Compound Annual Growth Rate (CAGR) of 12.5% during the forecast period. The market growth is primarily driven by the increasing prevalence of genital herpes infections worldwide, alongside substantial advancements in vaccine research and development.
One of the primary growth factors for the genital herpes vaccine market is the rising incidence of genital herpes infections globally. The World Health Organization (WHO) estimates that more than 500 million people are living with genital herpes, and this number is increasing due to a variety of factors including higher rates of sexual activity and better diagnostic methods. As awareness grows, so does demand for effective preventive measures, thereby propelling the market forward.
Advancements in biotechnology and vaccine development also significantly contribute to market growth. Innovations such as DNA vaccines and subunit vaccines are gaining traction due to their enhanced efficacy and reduced side effects compared to traditional vaccines. These technological advancements offer promising avenues for developing effective genital herpes vaccines, which can provide long-lasting immunity and reduce the frequency of outbreaks.
Government initiatives and funding for infectious disease research also play a crucial role in market expansion. Various public health organizations and governments are increasingly focusing on the development and distribution of vaccines, offering grants and subsidies to boost R&D activities in this field. This support not only accelerates the development process but also ensures affordable access to vaccines, thereby broadening the market scope.
Herpes Infection Treatment has become a focal point in the broader context of managing genital herpes. While vaccines are primarily aimed at prevention, effective treatment options are crucial for those already infected. Current treatments focus on antiviral medications that help reduce the severity and frequency of outbreaks. These treatments, however, do not cure the infection, highlighting the ongoing need for comprehensive management strategies. Research is continually evolving, with new therapies being explored to enhance patient outcomes and improve quality of life for those living with herpes infections. The integration of treatment and prevention strategies is essential for a holistic approach to combating this pervasive virus.
Regionally, North America and Europe dominate the genital herpes vaccine market due to robust healthcare infrastructure, high awareness levels, and substantial investments in healthcare R&D. However, the Asia Pacific region is expected to exhibit the highest growth rate during the forecast period, driven by increasing healthcare expenditures, rising awareness, and a growing patient population. The market dynamics in these regions are shaped by varied factors such as economic conditions, healthcare policies, and demographic trends.
The genital herpes vaccine market is segmented into live attenuated vaccines, inactivated vaccines, subunit vaccines, DNA vaccines, and others. Live attenuated vaccines involve the use of a weakened form of the herpes virus to stimulate an immune response. These vaccines have shown promise in preclinical studies and early-stage clinical trials, offering long-term immunity. However, concerns about safety and reactivation of the virus remain challenges that need addressing before widespread adoption.
On the other hand, inactivated vaccines use a killed form of the virus to elicit an immune response. These vaccines are generally considered safer than live attenuated vaccines but may require multiple doses to achieve optimal immunity. Research is ongoing to enhance the efficacy of inactivated vaccines, with several candidates currently undergoing clinical trials. The development of these vaccines is critical for individuals with compromised immune systems who cannot receive live vaccines.
Subunit vaccines, which use specific proteins from the herpes virus to trigger an immune response, are gaining significant attention due to their safety profile and effectiveness. These vaccines minimize the risk of reactivation and are suitable for a broader population, inclu
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Abbreviations: HSV = Human Herpesvirus; VZV = Varicella Zoster Virus; HHV = Human Herpesvirus; NOS = not otherwise specified.NA = Not available due to no observations recorded in the specified year.a) Annual growth rate is the yearly compounded growth supposing that the rate for year A is X and year B is Y, Growth Rate = (Y/X){1/(B-A)}-1Trends in encephalitis-associated hospitalization rates, 2000–2010.
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The global herpes simplex virus treatment market size was valued at USD 2.7 Billion in 2024. Looking forward, IMARC Group estimates the market to reach USD 4.0 Billion by 2033, exhibiting a CAGR of 4.51% during 2025-2033. North America currently dominates the market. The growing awareness among individuals about various medications of HSV, increasing healthcare expenditure, and wide availability of HSV medications through online and offline pharmacy stores represent some of the key factors driving the market.
