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The Facts
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Genital herpes is a sexually transmitted disease (STD) caused by
the herpes simplex virus (HSV). There are two strains that can cause either
genital or facial infections; HSV-1 generally affects the face (fever blisters
and cold sores), HSV-2 typically affects the genital area. |
The following is a list of the families included in the Human
Herpes Virus:
- Herpes Simplex 1 -- fever blisters /cold sores
- Herpes Simplex 2 -- genital blisters Varicella-Zoster -- chicken pox and shingles
- Epstein Barr -- mono and CFS-chronic fatigue syndrome
- Cytomegalovirus -- illness in newborns
- HHV-6 -- roseola
- HHV-7 -- rash
- HHV-8 -- Kaposi's sarcoma
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One out of four Americans age 12 or older, (45 million people)
are infected with HSV-2. HSV-2 infections are more common in women than in men
by 1-in-4 with the percentage for men being 1-in-5. HSV-2 is transmitted either
through direct sexual or skin-to-skin contact, and it is possible to transmit
the virus when sores or other symptoms are not evident. |
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Common symptoms include:
- Genital itching, burning, tingling or irritation
- Pain in the legs, buttocks or genital area
- Fever, swollen lymph nodes, headache, muscle ache, fatigue and other
flu-like symptoms
- Decreased appetite
- Painful or difficult urination
- Vaginal discharge
- Abdominal pressure
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In the first year of infection, outbreaks of painful genital
blisters and sores can occur up to four or five times. The first episode usually
occurs within two weeks of initial infection, and resulting sores typically heal
within two to four weeks. Overall, the risk of transmitting the virus is highest
within an individual's first year of infection, immediately before and after
visible "outbreaks" and by those who have frequent outbreaks.
Periodic
outbreaks known as "recurrences" can be triggered by illness, stress, fatigue,
skin irritation, menstruation and other stress factors. "Recurrences" are
generally milder than the initial outbreak and last about one week. The number
and pattern of recurrences are unique to each person and can also change over
time. |
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HSV-1 |
HSV-2 |
Prefers the trigeminal nerve area
Causes all cold sores and
fever blisters
Accounts for 1/3 of new genital infections
Causes most
ocular herpes and encephalitis
Presents special risks for newborns
(can
make new HSV-2 more likely to be
sub-clinical)
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Causes 2/3 of new genital infections
Recurs 4-5 times per
year in the genital area
Is very rarely oral and recurs .01 x per year
if
oral infection does occur
DOES protect against getting HSV-1
Can be
present for years without symptoms
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Diagnosis for HSV-1 and HSV-2 blood test can be determined
through the following:
- Western Blot at UW the gold standard
- POCkit test from Diagnology
- MRL HSV-1 and HSV-2 ELISA
- MRL Immunoblot
- Meridian Premiere ELISA for HSV-1 AND HSV-2
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Treatment Options
Medications are available to treat outbreaks and potentially
reduce recurrences. However, there is "NO CURE" for herpes at this time and once
an individual has been infected, they will remain infected for life.
Treatment options available are:
Acyclovir (Zovirax) -- An antiviral drug used in the treatment of herpes simplex virus
1 (fever blisters, cold sores), herpes simplex virus 2 (genital herpes) and
herpes zoster (shingles). Acyclovir comes in the form of pills, ointment or
injection. The drug functions as a nucleoside analog, but must be converted to
an active (phosphated) form by the thymidine kinase enzyme produced only by
cells infected by certain herpes viruses, including varicella zoster virus
(shingles) and herpes simplex-1 and -2. Acyclovir causes few side
effects--occasionally nausea, diarrhea or headaches. It is now available in a
generic form.
Valtrex -- An antiviral drug used in the treatment
of herpes simplex virus 2 (genital herpes)
Famciclovir (Famvir) --
A prodrug (see) for an acyclovir-like active compound. It has especially high
bioavailability (see) and is an approved therapy for shingles. It also is under
investigation for herpes simplex-2 (genital herpes).
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Definitions
Antiretroviral -- A substance that stops or suppresses the
activity of a retrovirus such as HIV, AZT, ddC, ddI and d4T are examples of
antiretroviral drugs.
Asymptomatic -- Without signs or symptoms of
disease or illness.
CMV (Cytomegalovirus) -- A herpes infection that
causes serious illness in people with AIDS, CMV can develop in any part of the
body but most often appears in the retina of the eye, the nervous system, the
colon or the esophagus.
Cold Sores -- Otherwise known as "fever
blisters" and herpes type-1 infection.
Disseminated Infection -- A
herpes infection that spreads over a wider than usual area of the body,
frequently afflicting internal organs.
Encephalitis -- A brain
inflammation of viral or other microbial origin. Symptoms include headaches,
neck pain, fever, nausea, vomiting and nervous system problems. Several types of
opportunistic infections can cause encephalitis.
Epstein-Barr Virus
(EBV) -- A member of the herpes virus family that causes one of two kinds of
mononucleosis (the other is caused by CMV). It infects the nose and throat and
is contagious. It lies dormant in the lymph glands and has been associated with
Burkitt's lymphoma and oral hairy leukoplakia.