Report Attribute
|
Key Statistics
|
---|---|
Base Year
|
2024
|
Forecast Years
|
2025-2033
|
Historical Years
| 2019-2024 |
Market Size in 2024
| USD 2.7 Billion |
Market Forecast in 2033
| USD 4.0 Billion |
Market Growth Rate 2025-2033 | 4.51% |
IMARC Group provides an analysis of the key trends in each segment of the global herpes simplex virus treatment market, along with forecast at the global, regional, and country levels from 2025-2033. The market has been categorized based on type, drug type, route of administration and distribution channel.
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The Herpes Simplex Treatment market, valued at $2.48 billion in 2025, is projected to experience robust growth, driven by rising prevalence of herpes simplex virus (HSV) infections globally, increasing awareness and diagnosis rates, and the continuous development of new and improved antiviral treatments. The market's Compound Annual Growth Rate (CAGR) of 4.77% from 2025 to 2033 indicates a steady expansion, fueled by factors such as an aging population (increasing susceptibility to HSV reactivation), improved healthcare infrastructure in developing economies, and the growing demand for convenient and effective treatment options. The oral route of administration segment currently dominates, owing to ease of use and patient preference. However, advancements in topical formulations are expected to gain traction, driven by the development of improved delivery systems minimizing side effects. Competition among major pharmaceutical companies like Teva Pharmaceuticals, Apotex, Viatris, and GSK is intense, driving innovation and price competitiveness. The North American market holds a significant share due to higher healthcare expenditure and prevalence rates, while Asia-Pacific is expected to witness substantial growth owing to rising awareness and increasing affordability of treatment options. The market segmentation by drug (Acyclovir, Valacyclovir, Famciclovir, and others) reflects diverse therapeutic options, each with its own efficacy profile and side-effect considerations. The preference for specific drugs may shift based on evolving clinical guidelines, patient tolerance, and cost considerations. Future growth will likely be influenced by the development of novel therapies targeting specific HSV subtypes, potentially offering improved efficacy and reduced recurrence rates. Challenges remain, including the inherent nature of HSV as a latent virus, resulting in potential recurrence, and managing drug resistance. The continued research and development of new therapies and improved management strategies will be crucial for maintaining market growth and providing effective solutions for patients. Expansion into underserved regions and public awareness campaigns will also play a significant role in expanding the market. Recent developments include: In October 2022, Replay, a genome writing company, reported the launch of Eudora, a herpes simplex virus (HSV) gene therapy company targeting genetic retinal diseases. It is the first of Replay's product companies to leverage its high payload capacity HSV delivery vector, synHSV., In August 2022, Rational Vaccines, a company focused on revolutionizing the treatment and prevention of herpes to eradicate the disease, reported the initiation of a clinical trial designed to determine the baseline characteristics of patients diagnosed with recurrent symptomatic HSV type 2. It is to be conducted in two research institutions in the United Kingdom. The results of the study will inform the protocol design of the Phase 1/2 clinical trial of the company's lead HSV-2 therapeutic vaccine candidate.. Key drivers for this market are: Growing Burden of Herpes Simplex Virus Infections, Increasing R&D Activities. Potential restraints include: Growing Burden of Herpes Simplex Virus Infections, Increasing R&D Activities. Notable trends are: Acyclovir Segment is Expected to Hold a Significant Market Share in the Herpes Simplex Virus Treatment Market.
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Abbreviations: HSV = Herpes Simplex Virus; VZV = Varicella Zoster Virus; HHV = Human Herpesvirus.a) Applies to enteroviruses diseases of central nervous system other than meningitis (ICD-9 047).b) Postinfectious encephalitis applies to infectious acute disseminated encephalomyelitis (ADEM).c) Other specified encephalitis applies to noninfectious acute disseminated encephalomyelitis (ADEM), allergic encephalitis, autoimmune encephalitis, Bickerstaff's brainstem encephalitis, eosinophilic meningoencephalitis, paraneoplastic limbic encephalitis, and systemic lupus erythematosus encephalitis.Diagnosis codes for encephalitis.
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According to Cognitive Market Research, the global Acyclovir market size is USD XX million in 2024 and will expand at a compound annual growth rate (CAGR) of 6.00% from 2024 to 2031.
North America held the major market of more than 40% of the global revenue with a market size of USD XX million in 2024 and will grow at a compound annual growth rate (CAGR) of 4.2% from 2024 to 2031.
Europe accounted for a share of over 30% of the global market size of USD XX million.
Asia Pacific held the market of around 23% of the global revenue with a market size of USD XX million in 2024 and will grow at a compound annual growth rate (CAGR) of 8.0% from 2024 to 2031.
Latin America market of more than 5% of the global revenue with a market size of USD XX million in 2024 and will grow at a compound annual growth rate (CAGR) of 5.4% from 2024 to 2031.
Middle East and Africa held the major market ofaround 2% of the global revenue with a market size of USD XX million in 2024 and will grow at a compound annual growth rate (CAGR) of 5.7% from 2024 to 2031.
The Herpes Simplex Virus held the highest Acyclovir market revenue share in 2024.
Key Drivers of Acyclovir market
Increasing Incidence of Herpes Simplex Virus Infections to Increase the Demand Globally
The primary driver fueling the growth of the acyclovir market is the rising incidence of herpes simplex virus (HSV) infections worldwide. HSV infections, including genital herpes and cold sores, are highly prevalent, affecting millions of individuals globally. Acyclovir, an antiviral medication, is widely used for the treatment and management of HSV infections due to its effectiveness in reducing the severity and duration of symptoms. As the prevalence of HSV infections continues to rise, especially in regions with high population density and limited access to healthcare, the demand for acyclovir is expected to increase significantly, driving market growth.
Growing Awareness and Accessibility of Antiviral Medications to Propel Market Growth
Another key driver propelling the acyclovir market is the growing awareness among healthcare professionals and patients about the benefits of antiviral medications for treating viral infections. Increasing healthcare expenditure, coupled with government initiatives to combat infectious diseases, has led to improved accessibility of antiviral drugs like acyclovir in both developed and developing regions. Moreover, advancements in pharmaceutical formulations, such as the development of topical creams and oral tablets, have enhanced the convenience and efficacy of acyclovir treatment. With a greater emphasis on preventive healthcare and the importance of early intervention in viral infections, the demand for acyclovir and other antiviral medications is expected to continue growing steadily in the foreseeable future.
Restraint Factors of Acyclovir market
Development of Drug Resistance to Limit the Sales
One of the significant challenges facing the acyclovir market is the development of drug resistance among herpes simplex virus (HSV) strains. Prolonged or inappropriate use of acyclovir can lead to the emergence of resistant HSV strains, rendering the medication less effective in treating infections. This phenomenon poses a threat to the efficacy of acyclovir therapy and necessitates the development of alternative treatment strategies. Healthcare providers must exercise caution in prescribing acyclovir and monitor patients closely to detect signs of drug resistance. Additionally, pharmaceutical companies need to invest in research and development efforts to discover new antiviral agents or enhance existing formulations to overcome drug-resistant HSV strains, thereby addressing this key restraint in the acyclovir market.
Strict regulations and approval processes for new formulations can delay market entry
In the Acyclovir market, one of the key restraints is the existence of strict regulatory guidelines and complicated approval procedures for new products. Acyclovir, as an antiviral medication employed to cure herpes virus infections, has to meet strict standards prescribed by health authorities like the U.S. FDA, EMA, and other global regulatory agencies. These rules guarantee the drug's safety, efficacy, and quality, especially when firms formulate new delivery forms (e.g., topical gels, extended-release tablets, or nanoparticle-based products). ...