Ganglion -- A knot-like
grouping of the nerves that serve a particular part of the body.
Herpes -- While "genital herpes" can cause symptoms in a variety of sites below the
waist, the term is used to denote all HSV infection that is latent in the sacral
ganglion, at the base of the spin. An estimated 45 million Americans have
genital herpes, with 500,000 new cases each year. Approximately two-thirds of
who are infected do not know they have genital herpes, either because they have
no symptoms or because their symptoms are so mild they go unnoticed. Symptoms of
the first infection usually appear one to twenty-six days after exposure and
last two to three weeks.
Herpes Encephalitis -- A rare, severe
illness that occurs when the brain becomes infected with HSV.
Herpes
Gladiatorum -- The presence of herpes lesions on the body caused by HSV
infection that is transmitted usually through the abrasion of skin in a contact
sport. Also known as gladitorum.
Herpes Whitlow -- The presence of
herpes lesions on the fingers or toes.
Herpes Zoster -- Acute
inflammatory disease with vesicles grouped in the course of cutaneous nerves.
See Shingles and Varicella Zoster Virus (VZV).
Herpes Zoster Auricularis
-- Herpes zoster of the ear.
Herpes Zoster Opthalmicus -- Herpes
affecting the opthalmic nerve
HHV-6 -- A newly observed agent found in
the blood cells (Tlymphocytes) of a few patients with a variety of diseases
affecting the immune system. This virus causes roseola infantum, a common
childhood infection of children under 4. Symptoms of roseola infantum include
high fever and listlessness followed by a rash.
HHV-7 -- This virus has
been identified in the laboratory, but has not been associated with any diseases
to date. It infects T-cells, and genetically resembles HHV-6.
HHV-8 -- A
recently recognized virus that has notable homology with several known herpes
viruses. Detection of HHV-8 in peripheral blood mononuclear cells or HHV-8
antibody seroconversion is associated with an increased risk of developing
Kaposi's sacroma.
Kaposi's Sarcoma (KS) -- An AIDS-defining illness
consisting of individual cancerous lesions caused by an overgrowth of blood
vessels. KS typically appears as pink or purple painless spots or nodules on the
surface of the skin or oral cavity. KS also can occur internally, especially in
the intestines, lymph nodes and lungs, and in this case is life-threatening.
There has been considerable speculation that KS is not a spontaneous cancer but
is sparked by a virus. A species of herpes virus similar to Epstein-Barr virus
is currently under extensive investigation. Up to now, KS has been treated with
alpha interferon, radiation therapy (outside the oral cavity) and various
systemic and intralesional cancer chemotherapies. KS frequently occurs in
immuno-compromised patients.
Malaise -- A vague feeling of bodily
discomfort and fatigue. This is a common sympton of many illnesses, including
many STDs, and can often be the result of infection or a drug's side
effects.
Ocular Herpes -- Herpes infection in the
eyes.
Oral-Facial Herpes -- The presence of latent herpes simplex
infection in the trigeminal ganglion, at the top of the spine. When reactivated,
oral-facial herpes can cause symptoms anywhere on the mouth, face, but typically
cold sores are on the lips. Recurrent oral-facial herpes is largely caused by
HSV-1.
Oral Hair Leukoplakia (OHL) -- A whitish lesion that appears on
the side of the tongue and inside cheeks. The lesion appears raised, with a
ribbed or "hairy" surface. OHL occurs mainly in people with declining immunity
and may be caused by Epstein-Barr virus infection.
Prodrome -- An early
warning symptom of illness (i.e., prodrome for a genital herpes outbreak often
involves an aching, burning, itching, or tingling sensation in the genital area,
buttocks, or legs).
Recurrence -- The return of symptoms after a
remission (time without symptoms). An example of this is outbreaks of herpes
after periods of time without herpes lesions.
Roseola -- Skin condition
marked by red spots of varying sizes on the skin. Measles or German
measles.
Sacral Ganglion -- The never root at the base of the spine.
(The sacral ganglion serves as the site of the latency in genital herpes
infections).
Serostatus -- The condition of having or not having
detectable antibodies to a particular microbe in the blood as a result of
infection -- for example, HSV-1, HSV-2 or HIV. One may have either a positive or
a negative serosatus.
Shingles -- A skin condition caused by
reactivation of a Varicella Zoster Virus (VZV) infection, usually acquired in
childhood (when it appears as chicken pox). Is consists of painful, inflammatory
blisters on the skin that follow the path of individual peripheral nerves. The
blisters generally dry and scab, leaving minor scarring. Standard treatment is
with famciclovir or acyclovir.
STD (Sexually Transmitted Disease) -- Any
infection that is acquired through sexual contact in a substantial number of
cases.
Trigger -(factor) -- Any biologic or behavioral event that
influences latent HSV to reactivate.
Varicella Zoster Virus (VZV) -- The
cause of chicken pox in children. Its reactivation in adults causes
shingles.
Viral Replication -- The process by which a virus makes more
copies of itself.
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