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The Herpes Zoster Ophthalmicus (HZO) drug market is experiencing steady growth, driven by an aging global population, increasing prevalence of herpes zoster, and rising awareness of the condition's potential for severe vision complications. The market size in 2025 is estimated at $500 million, exhibiting a Compound Annual Growth Rate (CAGR) of 5% from 2025 to 2033. This growth trajectory is fueled by several key factors. Firstly, the increasing geriatric population, which is highly susceptible to HZO, significantly contributes to the rising demand for effective treatments. Secondly, advancements in drug development and the availability of more effective therapies, including antiviral medications and topical treatments, are bolstering market expansion. Finally, improved diagnostic capabilities and increased physician awareness about the importance of early intervention are enhancing the early detection and treatment rates of HZO, further stimulating market growth.
However, the market faces certain restraints, including the high cost of treatment, potential side effects associated with certain drugs, and limited access to specialized healthcare in some regions. The market is segmented by drug type (oral, topical, injectable) and distribution channels (hospital pharmacies, retail pharmacies, online pharmacies). Oral drugs currently dominate the market share due to their convenience and ease of administration. However, topical and injectable medications are expected to witness significant growth in the coming years, driven by their targeted action and reduced systemic side effects. The North American and European regions currently hold the largest market shares, owing to established healthcare infrastructure, high disease prevalence, and strong regulatory frameworks. However, emerging markets in Asia-Pacific are anticipated to showcase promising growth potential in the long-term driven by rising healthcare expenditure and improving healthcare access. The competitive landscape features established pharmaceutical giants like Abbott, Novartis, and GlaxoSmithKline, alongside emerging players focused on innovative treatment options.
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The rapidoxuridine ophthalmic drug (IPDR) market presents a compelling investment opportunity, driven by a rising prevalence of ocular herpes simplex virus (HSV) infections and a growing geriatric population susceptible to these infections. While precise market sizing data is unavailable, considering the specialized nature of the drug and its application in treating a specific condition, we can estimate the 2025 market value to be in the range of $150-200 million globally. A compounded annual growth rate (CAGR) of 5-7% over the forecast period (2025-2033) is reasonable, driven by factors such as increasing awareness of effective treatment options, ongoing R&D efforts to improve drug efficacy and delivery systems, and expansion into emerging markets. Key market restraints include the potential for side effects, the emergence of antiviral resistance, and the high cost of treatment. Market segmentation includes different drug formulations (e.g., ointments, solutions), distribution channels (e.g., hospitals, pharmacies), and geographical regions. The North American and European markets currently dominate the global landscape, but significant growth potential exists in Asia-Pacific and Latin America due to increasing healthcare infrastructure development and growing awareness of ophthalmic diseases. The competitive landscape is likely characterized by a mix of established pharmaceutical companies and smaller specialized firms. Success in this market will hinge on factors like strong clinical trial data supporting efficacy and safety, efficient manufacturing and distribution networks, strategic partnerships, and effective marketing campaigns targeting ophthalmologists and healthcare providers. Furthermore, continuous monitoring of regulatory changes and evolving treatment guidelines will be crucial for maintaining market competitiveness. The focus should remain on innovative product development, including improved delivery methods and combination therapies that minimize side effects and improve patient compliance. The long-term outlook for the rapidoxuridine IPDR market remains positive, fueled by the persistent need for effective treatment of ocular HSV infections and ongoing advancements in ophthalmic drug development.
This statistic shows the number of initial visits to physicians' offices for genital herpes in the U.S. from 1966 to 2014. In 2014, there were approximately ******* initial visits to physicians' offices for genital herpes.
Sexually Transmitted Diseases Treatment Market Size 2024-2028
The sexually transmitted diseases (STD) treatment market size is forecast to increase by USD 14.3 billion at a CAGR of 4.5% between 2023 and 2028.
The market is experiencing significant growth due to several key factors. The increasing prevalence of STDs worldwide is a major driver for market expansion. According to the World Health Organization, there were an estimated 376 million new cases of curable STDs in 2012. According to the World Health Organization, approximately one million new STD infections occur daily worldwide. Bacterial STDs, such as Chlamydia and Gonorrhea, can be effectively treated with antibiotics. Advances in rapid diagnosis techniques are also contributing to market growth, allowing for earlier detection and treatment of STDs. However, limited healthcare services in developing regions pose a challenge to effective STD treatment, particularly in populations that are most at risk. Despite these challenges, the market is expected to continue growing as efforts to increase awareness and access to healthcare services persist. The market analysis report provides a comprehensive examination of these trends and the factors shaping the future of the STD treatment market.
What will be the Size of the STD Treatment Market During the Forecast Period?
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The market encompasses a range of contagious and serious conditions that affect the reproductive organs and require medical intervention. Bacterial STDs, such as gonorrhea and syphilis, can be treated with antibiotics, while viral STDs, including HIV/AIDS, hepatitis B, and genital warts, often require antiretroviral drugs or suppressive therapy. Symptoms of these infections can vary from nonexistent to severe, making early diagnosis and treatment crucial to prevent permanent damage and potential complications. The market for STD treatments and infectious disease diagnostics continues to evolve, with ongoing research and development efforts aimed at creating more effective medications and vaccines.
Additionally, antibiotic-resistant strains of gonorrhea and syphilis pose a challenge, necessitating the exploration of alternative treatment options. Antiviral medication and surgical interventions, such as freezing or removal of genital warts, also play a role in managing these conditions. Outbreaks of STDs can lead to increased demand for treatments and heightened awareness of the importance of safe sexual practices. The ongoing global fight against HIV/AIDS and efforts to improve access to STD testing and treatment for underserved populations remain key priorities in the market.
The sexually transmitted diseases (STD) treatment market is evolving with advancements in both pharmaceutical and diagnostic technologies. Antiviral STD drugs and antibiotic STD treatments are essential for managing infections like gonorrhea, chlamydia, and syphilis, with updated syphilis treatment guidelines ensuring more effective care. HIV antiretroviral therapy remains critical for managing HIV, while herpes treatment advancements continue to improve patient outcomes. The HPV vaccine market is also expanding, providing a preventive measure for HPV-related cancers. Bacterial vaginosis drugs and trichomoniasis medication address common infections, while STD rapid test kits and STI prevention therapies are enhancing early detection and prevention efforts. Emerging STD drug research and telemedicine for STD treatment are further improving accessibility and patient care in public health STD initiatives.
How is this Sexually Transmitted Diseases Treatment Industry segmented and which is the largest segment?
The sexually transmitted diseases (STD) treatment industry research report provides comprehensive data (region-wise segment analysis), with forecasts and estimates in 'USD billion' for the period 2024-2028, as well as historical data from 2018-2022 for the following segments.
Type
Viral infections
Bacterial infections
Others
Geography
North America
US
Europe
Germany
UK
Asia
China
Japan
Rest of World (ROW)
By Type Insights
The viral infections segment is estimated to witness significant growth during the forecast period.
The market is driven by the rise in viral STD infections, such as human papillomavirus (HPV), herpes simplex virus (HSV), hepatitis B virus (HBV), and HIV. According to the Centers for Disease Control and Prevention (CDC), genital HPV infection is the most common STD in the US, affecting approximately 45% of adults aged 18-59 years during 2021-2022. HPV can lead to health complications, including cervical cancer and genital warts. Other viral STDs, such as genital herpes and hepatitis B, can also cause significant health issues. Antiviral medications and suppressive therapy are common treatments for viral STDs, while vaccines are
This statistic shows the sales share of the leading cold sore medication brands in the United States in 2019. In that year, the Abreva brand accounted for about **** percent of total dollar sales in the United States.
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Epidemiology and burden of HZ in LAC.
This statistic shows the percentage of U.S. Americans who had herpes simplex virus type two, commonly known as genital herpes, from 1999 to 2016, by ethnicity. In 2015-2016, around *** percent of Mexican-Americans had genital herpes.